IMMUNOFLUORESCENCE has long been an objective test for the diagnosis of pemphigus and allied disorders having circulating autoantibodies or having in vivo deposition of immunoglobulins or complements in the lesional skin since the discovery of autoantibodies by Ernst H. Beutner, PhD, and Robert E. Jordon, MD, in the 1960s. However, it was soon noted that immunofluorescence cannot differentiate pemphigus vulgaris (PV) and pemphigus foliaceus (PF) from its staining pattern. Immunoblotting using bovine snout extracts or human epidermal extracts as antigen sources made it possible to differentiate PV and PF by detecting a specific target antigen for each pemphigus, which has a different molecular weight. However, immunoblotting had a limitation because antigens are denatured during immunoblotting procedure and only autoantibodies against sequential or denatured epitopes are detected. This limitation was especially applied to PF antigen.1
Nishikawa T. Desmoglein ELISAs: A Novel Diagnostic Tool for Pemphigus. Arch Dermatol. 1999;135(2):195–196. doi:10.1001/archderm.135.2.195
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