Direct immunofluorescence in oral mucosal disease: a diagnostic analysis of 130 cases

We retrospectively analyzed direct immunofluorescence (DIF) findings from 130 cases of oral mucosal disease. The diagnosis of each case was based on history, clinical features, histopathology, and clinical follow-up. To avoid circular reasoning, we did not use the DIF results in forming the diagnoses. Our results indicate that the presence of characteristic fluorescent patterns produced by several DIF reagents can establish the diagnosis of the oral lesions of pemphigus and pemphigoid and strongly indicate the diagnoses of lichen planus and lupus erythematosus. The absence of these fluorescent patterns can help to rule out these conditions, thereby strengthening the diagnoses of other oral mucosal diseases. The results of DIF are sufficiently distinguishing to be routinely helpful as diagnostic criteria for chronic ulcerative diseases of the oral mucosa.