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Lupus band test
Direct imunofluorescence of systemic LE with granular
deposits of IgM at dermoepidermal junction. The lupus band test is
considered positive when one or more immunoreactasnt ( IgG,IgM, IgA , C3) is found at dermoepidermal
junction.When 3 or more of immunoreactants are present at dermoepidermal junction in non lesional region, the
diagnosis specificity for systemic LE is very high
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Direct imunofluorescence of systemic LE with granular
deposits of IgG at dermoepidermal junction
Uses of lupus band test
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1.It is of diagnostic specificity for differentiating LE from other clinically
similar cutaneous diseases e.g. polymorphic light eruption, benign
lymphocytic infiltrate of Jessner, lymphocytoma cutis…etc
2. For differentiating systemic LE from discoid LE. Both involved & non
involved skin in systemic LE show positive lupus band test but in discoid LE
, only involved skin is positive
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3. Systemic LE without cutaneous lesion shows positive lupus band skin in
the uninvolved skin.
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4. Lupus band test is positive in systemic LE but not in other antinuclear –
antibody positive diseases e.g. drug induced LE, scleroderma,
dermatomyositis & connective tissue disease
Direct immunofluorscence to bullous pemphigoid with a band of IgG with dark
center & brighter , sharply demarcated margins while LE band is wider &
homogenous. In addition, bullous pemphigoid has a circulating antibodies
against epithelial basement membrane & a negative ANA
Direct immunoflourescence of dermatitis herpeitiformis with granular deposits
of IgA at dermo-epdermal junction with suprapapillary accentuation
Direct immunofluorecence of porphyria: the flourescence is much less
in the band than that found in the blood vessels. The reverse is seen in
LE. In addition complement is rarely found in the band
False positive lupus band test
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1. Bullous pemphigoid
2. Porphyria
3. Dermatitis herpitiformis
4. Rosacea: The band is weaker in intensity & more focal & interrupted
pattern is seen.
5. Autoflourescence of dermal collagen & elastic fibers forming a fibrillar
pseudo-band.
6. 2O% of healthy adults have a positive lupus band test in son exposed
non lesional skin regions. Positive immunofluorescence in non sun
exposed areas is rare in normal healthy iondividuals