{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:17:44Z","timestamp":1787771864749,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"ABSTRACT<\/jats:title>\n \n Introduction:<\/jats:title>\n Pemphigus is a group of bullous disorders of the skin characterized by the formation of autoantibodies present in the intercellular junction of the epidermis. Diagnosis is made by clinical, histopathological examination, and DIF. As DIF needs frozen sections, fluorescent tagged antibodies, UV light microscope for examination, and trained personnel, its non-availability makes a definitive diagnosis challenging.<\/jats:p>\n <\/jats:sec>\n \n Aims and Objectives:<\/jats:title>\n To evaluate the utility of IHC staining of complements and Ig in cases of Pemphigus.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Twenty-six diagnosed cases of Pemphigus were stained by Peroxidase immunohistochemical method using monoclonal antibody to IgG, IgA, IgM, IgG4, C3, C4 d with DAB as chromogen. Pemphigus cases include twenty of pemphigus vulgaris (PV), four cases of pemphigus foliaceous (PF), and two of pemphigus vegetans (Pveg). Positivity was defined as the deposition of Ig and complements as distinct, continuous brown staining of keratinocytes at intercellular junctions.<\/jats:p>\n <\/jats:sec>\n \n Result:<\/jats:title>\n \n On IHC total of 20 PV 17 showed positivity (85%) for IgG, 11 (55%) C4d, 19 (95%) C3d, and 16 (80%) IgG4 deposits at the intercellular junction of the epidermis. All cases of PF showed a deposit of IgG, with three (75%) cases for IgG4, C3d, and C4d. Both cases of Pveg showed positivity for IgG and C4d while one case was negative for IgG4 and C3d. The overall IgG, C3, IgG4, and C4d expression for pemphigus was seen in 88%, 88%, 76.9%, and 61.5% of cases. The relation between these markers, combination of IgG and C3, was best related to each other (\n P<\/jats:italic>\n value = 0.80). The sensitivities for IgG, IgG4, and C3 were 77.8%%, 73%, and 73% resp.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n We conclude that IHC is a useful tool in the diagnosis of PV with the highest sensitivity of IgG and C3d. The combination of IgG and C3d could replace the DIF in almost all of our cases, so IHC on FFPE sections be used as an alternative method to DIF.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijpm.ijpm_113_23","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T06:00:54Z","timestamp":1708495254000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Direct immunofluorescence (DIF) versus immunohistochemical (IHC) staining of complements and immunoglobulins (Ig) in pemphigus group"],"prefix":"10.4103","author":[{"given":"Deepika","family":"Rana","sequence":"first","affiliation":[{"name":"Department of Pathology, Maulana Azad Medical College, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nita","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maulana Azad Medical College, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shramana","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maulana Azad Medical College, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijay Laxmi","family":"Sahoo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Maulana Azad Medical College, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,2,19]]},"reference":[{"key":"R3-20240531","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/jcp.2006.037010","article-title":"Immunohistological analysis of immune cells in blistering skin lesions","volume":"60","author":"Hussein","year":"2007","journal-title":"J Clin Pathol"},{"key":"R4-20240531","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/apm.12643","article-title":"Can immunohistochemistry replace immunofluorescence in diagnosis of skin bullous diseases?","volume":"125","author":"Al-Shenawy","year":"2017","journal-title":"APMIS"},{"key":"R5-20240531","doi-asserted-by":"crossref","first-page":"450","DOI":"10.4103\/0378-6323.82398","article-title":"Bullous pemphigoid","volume":"77","author":"Khandpur","year":"2011","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R6-20240531","first-page":"2788","article-title":"A cross-sectional study of clinical, histopathological and direct immunofluorescence spectrum of vesiculobullous disorders","volume":"7","author":"S","year":"2013","journal-title":"J Clin Diagn Res"},{"key":"R7-20240531","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.autrev.2010.08.007","article-title":"Modern diagnosis of autoimmune blistering skin diseases","volume":"10","author":"Schmidt","year":"2010","journal-title":"Autoimmun Rev"},{"key":"R8-20240531","first-page":"11","article-title":"Evaluation of clinical and histopathologic\/direct immunofluorescence diagnosis in autoimmune vesiculobullous dermatitis: Utility of direct immunofluorescence","volume":"28","author":"Lebe","year":"2012","journal-title":"Turk Patoloji Derg"},{"key":"R9-20240531","doi-asserted-by":"crossref","first-page":"364","DOI":"10.4103\/0019-5154.135488","article-title":"A cross-sectional study of direct immunofluorescence in the diagnosis of immunobullous dermatoses","volume":"59","author":"Buch","year":"2014","journal-title":"Indian J Dermatol"},{"key":"R10-20240531","first-page":"654","article-title":"C3d immunohistochemistry on formalin-fixed tissue is a valuable tool in the diagnosis of bullous pemphigoid of the skin","volume":"37","author":"Pfaltz","year":"2010","journal-title":"J CutanPathol"},{"key":"R11-20240531","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":"R12-20240531","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.jaad.2008.06.022","article-title":"The use of C3d and C4d immunohistochemistry on formalin-fixed tissue as a diagnostic adjunct in the assessment of inflammatory skin disease","volume":"59","author":"Magro","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"R13-20240531","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/DAD.0000000000000333","article-title":"Application of C4d immunohistochemistry on routinely processed tissue sections for the diagnosis of autoimmune bullous dermatoses","volume":"38","author":"Villani","year":"2016","journal-title":"Am J Dermatopathol"},{"key":"R14-20240531","first-page":"586","article-title":"Immunohistochemistry versus immunofluorescence in the diagnosis of autoimmune blistering diseases","volume":"4","author":"Velez","year":"2013","journal-title":"Our Dermatol Online"}],"container-title":["Indian Journal of Pathology and Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpm.ijpm_113_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:18:22Z","timestamp":1787768302000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpm.ijpm_113_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,19]]},"references-count":12,"URL":"https:\/\/doi.org\/10.4103\/ijpm.ijpm_113_23","relation":{},"ISSN":["0377-4929","0974-5130"],"issn-type":[{"value":"0377-4929","type":"print"},{"value":"0974-5130","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,19]]},"assertion":[{"value":"2023-02-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}