Direct immunofluroscence pattern on plucked hair and tzanck smear in pemphigus vulgaris cases.

Pemphigus vulgaris is an autoimmune vesiculobullous disorder characterized by flaccid blisters and erosions of the skin and mucous membranes caused by autoantibodies directed against desmoglein 1 and 3. Diagnosis is confirmed by histopathology and direct immunofluorescence (DIF) of perilesional skin biopsy, which shows intercellular deposits of IgG and C3 in a fish-net pattern. However, skin biopsy requires invasive sampling and special laboratory facilities, which may not always be feasible.

This study aims to evaluate the diagnostic utility of DIF on Tzanck smear and plucked hair as less invasive alternatives to skin biopsy in pemphigus vulgaris. Tzanck smear involves scraping the base of a vesicle, while plucked hair DIF examines the outer root sheath for intercellular IgG and C3 deposits. The results of these tests will be compared with the gold standard DIF on skin biopsy to assess their sensitivity and specificity.

A cross-sectional observational study will be conducted on clinically and histologically confirmed cases at Maulana Azad Medical College, New Delhi. This research may help establish simple, rapid, and cost-effective diagnostic tools for pemphigus vulgaris, especially useful in patients where biopsy is difficult or contraindicated.