Ordering Recommendation

Optimal specimen location and complementary serum testing and/or histopathology examination vary according to disease type. Specimen must be labeled with the acceptable transport medium used (eg, Michel’s or Zeus).

Perilesional specimen is recommended for blisters and/or erosions, proximal anatomical location for pemphigoid. Use with serum immunobullous disease/epithelial antibody testing and formalin-fixed tissue histopathology for assessment of pruritic, urticarial, blistering, and/or erosive disorders (eg, immunobullous diseases with or without blistering including pemphigoid and pemphigoid variants, pemphigus and pemphigus subtypes, linear lgA disease, dermatitis herpetiformis, epidermolysis bullous acquisita, porphyria, and pseudoporphyria).

Newly developed lesional specimen of intact skin or mucous membrane is recommended with formalin-fixed tissue histopathology for assessment of inflammatory, immune-mediated cutaneous disease (including possible lupus and lupus variants, vasculitis, drug reactions, lichen planus and other lichenoid reactions).

Mnemonic

CUTDIF

Methodology

Direct Immunofluorescence

Performed

Varies

Reported

3-7 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

Tissue: skin, mucosa (oral, conjunctival, genital, esophageal), other epithelium (gastrointestinal, respiratory, urinary).

Specimen Preparation

Transport tissue (optimal 4-6 mm) in Michel's medium (ARUP supply #45462) available online through eSupply using ARUP Connector call ARUP Client Services at (800) 522-2787. Also acceptable: Zeus tissue fixative. Label container with transport medium type, if not an ARUP-supplied vial.

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Unacceptable Conditions

Formalin-fixed tissue. Solid organs or solid organ tissue. Tissue in container of unknown or unacceptable transport medium.

Remarks
Stability

Ambient: 10 days; Refrigerated: 10 days; Frozen: Unacceptable

Reference Interval

By report

Interpretive Data



Compliance Category

Not Applicable

Note

Hotline History

N/A

CPT Codes

88346; 88350 x5

Components

Component Test Code* Component Chart Name LOINC
0092571 Cutaneous Direct IF, Biopsy 6471-7
2010916 EER Cutaneous Direct IF, Biopsy
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Bullous Disease
  • Chronic Bullous Disease
  • Cutaneous Herpetiformis
  • Dermatitis Herpetiformis
  • Lichen Planus and Lichenoid
  • Linear IgA Bullous, Tissue
  • Lupus Erythematous, Tissue
  • Pemphigoid, Tissue
  • Pemphigus
  • Porphyria and Pseudoporphyria, Tissue
  • Skin Immunofluorescence
  • Urticaria
  • Urticarial Pemphigoid
  • Urticarial Vasculitis
  • Vasculitis
Cutaneous Direct Immunofluorescence, Biopsy (INACTIVE as of 11/15/21: Refer to 3004000 in the November Hotline)