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The biopsy specimen is immediately put into 10% formalin. If there are multiple biopsies, these must be put into separate pots and labelled correctly. Samples for direct immunofluorescence should be placed in Michel’s medium, which is a useful transport medium with the specimen being stable for 28 days [7]. Direct immunofluorescence (DIF) is used in the investigation of immunobullous disease and detects auto‐antibody/antigen complexes and uses fluorescent labelled antibodies to bind directly to the target antigen in the skin. There are specific immunoglobulins and binding patterns in different immunobullous disease (see Chapter 26).

Specimens for electron microscopy are put into liquid nitrogen or glutaraldehyde.