An appraisal of routine direct immunofluorescence in vulvar disorders

Sixty-four biopsies were obtained from patients with a variety of vulvar disorders for direct immunofluorescence study. Twelve of 24 vulvar biopsies from patients with lichen sclerosus demonstrated deposition of fibrin in the upper dermis, while 7 vulvar biopsies showed fibrin deposition at the dermal-epidermal junction. Blood vessel immunofluorescence was observed in several patients but was not a disease-specific finding. Patients with pemphigus and pemphigoid yielded characteristic reactions and served as positive controls. Direct immunofluorescence may be of value in assessing patients with vulvar disorders, and in particular lichen sclerosus.