a skin or mucosal biopsy should be obtained for histology and direct immunofluorescence
direct immunofluorescence of perilesional skin shows intra-epidermal deposition of IgG between cells throughout the epidermis (1)
indirect immunoflourescence of serum is frequently positive, but is less sensitive than direct immunofluorescence. It is useful in instances where a biopsy is difficult to obtain e.g. - in children, uncooperative adults (1)
ELISA - to detect anti-desmoglein 1 and anti-desmoglein 3 IgG autoantibodies (2)
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