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Binding: These lab antibodies seek out and idenify antibodies/proteins (IgG, IgM, IgA, C3 +/- fibrinogen) which is bound to the tissues Result: Under a fluorescent microscope , the "tagged" areas glow a bright green and we can see the patterns of where and how they are deposited Result: DIF is used to narrow down the diagnosis according to the deposited immunoglobulin subclass and the binding pattern seen However, it provides limited information on the specific antigens that are targeted Pemphigus diseases (superficial): Antibodies bind to keratinocytes Forms a 'chicken wire pattern' Intercellular deposition of IgG +/- C3 Pemphigoid diseases (deep): Antibodies bind linearly to the dermo-epidermal junction (DEJ) Linear deposition of IgG +/- C3 at the basement membrane zone Dermatitis herpetiformis: Granular or fibrillar deposition of IgA +/- C3 in dermal papillae Linear IgA disease: Linear deposition of IgA +/- C3/IgG at basement membrane zone Intensity of IgA fluorescence higher than IgG and C3 SALT SPLIT SKIN TEST Helps differentiate bullous pemphigoid from other sub-epidermal blistering conditions