A comparative study of Michel's medium versus honey as a transport medium for skin specimens prior to direct immunofluorescence microscopy and antigen mapping

Background: Michel's medium (MM) is currently the recommended transport medium for skin biopsy specimens prior to direct immunofluorescence (DIF) microscopy. Objective: To compare the utility of honey with that of MM as a transport medium for skin biopsy specimens used for DIF and antigen mapping. Methods: Group I consisted of 45 freshly-taken skin specimens earmarked for DIF testing. It was divided into three groups (A, B and C), each containing 15 specimens. Biopsy specimens were sliced into two, one each for MM and honey. Samples in group A were processed at the end of week 1 while those in group B and C were processed at the end of weeks 2 and 4, respectively. Group II consisted of five specimens of epidermolysis bullosa (EB) which was further divided into three groups; two specimens were processed for antigen mapping at the end of week 1, while others were processed at the end of week 2 (two specimens) and 4 (one specimen). Results: Sensitivity of honey as a transport medium for skin biopsy specimens was 100%, 92.6% and 53.8% at weeks 1, 2 and 4, respectively. The antigen mapping was positive in all specimens. Conclusion: Utility of honey was comparable to MM for DIF samples tested at weeks 1 and 2 but was lower at week 4.