Diagnostic value of the mosaic based indirect immunfluorescan (IIF) biochip method in patients with chronic pruritus, prurigonodularis and dermatitis herpetiformis

Bullous pemphigoid (BP) and dermatitis herpetiformis (DH) are two autoimmune blistering diseases leading to chronic pruritus and prurigo nodularis. Early diagnosis of these diseases is important for the successful management of pruritus and to prevent disease-related morbidity. In this study, it was aimed to determine the validity of the biochip in the diagnosis of possible BP and DH in the etiology in patients presenting with chronic pruritus, prurigo nodularis and dermatitis herpetiformis. The study included 39 chronic pruritus, 16 prurigo nodularis and 14 patients diagnosed with DH, and 24 healthy volunteers who admitted to Dermatology and Venereology Outpatient Clinic of Akdeniz University School of Medicine. All patient and healthy serums were studied by biochip method and the compatibility values of the obtained data in the diagnosis were calculated. In patients presenting with chronic pruritus, the sensitivity of the detection of BP 180 antibodies in biochip for probable BP was 66.6%, the specificity was 100%, the sensitivity and specificity of the detection of BP 180 antibodies and ELISA were found to be compatible with each other (Kappa = 0.792, Consistency = 98.42%). In diagnosing prurigo nodularis-like BP, on biochip, monkey esophagus, BP 180, salt-split skin test, and detection of BP 230 antibodies were found compatible. Similarly, detection of BP 180 and BP 230 antibodies with ELISA was consistent with the diagnosis. Biochip and ELISA were found compatible for BP 180 and BP 230 (Kappa = 1, Consistency = 100%). In the newly diagnosed DH group, the sensitivity of GAF 3X with biochip was 100%, the specificity was 87.5%, the sensitivity and specificity of ELISA and GAF 3X Ig A and tissue transglutaminase Ig A were 100%. In the new diagnosis DH, biochip GAF 3X and ELISA GAF 3X Ig A were found compatible. As a result, the biochip method is a cheaper, practical, less time-consuming and less invasive method in patients presenting for chronic pruritus, prurigo nodularis and DH and it can be used in screening and differential diagnosis for the diagnosis of OBH, which is possible in etiology.