Biopsy sites with a diagnosis of pemphigusand mucous membrane pemphigoid
Reviewed by Stuart Clark

This is a systemic review and met-analysis to critically evaluate optimal biopsy site for patients presenting with pemphigus or mucous membrane pemphigoid. Historically, diagnosis is made if H&E staining direct immunofluorescence and serological testing of auto-antibodies. Direct immunofluorescence has been regarded as the most reliable diagnostic criteria. Sensitivity, however,  whensampling perilesional sites has varied between 66-100%. There has been evidence suggesting that normal appearing mucosa could be biopsied adjacent to the bullae. They conclude that perilesional mucosa remains the optimal biopsy site for oral pemphigus vulgaris, whilst normal appearing mucosa could be biopsied as an alternative to perilesional tissue in oral mucous membrane pemphigoid.

Optimal biopsy site for the diagnosis of oral pemphigus vulgaris and mucous membrane pemphigoid; a systemic and meta-analysis.
Zeng Q, Liu J, Mu J, et al.
INT J ORAL MAXILLOFAC SURG
2023;52(11):1162-11.