Immunodermatology Test Directory
Immunodermatology Test Directory
IMMUNODERMATOLOGY LABORATORY TEST MENU
The Immunodermatology Laboratory offers tests on skin and mucosal tissue specimens and serum specimens that aid in the diagnosis and management of many types of dermatological conditions and diseases. Tissue testing is more sensitive than serum testing in several diseases, and the findings from tissue testing may prompt serum testing to distinguish certain diseases and establish antibody levels for therapeutic tracking. Serum testing includes Antibody Panels and Specific Antibody Assays to identify disease-related immunological markers and patterns of autoantibody reactivity. Serum Antibody Panel Testing is most useful for initial diagnostic testing, assessing changing disease presentations, and periodically evaluating antibody expression profiles in established diseases. Specific antibody assays may be helpful in the diagnosis of certain diseases and indicated for monitoring disease activity. Of note, ELISA testing detects serum antibodies to specific epitopes in major target antigens, and patients may develop antibodies to other epitopes or other epithelial antigens; therefore, the combination of indirect immunofluorescence and ELISA testing can provide more comprehensive immunopathological information that either alone.
Please contact us if you have any questions about our testing.
Serum Panel and Chart
SERUM PANEL |
PANEL TEST COMPONENTS-INCLUSIVE OTHER PANELS AND INDIVIDUAL TESTS |
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Immunobullous Disease Antibody Panel (Preferred initial diagnostic panel for suspected epithelial antibody-associated disease in patients with blisters, pruritus, urticaria, eczema, and/or mucositis; with potentially overlapping epithelial antibody expression, or without distinguishing clinical features; consider with additional testing, Laminin 332 and p200 Antibodies, IgG by IIF and/or Dermatitis Herpetiformis Antibody Panel testing) |
Basement Membrane Zone Antibody Panel
Pemphigus Antibody Panel, IgG
Pemphigus Antibodies, IgA by IIF |
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Basement Membrane Zone Antibody Panel (Preferred initial diagnostic panel for suspected or known basement membrane zone antibody-associated/pemphigoid disease; consider expanded panel with additional testing, Laminin 332 and p200 Antibodies, IgG by IIF) |
Pemphigoid Antibody Panel
Collagen Type VII Antibody, IgG by ELISA |
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Basement Membrane Zone Expanded Antibody Panel (Diagnostic panel for suspected or known basement membrane zone antibody-associated/pemphigoid disease, including mucous membrane zone pemphigoid) |
Basement Membrane Zone Antibody Panel
Laminin 332 IgG/IgG4 and Laminin Beta4 (p200) IgG/IgG4 Antibodies by IIF |
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Pemphigoid Antibody Panel (Same as Basement Membrane Zone Antibody Panel without ELISA for IgG type VII collagen antibodies; better for monitoring than initial test) |
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Pemphigus Antibody Panel, IgG (Preferred initial diagnostic and monitoring panel for suspected or known IgG epithelial cell surface/intercellular substance antibody-associated disease; consider with additional testing, Pemphigus Antibodies, IgA by IIF) |
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Basement Membrane Zone and Cell Surface (Epithelial) Antibodies, IgG and IgA by IIF (Useful to monitor IgG and IgA epithelial basement membrane zone and/or cell surface/intercellular substance antibodies, especially if specific target antibodies are not detected, or for overlapping antibody expression, or changing antibody profiles) |
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Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Expanded Antibody Panel by IIF with ELISA (Preferred expanded panel to aid in diagnosis and monitoring of paraneoplastic pemphigus/paraneoplastic autoimmune multiorgan syndrome) |
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Celiac Disease IgA Panel (Same as Dermatitis Herpetiformis IgA Panel without IgA epidermal transglutaminase (eTG/TG3) antibody ELISA) |
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Dermatitis Herpetiformis IgA Panel |
Celiac Disease IgA Panel
Epidermal transglutaminase (eTG)/transglutaminase 3 (TG3), IgA by ELISA |
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Celiac Disease / Dermatitis Herpetiformis IgG Panel |
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Celiac Disease Panel, IgA and IgG |
Celiac Disease IgA Panel
