Contacts
The immunofluorescence laboratory uses immunofluorescence, immunoelectron microscopy and other techniques to aid in the evaluation of patients with suspected or established cutaneous autoimmune disease.
As well as diagnostic work, our laboratory has an active research programme in cutaneous immunology, including the mechanisms, diagnosis and therapy of autoimmune blistering disease, often in collaboration with colleagues in the UK and internationally.
Founded in 1975, the lab initially functioned as an experimental unit, developing immunofluorescence techniques and establishing immunofluorescence as a key diagnostic technique in dermatology. We are now regarded as a skin immunofluorescence referral centre for the UK.
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Referrals
Please contact the laboratory before sending specimens to discuss specimen type, transportation, and charges. Specimens should be sent to the address at the top of this webpage.
Requests are accepted from consultants and hospitals in the UK and internationally, for both NHS and private patients.
If a specimen is urgent, please notify the laboratory and ensure contact information is provided.
We are happy to provide telephone or written advice to clinical colleagues on the interpretation of results and management of patients with immunologically mediated skin disease.
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Specimen requirements for direct immunofluorescence (IF)
This is a one-step procedure for detecting in-vivo deposition of immunoglobulins, complement components and fibrinogen in a patient's skin.
Procedure for biopsy
Whenever possible, biopsy a single fresh small blister including adjacent clinically uninvolved skin (perilesional). For a large blister, biopsy edge of blister and adjacent uninvolved skin (perilesional).
Cut the perilesional end and send for IF studies and the remaining blister for histology.
For uninvolved skin, a 3mm punch biopsy is sufficient.
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Condition
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Biopsy site(s) for IF studies
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Pemphigus (all forms)
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Perilesional and uninvolved (buttock)
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Pemphigoid (all forms)
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Perilesional and uninvolved (thigh or arm)
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Pemphigoid (herpes) gestationis
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Perislesional
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Epidermolysis bullosa acquisita
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Perilesional
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Linear IgA bullous dermatosis (LAD & CBDC)
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Perilesional and uninvolved (buttock)
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Dermatitis herpetiformis
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Uninvolved (buttock)
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Discoid lupus erythematosus
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Lesional
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Systemic lupus erythematosus
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Lesional and uninvolved (non-sun exposed, buttock)
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Lichen planus
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Lesional
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Porphyria
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Lesional
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Vasculitis
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Lesional
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Amyloid
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Lesional
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Specimen requirements for indirect immunofluorescence (IF)
This is a two-step procedure for demonstrating circulating autoantibodies in a patient's serum.
10ml clotted blood should be sent to the laboratory within 48 hours or serum separated and sent within one month of collection.
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Results and costs
We aim to report both direct and indirect IF results within 48 hours of specimen receipt.
Results are available to clinicians by telephone on 020 7188 6364 or by fax on 020 7188 6259. No information will be given to patients or their relatives.
Please contact the laboratory to discuss tests required and charges.
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Transportation
Transport of specimens for direct immunofluorescence to the laboratory should be in Michel's liquid fixative which can be obtained from our department on request.
Michel's fixative can be stored at room temperature for 1 year without deterioration.
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Staff
Consultants:
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Dr. Richard Groves FRCP (Director) - consultant dermatologist
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Dr. Catherine M. Stefanato MD - consultant dermatopathologist
Other staff:
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Balbir. S. Bhogal – head of laboratory
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Peter Carrington – medical laboratory assistant
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Dr John Mee - clinical scientist
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Janne Warrick – biomedical scientist
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Elaine Wellington – medical secretary
Visit the International Pemphigus and Pemphigoid Foundation| website for more information about pemphigus and pemphigoid.