Contemporary development of findings concerning bullous diseases, associated with the steady increase of new pathological units with a clinically similar morphology but different pathogenesis and different therapeutic requirements, makes dermatological departments face pretentious tasks associated with the diagnosis of these diseases. The objective of the present work is a review of immunomorphological methods recommended by the authors to dermatological departments to cope with the diagnosis of bullous diseases. The authors used for assessment of bullous diseases the method of direct immunofluorescence for estimation of deposits of IgG, IgA, the C3 component of complement in tissues, the method of indirect immunofluorescence on the monkey and pig oesophagus resp., on the salt split skin test, on trypsin and dispase substrates to assess circulating IgG andIgA antibodies,immunoblotting to detect with which antigens these antibodies react and to assess the structure of the bulla by means of laminine, fibronectin and collagen type IV. Based on their experience the authors recommend the following procedure: 1. Routine histological examination which makes possible assessment of the presence of subepidermal bullous disease. 2. Direct immunofluorescent method which assesses deposits in the IgG and IgA class and makes it possible to differentiate pemphigoids from linear IgA dermatosis and dermatitis herpetiformis. 3. Indirect immunofluorescence using separated skin in hypertonic NaCl solution which in case of the presence of circulating antibodies makes possible the differential diagnosis of pemhigoids from epiligrine pemphigoid and epidermolysis bullosa acquisita and linear IgA dermatosis from IgA epidermolysis bullosa acquisita. 4. The use of substrates treated with trypsin or dispase which make possible the differential diagnosis of epiligrine pemphigoid from epidermolysis bullosa acquisita. 5. In case of the presence of circulating autoantibodies it is possible to use immunoblotting to assess antigens with which the patient’s autoantibodies react. 6. Immunohistological assessment of the site of the blister in the zone of the basal membrane which is particularly important in the absence of circulating antibodies.

        Key words: bullous dermatoses - direct fluorescence - indirect immunofluorescence - salt split skin test - laminine - fibronectin - collagen type IV - immunoblotting