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Think Immunodermatology Testing!
Immunodermatology testing is essential for the correct diagnosis and treatment of several diseases affecting epithelial organs, especially skin and mucous membranes. The various diseases often overlap in clinical and histological presentation and, although the diseases themselves are not common, may present with features of common skin disorders such as urticaria, eczema and chronic itch. Therefore, the diagnosis of an immunodermatological disease is often delayed. Immunodermatology testing encompasses identification of immunological patterns on biopsy specimens and in serum. Direct immunofluorescence is performed on perilesional skin for blistering disorders and on lesional skin for connective tissue diseases and vasculitis. Serum testing by indirect immunofluorescence and enzyme linked immunosorbent assay (ELISA) is critical in confirming a diagnosis and in differentiating among immunobullous disorders and subtypes. Serum testing can be helpful for diagnosis when it is not practical to obtain a biopsy specimen. Serum antibody profiles and levels are useful in monitoring disease expression and response to therapy.
Originally presented on August 21, 2014 in Salt Lake City, Utah.
Kristin M. Leiferman, M.D., FAAD, FAAAAI
Professor of Dermatology, University of Utah School of Medicine
Co-Director of Immunodermatology Laboratory, Department of Dermatology, University of Utah School of Medicine
Dr. Kristin M. Leiferman is Professor of Dermatology and Co-Director of the Immunodermatology Laboratory at the University of Utah. She is a Dermatologist and Immunodermatologist with expertise in immune-mediated skin diseases, especially diagnosis and management of allergic skin diseases and diagnosis of autoimmune blistering diseases that affect skin and mucous membranes. Before being recruited to the University of Utah, she was a Professor of Dermatology at the Mayo Clinic in Rochester, Minnesota. At the Mayo Clinic, she was a former Vice Chair of the Department of Dermatology, where she also was the Director of the Immunodermatology Laboratory and Director of the Immunodermatology Fellowship Program.
Dr. Leiferman has authored more than 30 book chapters including for major reference books in Dermatology. She has published more than 100 original scientific and medical papers. She has been a reviewer of submitted manuscripts for Dermatology and Allergy journals. Recognized internationally as an expert in her field, Dr. Leiferman has served on national scientific boards and is a fellow of both the American Academy of Dermatology and the American Academy of Allergy, Asthma and Immunology.
Dr. Leiferman has board certifications in Dermatology and Dermatological Immunology/Diagnostic and Laboratory Immunology.
After this presentation, participants will be able to:
- To comprehend the range of diseases for which immunodermatology testing is helpful in clinical management from diagnosis to monitoring disease activity.
- To recognize that the diseases may show features of common dermatoses and have overlapping clinical features, especially among the immunobullous disorders.
- To know how and where to obtain biopsy specimens that provide the most clinically useful information and when serum testing is important.
University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories