DIF Microscopy Helps Diagnose Pediatric Skin Diseases

TOPLINE:

Instruct immunofluorescence (DIF) microscopy confirmed a 15.5% positivity rate in pediatric patients and changed the scientific diagnosis in 16.7% of these conditions.

METHODOLOGY:

• Researchers conducted a retrospective evaluation of DIF recordsdata from 986 patients feeble 0-18 years (mean age, 12 years) on the Mayo Medical institution’s reference immunodermatology laboratory between August 2017 and November 2023.
• Biopsy web sites included head and neck (cutaneous), head and neck (mucosal), trunk, pelvic space, higher extremities, and decrease extremities.
• Results were categorized as sure if characteristic immunofluorescence patterns were noticed (pemphigoid sample, pemphigus sample, lupus sample, dermatitis herpetiformis sample, linear immunoglobulin A [IgA] bullous dermatosis sample, vasculitis/vasculopathy sample, or lichenoid tissue response sample).
• At some stage within the identical period, 40,859 DIF specimens from adults were also interpreted.

TAKEAWAY:

• The DIF positivity rate changed into 15.5% in children and 20.9% in adult specimens.
• IgA-predominant vasculitis changed into essentially the most frequent DIF sample in children (55.5%), followed by lichenoid tissue response (13.7%), pemphigoid problems (7.2%), lupus (7.2%), dermatitis herpetiformis (5.2%), linear IgA bullous dermatosis (4.6%), pemphigus (3.3%), and non-IgA predominant vasculitis (3.3%).
• Of the 114 sure DIF patterns with a pretest diagnosis, researchers noticed “moderately high” concordance between the scientific pretest diagnosis and DIF results (83.3%), but in 16.7% of conditions, the initial scientific impression differed from sure DIF results. Linear IgA bullous dermatosis (100%) and dermatitis herpetiformis (100%) confirmed the ultimate concordance.
• Specimens from the decrease extremities confirmed the ultimate yield of sure DIF when in contrast with all other web sites (19.7% vs 12.2%; P = .001).

IN PRACTICE:

The look findings confirmed that “related thresholds for DIF biopsy are held” for pediatric and adult patients and “high concordance rates between sure DIF reports and scientific pretest diagnosis imply acceptable test specificity,” the look authors wrote. “The look demonstrated that DIF results supplied recordsdata that changed the scientific impressions in a in actual fact wide proportion of conditions, supporting the utility of DIF biopsy when immune-mediated dermatoses are clinically suspected,” they added.

SOURCE:

The look changed into led by Clint Christian T. Garbanzos, MD, Division of Pathology and Laboratory Medication, MedStar Georgetown University Clinical institution, Washington, DC, and changed into published online on Might perhaps 29 in Pediatric Dermatology.

LIMITATIONS:

Barriers included the retrospective assemble and absence of a negative diagnosis. False-sure and fraudulent-negative results would perhaps perhaps perhaps no longer be definite.

DISCLOSURES:

This look changed into supported by the American Society of Dermatopathology Mentorship in Dermatopathology Award. The authors declared having no conflicts of passion.

This text changed into created the utilization of several editorial tools, including AI, as section of the system. Human editors reviewed this drawl material earlier than publication.