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Background: Pemphigus vulgaris (PV) is a severe, potentially life-threatening autoimmune blistering disease that is relatively common in India and occurs due to circulating autoantibodies against Desmoglein (Dsg)3. Diagnosis is based on clinical features, histopathology, and immunofluorescence findings (IF). ELISA against Dsg 3 has been developed, which is highly sensitive and specific. There is a scarcity of Indian data about the utility of ELISA in patients with PV.

Aim: To detect antibodies to Dsg-3 for diagnosing Pemphigus vulgaris using ELISA and correlate levels of Desmoglein-3 with ABSIS clinical severity score.

Methods: Two serum samples were collected from 27 confirmed patients of PV. The diagnosis was confirmed on histopathology and/or IF. The first sample was taken at diagnosis, and the second, at least 6 weeks after instituting therapy. These samples were tested for antibodies against Dsg-3 using semi-quantitative ELISA. Correlation of ELISA results with clinical severity scoring (ABSIS) was done.

Results: We found a positive association between the total and cutaneous ABSIS scores with ELISA titres in both samples. The oral mucosal score, however, showed a positive association in the first set of samples and a negative association in the second set of samples. However, none of these were found to be statistically significant.

Conclusion: Although ELISA for Dsg-3 is a very sensitive tool for the initial diagnosis of PV, its' utility inassessing disease activity is limited, and the results should be interpreted cautiously.