Ordering Recommendation
- Order concurrently with serum antibody testing and fixed tissue histopathology for assessment of patient with pruritic, urticarial, blistering, and/or erosive disorders, including possible pemphigoid and pemphigoid variants, pemphigus and pemphigus subtypes, dermatitis herpetiformis, linear IgA bullous dermatosis, epidermolysis bullous acquisita, porphyria, and pseudoporphyria.
- Order concurrently with fixed tissue histopathology for assessment of patient with inflammatory, immune-mediated cutaneous disease, including possible lupus and lupus variants, vasculitis, drug reactions, lichen planus, and lichenoid reactions.
Information Required to Submit with Order
Completed Immunodermatology Laboratory requisition form and copies of both sides of insurance cards or completed billing information
Methodology
Direct immunofluorescence - IgG, IgG4, IgM, IgA, C3, and fibrinogen all submitted specimens;
- Additional IgG subclass (IgG1, IgG2, IgG3) staining by request
- Epidermal transglutaminase (transglutaminase type 3, TG3) staining for dermatitis herpetiformis by request
Performed
Daily
Reported
2-5 business days (if concurrent serum or dermatopathology testing, may be 2-3 days longer)
New York State Department of Health (NYSDOH) Approval Status
This test is New York State DOH approved.
CPT Code(s)
88346; 88350 x5
SPECIMEN REQUIREMENTS
Collect
Epithelial tissue: skin, mucous membrane (oral, genital, ocular), gastrointestinal tract, respiratory tract:
- Perilesional (intact tissue with epidermis and dermis/epithelium and submucosal) for blistering/erosive diseases
- Lesional (active inflammatory border within a lesion, less than 48 hours old for vasculitis) for urticaria/lupus/vasculitis/others
Specimen Preparation
Transport in Michel's medium. Also acceptable: Zeus tissue fixative. Order complimentary specimen kit(s).
Storage/Transport Temperature
Room temperature.
Unacceptable Conditions
Exposure to formalin (even short contact will affect findings) and saline (longer than 2 hours on saline-soaked gauze, do not immerse in saline).
Stability
Ambient: 10 days
Refrigerated: 10 days
Frozen: indefinitely, only if frozen immediately and kept in frozen state, transported on dry ice or in liquid nitrogen