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Updated: Jul 19, 2026

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Clinical and diagnostic features of mucous membrane pemphigoid
Hiroyasu Endo1, Terry D Rees, Kayo Kuyama
1Department of Periodontology, Nihon University School of Dentistry, Matsudo, Chiba, Japan.
Abstract:
The aim of this study was to characterize the clinical and diagnostic features of mucous membrane pemphigoid (MMP). Five MMP patients were evaluated, and biopsies were obtained for routine histopathology and direct immunofluorescence. Circulating autoantibodies were verified by indirect immunofluorescence. Circulating immunoglobulin G autoantibody specific for 180 kDa bullous pemphigoid antigen (BP180) was evaluated by enzyme-linked immunosorbent assay (ELISA). All 5 patients complained of erythematous gingiva. Two patients had extraoral lesions involving the nasal mucosa, eyes, and skin. Histopathological confirmation was established for 4 of the patients, while direct immunofluorescence findings were positive in all 5. Although circulating autoantibodies were not identified by indirect immunofluorescence, the BP180 ELISA was positive in 3 cases. Both histopathological and direct immunofluorescence examinations are essential to establish a definitive diagnosis. Identification of circulating BP180 specific autoantibody shows promise.
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