Integration of dermatopathology and immunofluorescence testing is instrumental in the diagnosis and classification of immunologic disorders, helping you to provide superior care to your patients. We offer direct immunofluorescence to diagnose:

  • Blistering diseases (pemphigoid, pemphigus, dermatitis herpetiformis, epidermolysis bullosa acquisita, linear IgA dermatosis, porphyria cutanea tarda)
  • Connective tissue diseases (lupus erythematosus, dermatomyositis)
  • Vasculitis

You will have direct contact with our dermatopathologists regarding your cases.

We offer:

  • 24-48 hour turnaround time DIF performed on skin and mucosal tissue
  • Processing in our CAP- and CLIA-approved laboratory
  • Accurate, concise reporting with histologic correlation
  • Direct communication with our faculty

How to send a specimen for direct immunofluorescence testing

Please follow our disease-specific DIF Biopsy Guidelines for optimal tissue procurement. Place tissue specimen into the green direct immunofluorescence vial that we provide. Store at room temperature. Complete requisition form, and mail or schedule a courier pickup.

DIF Guidelines

Please use the following guidelines when performing a biopsy for direct immunofluorescence.

Blistering disorders

Pemphigus and pemphigoid groups (including linear IgA bullous dermatosis and epidermolysis bullosa acquisita):

  • Biopsy the edge of a blister or perilesional erythematous skin
  • Do not biopsy the center of a blister, denuded skin or an ulcer
  • Label as “perilesional”

Dermatitis herpetiformis

  • Biopsy perilesional skin (normal-appearing), at least 0.5 cm away from a blister
  • Do not biopsy active blisters
  • Label as “perilesional”

Porphyria and pseudoporphyria

  • Biopsy involved skin (preferably, the edge of a new blister)
  • Do not biopsy denuded skin or old lesions
  • Label as “lesional”

Collagen vascular diseases

Cutaneous lupus erythematosus 

  • Biopsy the erythematous or active border of a lesion
  • Do not biopsy old lesions (>3 months), ulcers or facial lesions, if possible
  • Label as “lesional”

Lupus band test for systemic lupus erythematosus

  • Biopsy non-exposed, non-lesional skin (preferably buttocks or thigh)
  • Label as “non-exposed, non-lesional”


  • Biopsy the active border of a new lesion, ideally one that is less than 48 hours old
  • Do not biopsy ulcers or old lesions; if possible, avoid the distal lower extremities
  • Label as “lesional”

Immunofluorescence supplies

Request supplies online or call to request complimentary specimen bottles, requisition forms, and preprinted FedEx air bills (courier service available for offices located in the Greater St. Louis area).