{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:37:11Z","timestamp":1787071031561,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,7]]},"abstract":"\n Introduction:<\/jats:title>\n \n Pemphigus comprises of a group of autoimmune bullous disorders with intraepithelial lesions involving the skin and mucous membranes. Pemphigus is characterized histologically by an intraepidermal blister and immunopathologically by the finding of\n in vivo<\/jats:italic>\n bound immunoglobulin G (IgG) antibodies against desmosomal adhesion proteins on the surface of keratinocytes. Indirect immunofluorescence for IgG is considered as a gold standard method for diagnosis of this group of bullous disorders on the condition that fresh frozen tissue is accessible.\n <\/jats:p>\n <\/jats:sec>\n \n Aim:<\/jats:title>\n We designed a new diagnostic method by immunohistochemistry (IHC) for IgG4 on paraffin sections instead of fresh frozen tissue and evaluated sensitivity, specificity, and positive and negative predictive values of this method.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n We searched our pathologic archive of pemphigus of 35 patients, including 29 cases of pemphigus vulgaris (PV) and 6 patients with pemphigus foliaceus (PF). In all cases, the diagnosis was confirmed by indirect immunofluorescence studies. Thirty-five specimens served as controls, including 31 specimens of safe margins of basal cell carcinoma and 4 specimens of normal skin. Sections with condensed and continuous immunoreactivity localized to the intercellular junctions of keratinocytes were considered as positive.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Sensitivity of IgG4 was estimated to be 72.4% in PV group and 83.3% in PF group. The overall sensitivity and specificity of IgG4 IHC for diagnosis of pemphigus were 74.2% and 82.8%, respectively, in PV and PF groups. Furthermore, positive predictive value and negative predictive value were 81.2% and 76.3%, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Immunohistochemical labeling for IgG4 on paraffin-embedded tissue provides a sensitive and specific test for diagnosing pemphigus in a situation when fresh frozen tissue is unavailable.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijd.ijd_87_18","type":"journal-article","created":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T04:14:30Z","timestamp":1562300070000},"page":"338-338","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Immunohistochemistry for Immunoglobulin G4 in the Diagnosis of Pemphigus"],"prefix":"10.4103","volume":"64","author":[{"given":"Mitra","family":"Heidarpour","sequence":"first","affiliation":[{"name":"From the Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parvin","family":"Rajabi","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elnaz Babaei","family":"Pour","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Fayyazi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Medical Students\u2019 Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250921","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.5858\/arpa.2011-0425-OA","article-title":"Immunohistochemistry for immunoglobulin G4 on paraffin sections for the diagnosis of pemphigus","volume":"136","author":"Zhang","year":"2012","journal-title":"Arch Pathol Lab Med"},{"key":"R2-20250921","doi-asserted-by":"crossref","first-page":"e126","DOI":"10.1111\/1346-8138.13772","article-title":"Pemphigus foliaceus developed in a patient with long-term erosion on the genital skin","volume":"44","author":"Kusudo","year":"2017","journal-title":"J Dermatol"},{"key":"R3-20250921","doi-asserted-by":"crossref","first-page":"a180","DOI":"10.1136\/bmj.a180","article-title":"Bullous pemphigoid and pemphigus vulgaris \u2013 Incidence and mortality in the UK: Population based cohort study","volume":"337","author":"Langan","year":"2008","journal-title":"BMJ"},{"key":"R4-20250921","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00403-007-0734-0","article-title":"The relevance of the IgG subclass of autoantibodies for blister induction in autoimmune bullous skin diseases","volume":"299","author":"Sitaru","year":"2007","journal-title":"Arch Dermatol Res"},{"key":"R5-20250921","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.4049\/jimmunol.1502233","article-title":"Overlapping IgG4 responses to self- and environmental antigens in endemic pemphigus foliaceus","volume":"196","author":"Qian","year":"2016","journal-title":"J Immunol"},{"key":"R6-20250921","doi-asserted-by":"crossref","first-page":"589","DOI":"10.3923\/pjbs.2013.589.592","article-title":"IgG antibodies in patients with pemphigus vulgaris before and after diagnosing with immunofluorescence","volume":"16","author":"Azimi","year":"2013","journal-title":"Pak J Biol Sci"},{"key":"R7-20250921","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1111\/j.1468-3083.2008.02715.x","article-title":"Anti-desmoglein IgG autoantibodies in patients with pemphigus in remission","volume":"22","author":"Kwon","year":"2008","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R8-20250921","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1046\/j.1365-2133.2000.03659.x","article-title":"The distribution of pemphigus vulgaris-IgG subclasses and their reactivity with desmoglein 3 and 1 in pemphigus patients and their first-degree relatives","volume":"143","author":"Kricheli","year":"2000","journal-title":"Br J Dermatol"},{"key":"R9-20250921","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1056\/NEJM198906013202206","article-title":"The pathogenic effect of IgG4 autoantibodies in endemic pemphigus foliaceus (fogo selvagem)","volume":"320","author":"Rock","year":"1989","journal-title":"N Engl J Med"}],"container-title":["Indian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00076423-201964040-00024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:40:34Z","timestamp":1787067634000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00076423-201964040-00024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.4103\/ijd.ijd_87_18","relation":{},"ISSN":["0019-5154","1998-3611"],"issn-type":[{"value":"0019-5154","type":"print"},{"value":"1998-3611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]},"assertion":[{"value":"2018-02-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}