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Original Paper

Diagnosis of Inherited Epidermolysis Bullosa in Resource-Limited Settings: Immunohistochemistry Revisited

Yenamandra V.K.a · Bhari N.a · Ray S.B.b · Sreenivas V.c · Dinda A.K.d · Scaria V.e · Sharma V.K.a · Sethuraman G.a

Author affiliations

Departments of aDermatology and Venereology, bAnatomy, cBiostatistics and dPathology, All India Institute of Medical Sciences, and eCSIR-Institute of Genomics and Integrative Biology, New Delhi, India

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 06, 2017
Accepted: June 02, 2017
Published online: October 26, 2017

Number of Print Pages: 7
Number of Figures: 4
Number of Tables: 2

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: https://www.karger.com/DRM

Abstract

Background: 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. Ob jective of the Study: To examine the diagnostic usefulness of immunohistochemistry (IHC) as compared to IFM in resource-limited settings. Methods: 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. Results: IFM and IHC accurately identified the subtype of EB in 80.9% (p < 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 (p < 0.001) in establishing the type of EB as IFM. Conclusions: 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.

© 2017 S. Karger AG, Basel


References

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  2. Pohla-Gubo G, Cepada-Valdes R, Hintner H: Immunofluorescence mapping for the diagnosis of epidermolysis bullosa. Dermatol Clin 2010;28:201-210, vii.
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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 06, 2017
Accepted: June 02, 2017
Published online: October 26, 2017

Number of Print Pages: 7
Number of Figures: 4
Number of Tables: 2

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: https://www.karger.com/DRM


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