Ordering Recommendation

Optimal specimen location and complementary serum testing and/or histopathology examination vary according to disease type. Note that specimen location and transport medium/fixative are different for direct immunofluorescence testing and fixed-tissue histopathology.

Use with serum immunobullous disease/epithelial antibody testing and formalin-fixed tissue histopathology for assessment of pruritic, urticarial, blistering, and/or erosive disorders. Use with formalin-fixed tissue histopathology for assessment of inflammatory, immune-mediated cutaneous disease. 

For more information on specimen collection requirements and diseases assessed, see the ARUP Immunobullous Disease Testing Comparison tool.


Direct Immunofluorescence




3-7 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation

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. Frozen in Michels medium. Solid organs or solid organ tissue. Tissue in container of unknown or unacceptable transport medium. Tissue sections on slides, prestained or unstained.


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

Reference Interval

By report

Interpretive Data

Refer to report

Compliance Category

Performed by non-ARUP Laboratory


Hotline History


CPT Codes

88346; 88350 x5


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.


  • atypical epithelial antibody-associated disease
  • basement membrane zone antibody-associated disease
  • Bullous Disease
  • bullous disease of childhood
  • bullous lupus erythematosus
  • bullous pemphigoid
  • childhood immunobullous disease
  • Chronic Bullous Disease
  • chronic bullous disease of childhood
  • cicatricial pemphigoid
  • Cutaneous Direct Immunofluorescence, Biopsy
  • Cutaneous Herpetiformis
  • cutaneous lupus
  • Dermatitis Herpetiformis
  • drug hypersensitivity
  • drug reaction
  • endemic pemphigus
  • epidermolysis bullosa acquisita
  • epithelial antibody-associated disease
  • fogo selvagem, IgA pemphigus
  • Henoch-Schönlein purpura
  • herpetiformis
  • hypocomplementemic urticarial vasculitis
  • IgA vasculitis
  • immune-mediated vasculitis
  • intercellular IgG/IgA dermatosis
  • intercellular substance antibodies
  • intraepidermal neutrophilic IgA dermatosis
  • leukocytoclastic vasculitis
  • lichen planus
  • Lichen Planus and Lichenoid
  • lichenoid
  • linear IgA bullous dermatosis
  • Linear IgA Bullous, Tissue
  • linear IgA disease
  • linear IgG/IgA bullous dermatosis
  • lupus
  • lupus erythematosus
  • Lupus Erythematous, Tissue
  • mixed epithelial antibody-associated disease
  • mixed immunobullous disease of childhood
  • mucous membrane pemphigoid
  • ocular cicatricial pemphigoid
  • pemphigoid gestationis
  • pemphigoid variants
  • Pemphigoid, Tissue
  • Pemphigus
  • pemphigus erythematosus
  • pemphigus foliaceus
  • pemphigus vegetans
  • pemphigus vulgaris
  • pemphigus, tissue
  • Porphyria and Pseudoporphyria, Tissue
  • porphyria, pseudoporphyria, tissue
  • Skin Immunofluorescence
  • subacute cutaneous lupus erythematosus
  • subcorneal pustular dermatosis
  • subepithelial immunobullous disease
  • Urticaria
  • Urticarial Pemphigoid
  • Urticarial Vasculitis
  • Vasculitis
  • vasculopathy
Direct Immunofluorescence, Tissue Biopsy (Cutaneous, Mucosal, Epithelial)