Immunofluorescence as a diagnostic tool in oral lesions: A narrative review

Background: Immunofluorescence (IF) is a laboratory test used for antigen detection by using specific antibodies linked to a fluorescent tag. This review article aims to explore and explain the principles, methods, and patterns of diagnosis, as well as the clinical implications of direct and indirect IF (IIF) tests, especially in oral mucosal disorders. Methods: A PubMed search was independently conducted by two reviewers to identify articles published between 2002 and 2021 describing the role of IF in the diagnosis of oral mucosal disorders. Results: The analysis of the literature indicates that IF, including both direct and indirect techniques, is a robust adjunctive diagnostic modality in vesiculobullous lesions of the oral mucosa. Direct IF aids in detecting tissue-bound antibodies and complement deposition, whereas IIF identifies circulating autoantibodies. When integrated with clinical findings and histopathological examination, these techniques substantially enhance diagnostic accuracy, facilitate early detection, and assist in disease differentiation. Discussion: While histopathology remains the cornerstone for diagnosing oral mucosal lesions, IF is an indispensable complementary tool. It enhances diagnostic precision and provides critical insights into disease pathogenesis, particularly in vesiculobullous lesions. Incorporating these techniques into routine diagnostic protocols can significantly improve patient management and clinical outcomes.