Celiac Disease / Dermatitis Herpetiformis IgG Panel
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Dermatitis Herpetiformis Panel, IgA and IgG |
Dermatitis Herpetiformis IgA Panel
Celiac Disease / Dermatitis Herpetiformis IgG Panel
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Serum Specific Disease-Associated Tests |
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Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Screening Antibodies by IIF |
IgG PNP (PAMS) Antibodies with rodent substrates, includes rat bladder, by IIF |
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Envoplakin Antibody, IgG by ELISA |
ELISA; no combination of tests (also listed as a panel component and individual test) |
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Pemphigus Antibodies, IgA by IIF |
Indirect immunofluorescence (IIF) two substrates; no combination of tests (also listed as a panel component and individual test) |
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Pemphigoid Gestationis, Complement-Fixing Basement Membrane Antibodies (Herpes Gestationis Factor) |
Complement-fixing antibody indirect immunofluorescence and IgG BP180 ELISA |
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Laminin 332 and p200 Antibodies, IgG/IgG4 by IIF |
Indirect immunofluorescence (IIF); two substrates, qualitative report (positive or negative results) for IgG/IgG4 antibodies to laminin 332 and to p200, laminin beta4 subunit; no combination of tests (also listed as an individual test) |
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Epidermal Transglutaminase (eTG/TG3) (Dermatitis Herpetiformis) Antibody, IgA by ELISA |
ELISA; no combination of tests (best also correlated with other testing for celiac disease) |
Serum Test Panel Components and Individual Tests |
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Basement Membrane Zone (Epithelial) Antibodies, IgG* +/- IgG4 by IIF |
Indirect immunofluorescence (IIF) two substrates; no combination of tests |
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Basement Membrane Zone (Epithelial) Antibodies, IgA by IIF |
Indirect immunofluorescence (IIF) two substrates; no combination of tests |
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Bullous Pemphigoid (BP180 and BP230) Antibodies, IgG by ELISA |
ELISAs (two); no combination of tests |
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Collagen Type VII Antibody, IgG by ELISA |
ELISA; no combination of tests |
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Laminin 332 and p200 Antibodies, IgG by IIF |
Indirect immunofluorescence (IIF); two substrates, qualitative report (positive or negative results) for IgG/IgG4 antibodies to laminin 332 and to p200, laminin beta4 subunit (also listed as a disease-associated test) |
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Cell Surface/Intercellular Substance (Epithelial) Antibodies, IgG* +/- IgG4 by IIF |
Indirect immunofluorescence (IIF) two substrates; no combination of tests |
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Pemphigus Antibodies, IgA by IIF |
Indirect immunofluorescence (IIF) two substrates; no combination of tests (also listed as a disease-associated test) |
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Desmoglein 1 and Desmoglein 3 (Pemphigus) Antibodies, IgG by ELISA |
ELISAs (two); no combination of tests |
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Envoplakin Antibody, IgG by ELISA |
ELISA; no combination of tests (also listed as a disease-associated test) |
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Endomysial Antibodies, IgA by IIF |
Indirect immunofluorescence (IIF) one substrate**; no combination of tests |
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Endomysial Antibodies, IgG by IIF |
Indirect immunofluorescence (IIF) one substrate**; no combination of tests |
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Epidermal Transglutaminase (eTG/TG3) Antibody, IgA by ELISA |
ELISA; no combination of tests (also listed as a disease-associated test) |
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Tissue Transglutaminase (tTG/TG2) Antibody, IgA by ELISA |
ELISA; no combination of tests |
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Tissue Transglutaminase (tTG/TG2) Antibody, IgG by ELISA |
ELISA; no combination of tests |
Test Directory
Tissue Specimens
Direct immunofluorescence (DIF): IgG, IgG4, IgM, IgA, C3, and fibrinogen; upon request other IgG subclasses (IgG1, IgG2, IgG3), another complement component (C4d), and epidermal transglutaminase (transglutaminase 3, TG3)
