1 research outputs found
Supplementary Material for: Diagnosis of Inherited Epidermolysis Bullosa in Resource-Limited Settings: Immunohistochemistry Revisited
<p><b><i>Background:</i></b> Immunofluorescence (IFM) antigen mapping is
the most commonly used technique to diagnose and differentiate
epidermolysis bullosa (EB). In India, IFM is limited to few research
laboratories and is not readily available, making the diagnosis largely
clinical and often inaccurate. <b><i>Ob</i></b><b><i> jective of the Study:</i></b> To examine the diagnostic usefulness of immunohistochemistry (IHC) as compared to IFM in resource-limited settings. <b><i>Methods:</i></b>
Forty-four consecutive EB patients were included in this study. IHC and
IFM were performed on 7-µm frozen tissue sections using standard
laboratory protocols with a limited panel of antibodies. The kappa
coefficient of agreement was calculated with genetic analysis as the
gold standard. <b><i>Results:</i></b> IFM and IHC accurately identified the subtype of EB in 80.9% (<i>p</i>
< 0.001) of the cases, when a clear blister cavity was evident on
biopsy. The sensitivities and specificities of IHC and IFM for
diagnosing EB simplex, junctional EB, and dystrophic EB were 100, 100,
and 60% and 82.4, 100, and 100%, respectively. IHC was equally effective
(<i>p</i> < 0.001) in establishing the type of EB as IFM. <b><i>Conclusions:</i></b>
IHC staining and its interpretation were simple and comparable to IFM.
IHC had an advantage of showing subtle changes in the epidermal
architecture that could not be appreciated on IFM and hence can be
considered useful in resource-limited settings.</p