{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T06:19:18Z","timestamp":1791094758886,"version":"4.1.0"},"reference-count":13,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,11,1]]},"abstract":"<jats:p>Context.\u2014Pemphigus is a group of autoimmune vesiculobullous diseases characterized by immunoglobulin G (IgG) antibodies directed against desmosomal adhesion proteins, with IgG4 being the predominant subclass in active diseases. Direct immunofluorescence for IgG performed on fresh-frozen tissue plays a crucial role in diagnosing pemphigus. However, the diagnosis might be hindered when frozen tissue is not available.<\/jats:p>\n                  <jats:p>Objective.\u2014To evaluate the usefulness of immunohistochemistry for IgG4 performed on paraffin sections as a diagnostic test for pemphigus.<\/jats:p>\n                  <jats:p>Design.\u2014Eighteen immunofluorescence-proven pemphigus cases (12 pemphigus vulgaris, 6 pemphigus foliaceus) were studied. Four normal skin specimens and 32 nonpemphigus vesiculobullous disease specimens served as controls. Paraffin sections of all cases were examined immunohistochemically for IgG4 expression. Positivity was defined as distinct, condensed, continuous immunoreactivity localized to the intercellular junctions of keratinocytes.<\/jats:p>\n                  <jats:p>Results.\u2014The immunostains were independently evaluated in a masked manner by 3 pathologists, with a 100% interobserver agreement. Nine of 12 pemphigus vulgaris cases (sensitivity 75.0%), and 4 of 6 pemphigus foliaceus cases (sensitivity 66.7%), were positive for IgG4 immunostain. The overall sensitivity was 72.2%. One control specimen (bullous pemphigoid) showed IgG4 positivity (specificity 97.2%). In specimens demonstrating acantholysis, 8 of 10 pemphigus vulgaris cases (sensitivity 80.0%) and 4 of 4 pemphigus foliaceus cases (sensitivity 100.0%) were positive for IgG4. The overall sensitivity for specimens with acantholytic lesions was 85.7%.<\/jats:p>\n                  <jats:p>Conclusion.\u2014Immunohistochemistry for IgG4 provides a reasonably sensitive and highly specific test for diagnosing pemphigus, especially when frozen tissue is not available, and active acantholytic lesions are examined.<\/jats:p>","DOI":"10.5858\/arpa.2011-0425-oa","type":"journal-article","created":{"date-parts":[[2012,10,30]],"date-time":"2012-10-30T08:09:34Z","timestamp":1351584574000},"page":"1402-1407","source":"Crossref","is-referenced-by-count":24,"title":["Immunohistochemistry for Immunoglobulin G4 on Paraffin Sections for the Diagnosis of Pemphigus"],"prefix":"10.5858","volume":"136","author":[{"given":"Xuefeng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hyjek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyoumars","family":"Soltani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna","family":"Petronic-Rosic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Shea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"4","key":"2020081217025261000_i1543-2165-136-11-1402-b01","doi-asserted-by":"crossref","first-page":"371","DOI":"10.7861\/clinmedicine.9-4-371","article-title":"Pemphigus: a brief review","volume":"9","author":"Groves","year":"2009","journal-title":"Clin Med"},{"issue":"12","key":"2020081217025261000_i1543-2165-136-11-1402-b02","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1111\/j.1468-3083.2008.02825.x","article-title":"Pemphigus","volume":"22","author":"Ioannides","year":"2008","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2020081217025261000_i1543-2165-136-11-1402-b03","doi-asserted-by":"crossref","first-page":"a180","DOI":"10.1136\/bmj.a180","article-title":"Bullous pemphigoid and pemphigus vulgaris\u2014incidence and mortality in the UK: population based cohort study","volume":"337","author":"Langan","year":"2008","journal-title":"BMJ"},{"issue":"1","key":"2020081217025261000_i1543-2165-136-11-1402-b04","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0923-1811(00)00158-4","article-title":"Predominant IgG4 subclass in autoantibodies of pemphigus vulgaris and 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