Test Catalog

Test ID: CIB    
Cutaneous Direct Immunofluorescence Assay (IFA), Varies

Useful For Suggests clinical disorders or settings where the test may be helpful

Confirming a diagnosis of bullous pemphigoid, cicatricial pemphigoid, pemphigoid gestationis and other variants of pemphigoid, all types of pemphigus, including paraneoplastic pemphigus (paraneoplastic multiorgan syndrome), dermatitis herpetiformis, linear IgA bullous dermatosis, chronic bullous disease of childhood, epidermolysis bullosa acquisita, porphyria cutanea tarda, bullous eruption of lupus erythematosus, and atypical or mixed forms of bullous disease, systemic lupus erythematosus, cutaneous lupus erythematosus, or other variants, vasculitis, lichen planus, and other inflammatory diseases


This test is not useful for diagnosis of malignancies involving the skin.

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

See Pathology Consultation Ordering Algorithm in Special Instructions.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Skin or mucosal tissue from patients with autoimmune bullous diseases, connective tissue disease, vasculitis, lichen planus, and other inflammatory conditions often contains bound immunoglobulin, complement, or fibrinogen.


Biopsy specimens are examined for the presence of bound IgG, IgM, IgA, third component of complement (C3), and fibrinogen.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Report includes description and interpretation of staining patterns.

Interpretation Provides information to assist in interpretation of the test results

A board-certified Dermatopathologist will review and interpret the test results in correlation with other clinical findings as provided.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test is an adjunctive test to be interpreted in the context of clinical information, histologic studies, and serologic studies as clinically indicated.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Jain S, Basavaraj V, Vimala MG: Utility of Direct Immunofluorescence Studies in Subclassification of Autoimmune Sub-Epidermal Bullous Diseases: A 2-Year Study in a Tertiary Care Hospital. Turk Patoloji Derg 2016;32(2):91-98. doi: 10.5146/tjpath.2015.01345

2. Diercks GF, Pas HH, Jonkman MF: Immunofluorescence of Autoimmune Bullous Diseases. Surg Pathol Clin 2017 Jun;10(2):505-512. doi: 10.1016/j.path.2017.01.011

3. Kershenovich R, Hodak E, Mimouni D: Diagnosis and classification of pemphigus and bullous pemphigoid. Autoimmun Rev. 2014 Apr-May;13(4-5):477-481. doi: 10.1016/j.autrev.2014.01.011