Potential Pitfalls of IgG4 Immunohistochemical Staining on Lesional Tissue in Cutaneous Acantholytic Disorders
2024
Potential Pitfalls of IgG4 Immunohistochemical Staining in Skin Disorders
Sample size: 27
publication
Evidence: moderate
Author Information
Author(s): Stephan Carla, Ma Linglei
Primary Institution: Weill Cornell Medical Center
Hypothesis
This study aimed to evaluate the staining pattern of IgG4 in non-immunobullous disorders to highlight the potential pitfalls when using this stain.
Conclusion
The interpretation of IgG4 staining in cutaneous acantholytic disorders should be approached with caution.
Supporting Evidence
- 12 out of 27 cases showed IgG4 intercellular staining.
- Four cases had direct immunofluorescence performed and were negative.
- One case was misdiagnosed as bullous impetigo but was later confirmed as IgA pemphigus.
Takeaway
Doctors need to be careful when using a specific test for skin diseases because it can sometimes give misleading results.
Methodology
A retrospective review of cases where IgG4 immunohistochemistry was performed on non-immunobullous disorders.
Limitations
The study is limited to a small sample size and specific conditions.
Digital Object Identifier (DOI)
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