Ordering Recommendation

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

Use 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). Newly developed lesional specimen of intact skin or mucous membrane is recommended.

Optimal specimen location varies according to disease type (ie, blistering or nonblistering).

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 Connect or call ARUP Client Services at (800) 522-2787. Also acceptable: Zeus tissue fixative.

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Unacceptable Conditions

Formalin-fixed tissue. Solid organs or solid organ tissue.

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