Table 7.

Diagnostic Criteria for Paraneoplastic Pemphigus

Investigation	Finding
Clinic	Severe stomatitis, cheilitis, multiform lesions, acral distribution
	Obligate association with neoplasia
Histology	Intraepidermal acantholytic blisters and/or lichenoid inflammation
Direct immunofluorescence microscopy	Intraepidermal deposits of IgG (+/- C3) with an intercellular pattern Linear deposits of IgG and C3 at the basement membrane
Indirect immunofluorescence microscopy (esophagus)	Binding of IgG autoantibodies to epithelial cells with an intercellular pattern
Immunoprecipitation	Desmoglein 1,3, desmoplakin, envoplakin, periplakin, BP230, alpha-2-macroglobuline-like-1, plectin, desmocollins 1-3
ELISA/Immunoblotting	IgG against envoplakin, periplakin, desmoglein 1, desmoglein 3