title: Comparative study of indirect immunofluorescence, enzyme-linked immunosorbent assay, and the Tzanck smear test for the diagnosis of pemphigus.
abstract: BACKGROUND
  Pemphigus is one of the potentially fatal autoimmune blistering diseases. An early and accurate diagnosis is important for prognosis and therapy. It may be difficult to diagnosis based on clinical grounds alone. Direct and indirect immunofluorescence, enzyme-linked immunosorbent assay, the Tzanck smear test, or histopathology are all available for the diagnosis of pemphigus. However, there are no generally accepted diagnostic criteria for the diagnosis of this condition at present.
  
  
  OBJECTIVE
  To evaluate the diagnostic value of indirect immunofluorescence, enzyme-linked immunosorbent assay, and the Tzanck smear test for the diagnosis of pemphigus in dental clinics.
  
  
  METHODS
  A single-center retrospective study was conducted, and the clinical data of 33 patients with pemphigus and 61 controls were collected and analyzed from the Department of Oral Medicine, Peking University School of Stomatology, during 2010-2014. The sensitivities and specificities of indirect immunofluorescence, enzyme-linked immunosorbent assay, and the Tzanck smear test were calculated and compared in two groups.
  
  
  RESULTS
  Sensitivities for the Tzanck smear test, indirect immunofluorescence, and enzyme-linked immunosorbent assay were 96.7%, 84.8%, and 84.8%, respectively, whereas the specificities of these tests were 60%, 91.8%, and 96.7%, respectively. The serial tests for the Tzanck smear test and enzyme-linked immunosorbent assay showed 82% sensitivity and 98.7% specificity.
  
  
  CONCLUSIONS
  The serial test for the Tzanck smear test and enzyme-linked immunosorbent assay may represent a simple, rapid, and reliable way to definitive diagnosis of pemphigus. It is recommended as a common test for the diagnosis of pemphigus in dental clinics.
authors.affiliation: Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Zhou
authors.affiliation: Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Siyue
authors.initials: S
authors.lastname: Fang
authors.affiliation: Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Chunlei
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China. honghua1968@aliyun.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Hua
mesh_terms: D000328:Adult; D000368:Aged; D003584:Cytological Techniques / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000175:diagnosis* / Q000473:pathology*; D012189:Retrospective Studies
keywords: Tzanck smear test; enzyme-linked immunosorbent assay; indirect immunofluorescence; pemphigus; serial test