Abstract
Background: Since the outer root sheath of hair follicle is structurally analogous to epidermal keratinocytes, direct immunofluorescence of hair may be an alternate method for monitoring disease activity of pemphigus vulgaris. Our objective was to find the effectiveness of direct immunofluorescence of outer root sheath as an alternate method in monitoring patients with pemphigus vulgaris. Materials and methods: Sixteen diagnosed cases of pemphigus vulgaris and in clinical remission for at least three months were enrolled. Skin biopsy sample and five plucked scalp hair samples of each patient were stained with Fluorescein isothiocyanate conjugate .Results: Hair direct immunofluorescence was positive in 13 (81.25%) patients and skin direct immunofluorescence was also positive in 13 patients (81.25%).Conclusion: Direct immunofluorescence of hair is a simple, specific and non-invasive method, and provides the opportunity to avoid repeated skin biopsies as an appropriate alternative technique for the disease monitoring in patients with pemphigus vulgaris.
Highlights
The bullous diseases have a history as old as that of medicine
The hair samples were placed on a ring glass slide and they were incubated with Fluorescein isothiocyanate conjugated (FITC) rabbit anti-sera against human immunoglobulin G (IgG) and complement 3 (Dako, Glostrusp, Denmark) for at least 30 minutes
A total of 16 patients clinically, histologically and immunologically diagnosed cases of pemphigus vulgaris on clinical remission were included in this study and scalp hair and perilesional skin biopsy were taken and direct immunofluorescence (DIF) was done to compare both
Summary
The bullous diseases have a history as old as that of medicine. In the early 1950’s, Lever was able to differentiate most of these by using histological criteria. Pemphigus vulgaris (PV) is a very serious skin disease that causes blisters. Pemphigus vulgaris affects 0.1- 0.5 patients per 1,00,000 population per year[1] and 0.58-0.80 per 1,00,000 person each year in the UK.[2] Incidence of PV is increasing and the reasons for the changes in incidence are not clearly understood but have implications for identifying causative factors.[2] Most cases develop in people aged over 50 years. Since the outer root sheath of hair follicle is structurally analogous to epidermal keratinocytes, direct immunofluorescence of hair may be an alternate method for monitoring disease activity of pemphigus vulgaris. Our objective was to find the effectiveness of direct immunofluorescence of outer root sheath as an alternate method in monitoring patients with pemphigus vulgaris
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