Abstract

Immunoglobulins are deposited at the dermal-epidermal (D-E) junction in the skin lesions of most patients with systemic and discoid lupus erythematosus. These immunoglobulins can be detected by the direct cutaneous immuno-fluorescent test, allowing early diagnosis. A great value of the test also lies in its prognostic ability. Systemic LE patients who show positive fluorescence at the D-E junction in normal skin usually have more severe disease and a poorer prognosis. A shortcoming of this test is the failure of some LE lesions to react positively. Also, skin lesions in certain other disorders can produce similar immunofluorescence, although additional studies will usually confirm or exclude the diagnosis of LE. Our experience with direct immunofluorescence in lupus erythematosus was based on studies of 37 patients. For comparison, 45 patients with miscellaneous skin diseases were also studied by this technic. Our data stress the value of this test as both a diagnostic and prognostic tool in LE patients