Eosinophil granule proteins: Eosinophil granule major basic protein 1 (eMBP1) and eosinophil-derived neurotoxin (EDN)
Serum Specimens
- Immunobullous Disease Antibody Panel
- Basement Membrane Zone Antibody Panel
- Epidermolysis Bullosa Acquisita Antibody Panel
- Pemphigoid Antibody Panel
- Pemphigoid Gestationis Panel
- Pemphigus IgG Antibody Panel
- Pemphigus IgG & IgA Antibody Panel
- Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Expanded IgG Antibody Panel by Indirect Immunofluorescence with Envoplakin ELISA (includes rat bladder substrate; IgA indirect immunofluorescence by request)
- Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Screening IgG Antibodies by Indirect Immunofluorescence (includes rat bladder substrate; does NOT include IgG envoplakin ELISA; IgA indirect immunofluorescence by request)
- Dermatitis Herpetiformis IgA Antibody Panel
- Dermatitis Herpetiformis IgA & IgG Antibody Panel
- Celiac Disease IgA Antibody Panel
- Celiac Disease IgA & IgG Antibody Panel
- Celiac Disease / Dermatitis Herpetiformis IgG Antibody Panel
- Indirect Immunofluorescence
- IgG basement membrane zone antibodies
- IgG laminin-332 antibodies (in validation process, by request)
- IgA basement membrane zone antibodies
- IgM basement membrane zone antibodies (by request)
- IgA cell surface / intercellular substance (ICS) antibodies (IgA Pemphigus)
- IgG cell surface / intercellular substance (ICS) antibodies
- IgA endomysial antibodies (EMA)
- IgG endomysial antibodies (EMA)
- Enzyme-Linked Immunosorbent Assay (ELISA)
- IgG BP180 and IgG BP230 antibody levels
- IgG type VII collagen antibody level
- IgG desmoglein 1 and IgG desmoglein 3 antibody levels
- IgA tissue transglutaminase (tTG) / transglutaminase 2 (TG2) antibody level
- IgG tissue transglutaminase (tTG) / transglutaminase 2 (TG2) antibody level
- IgA epidermal transglutaminase (eTG) / transglutaminase 3 (TG3) antibody Level
- IgG Envoplakin Antibody Level by ELISA
ORDER DIRECT IMMUNOFLOURESCENCE (DIF) TEST
- Procurement
- Punch or deep shave biopsy specimen, 4-6 mm optimal (minimum 3 mm
- Location and integrity of specimen is critical
• Perilesional for blistering/erosive disease with intact epidermis/epithelium, basement membrane zone, and dermis/ subepitheliumm
▪ Consider submitting accompanying serum for antibody testing and formalin-fixed tissue for dermatopathology evaluation to assess blistering, erosive, urticarial, and/or pruritic presentations
• Lesional, newly developed intact affected skin or mucosa, for nonblistering inflammatory disease, including lupus and vasculitis lesions (note that in nonblistering disorders, positive findings may be observed only in affected, inflamed tissue and not in perilesional tissue)
▪ Consider submitting accompanying formalin-fixed tissue for dermatopathology evaluation to assess inflammatory, immune-mediated presentations
- Transport medium requirement
• DIF tissue must be submitted in Michel or Zeus medium
• Assure that the container with the specimen is sealed and labeled with patient identification and medium type (if not in the kit supplied container) - Test requisition form is essential
• A completed test requisition form must accompany specimen - Shipping information
• Ship in prepaid, preaddressed kit mailer
Alternatively,
• Send or courier to:
Immunodermatology Laboratory
417 South Wakara Way, Suite 2151
Salt Lake City, UT 84108 USA - Call if questions or if any assistance would be helpful:
Telephone 1-801-581-7139
ORDER SERUM TEST
- Procurement
• Venous blood by phlebotomy in red top or Serum Separator Tube (SST)
• Allow blood to clot and centrifuge, if possible - Transfer 2 mL serum (minimum 0.5 mL) to a transport tube
• Assure that the container with the specimen is sealed and labeled with patient identification - Test requisition form is essential
• A completed test requisition form must accompany specimen that includes
▪ Patient demographics for identification
▪ Insurance and other billing details
▪ Specific requested tests - Shipping information
• Ship in prepaid, preaddressed kit mailer
Alternatively,
• Send or courier to:
Immunodermatology Laboratory
417 South Wakara Way, Suite 2151
Salt Lake City, UT 84108 USA - Call if questions or if any assistance would be helpful at 801-581-7139
ANITBODY TESTING
Antibody panel testing is most useful for initial diagnostic testing, changing disease presentations, and periodically evaluating antibody expression profiles in established diseases. Antibody Panels are comprised of various combinations of Specific Antibody Assays and provide the broadest assessment of disease-related autoantibody expression.
Please contact us if you have any questions about our testing.
