Diagnosis of autoimmune bullous skin diseases

Detlef Zillikens*

*Corresponding author for this work
23 Citations (Scopus)


Autoimmune blistering skin diseases are characterized by autoantibodies to structural components of the skin. Diagnosis is based on the detection of autoantibodies in the skin and/or serum of the patients. Tissue-bound auto-antibodies are found by direct immunofluorescence microscopy of tissue-bound autoantibodies and are still considered the gold standard for the diagnosis of autoimmune bullous diseases. Circulating antibodies are first characterized by indirect immunofluorescence microscopy on organ sections including monkey esophagus and 1M NaCI-split human skin. Specificities of these circulating autoantibodies are then analyzed by immunoblotting, ELISA, or immunoprecipitation. More recently, ELISA-based detection systems for some of these autoantibodies have become commercially available. Frequently, the levels of circulating autoantibodies as detected by ELTSA correlate with disease activity and facilitate the evaluation for further need of treatment. In cases where the clinical picture strongly suggests an autoimmune bullous disease, diagnosis may be based only on serological tests. This review summarizes the diagnostic steps in the different autoimmune bullous skin diseases.

Original languageEnglish
JournalClinical Laboratory
Issue number11-12
Pages (from-to)491-503
Number of pages13
Publication statusPublished - 2008


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