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Limited Formalin Exposure May Impair Disease Diagnosis

Dermatitis herpetiformis, pemphigoid retain immunogenicity but not pemphigus

THURSDAY, June 23 (HealthDay News) -- Limited exposure to formalin may impair the immunogenicity of some biopsy specimens for select diseases, according to a study published in the July issue of the Journal of the American Academy of Dermatology.

Joshua Arbesman, M.D., from the University at Buffalo in New York, and colleagues investigated the amount of time that biopsy specimens can retain their diagnostic properties in 10 percent buffered formalin. A total of 12 specimens of bullous pemphigoid, six specimens of dermatitis herpetiformis, and six specimens of pemphigus vulgaris with established diagnoses were exposed to formalin for different time periods varying from two minutes to four hours.

The investigators found that the majority of samples had detectable immunoreactants after two minutes of formalin exposure. Samples of dermatitis herpetiformis and pemphigoid retained immunogenicity for 10 minutes, but reduced immunogenicity was seen for pemphigus samples. Some of the samples showed a nonimmunologic nuclear fluorochroming pattern after immersion in formalin.

"Our findings demonstrate that limited exposure of direct immunofluorescence samples to formalin may significantly impair immunogenicity for select diseases, whereas others only demonstrate reduced immunogenicity with increasing exposure," the authors write.

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