Indirect Immunofluorescence
- IgG & IgA (Epithelial) Basement Membrane Zone Antibodies, including split skin / salt split skin substrate
- IgG & IgA (Epithelial) Cell Surface / Intercellular Substance (ICS) Antibodies
- IgG Laminin-332 Antibodies (in validation process, included if requested, especially for mucosal involvement)
ELISA
- IgG BP180 & IgG BP230 Antibodies
- IgG Type VII Collagen Antibody
- IgG Desmoglein 1 & IgG Desmoglein 3 Antibodies
Indirect Immunofluorescence
- IgG & IgA (Epithelial) Basement Membrane Zone Antibodies, including split skin / salt split skin substrate
- IgG Laminin-332 Antibodies (in validation process, included if requested, especially for mucosal involvement)
ELISA
- IgG BP180 & IgG BP230 Antibodies
- IgG Type VII Collagen Antibody
Indirect Immunofluorescence
- IgA Endomysial Antibodies
ELISA
- IgA & IgG Tissue Transglutaminase (tTG / TG2) Antibodies
- IgA Epidermal Transglutaminase (eTG / TG3) Antibody
Indirect Immunofluorescence
- IgG (Epithelial) Cell Surface / Intercellular Substance (ICS) Antibodies
ELISA
- IgG Desmoglein 1 & IgG Desmoglein 3 Antibodies
Indirect Immunofluorescence
- IgG & IgA (Epithelial) Basement Membrane Zone Antibodies, including split skin / salt split skin substrate
ELISA
- IgG BP180 & IgG BP230 Antibodies
Indirect Immunofluorescence
- IgA & IgG Endomysial Antibodies
ELISA
- IgA & IgG Tissue Transglutaminase (tTG / TG2) Antibodies
- IgA Epidermal Transglutaminase (eTG / TG3) Antibody
Indirect Immunofluorescence
- IgG & IgA (Epithelial) Cell Surface / Intercellular Substance (ICS) Antibodies
ELISA
- IgG Desmoglein 1 & IgG Desmoglein 3 Antibodies
Indirect Immunofluorescence
- IgG & IgA (Epithelial) Basement Membrane Zone Antibodies, including split skin/salt split skin substrate
ELISA
- IgG Type VII Collagen Antibody
Indirect Immunofluorescence
- IgA Endomysial Antibodies
ELISA
- IgA Tissue Transglutaminase (tTG / TG2) Antibodies
Indirect Immunofluorescence
- IgG (Epithelial) Cell Surface & Basement Membrane Zone Antibodies on rat and mouse bladders and other rodent substrates including mouse heart and liver
ELISA
- IgG Envoplakin Antibodies (in validation process, included if requested)
Indirect Immunofluorescence
- Complement-Fixing Basement Membrane Zone Antibodies (herpes gestationis factor)
- IgG & IgA (Epithelial) Basement Membrane Zone Antibodies, including split skin/salt split skin substrate
ELISA
- IgG BP180 & IgG BP230 Antibodies
Indirect Immunofluorescence
- IgA & IgG Endomysial Antibodies
ELISA
- IgA & IgG Tissue Transglutaminase (tTG / TG2) Antibodies
Indirect Immunofluorescence
- IgG Endomysial Antibodies
ELISA
- IgG Tissue Transglutaminase (tTG/TG2) Antibodies
| SERUM TEST EXAMPLE | TEST EXAMPLE GUIDE |
| ABCDE | 1234567 |
Board Certified
John J. Zone, M.D., Kristin M. Leiferman, M.D., and Melanie K. Kuechle, M.D. are American Board of Dermatology Diplomats in Dermatology and Dermatological Immunology / Diagnostic and Laboratory Immunology. Mazdak A. Khalighi, M.D. and Margaret M. Cocks, Ph.D., M.D. are American Board of Pathology Diplomats in Anatomic Pathology. Dr. Khalighi additionally has fellowship training and faculty experience in Renal Pathology/Immunopathology. Dr. Cocks additionally is an American Board of Pathology Diplomat in Clinical Pathology and is an American Board of Dermatology Diplomat in Dermatology and Dermatopathology. Drs. Khalighi and Cocks have had specialized, fellowship-equivalent training in laboratory immunodermatology by Drs. Zone and Leiferman.
Contact Us
Immunodermatology Laboratory,
Department of Dermatology
University of Utah Health
417 South Wakara Way, Suite 2151
Salt Lake City, UT 84108