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We aimed to assess the performance of ex vivo CLSM in identifying histomorphology and immunoreactivity in lichen planus (LP) and comparing its accuracy with conventional histopathology and direct immunofluorescence (DIF). Thirty\u2010three sections of 17 LP patients stained with acridine orange (AO) and FITC\u2010labelled anti\u2010fibrinogen antibody and 21 control samples stained with AO were examined using ex vivo CLSM. Ex vivo CLSM was in perfect agreement with conventional histopathology in identifying interface dermatitis, vacuolar degeneration and band\u2010like infiltration. ROC analysis showed that the presence of vacuolar degeneration, interface dermatitis and band\u2010like infiltration was useful to distinguish LP sections from controls (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). The detection rates of fibrinogen deposition using DIF and in conclusion ex vivo CLSM were 93.8% and 62.5%, respectively. ex vivo CLSM enables histopathological and immunofluorescence examination in LP with the advantage of digital H&amp;E\u2010like staining.<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/jbio202000328-gra-0001.png\" xlink:title=\"image\"\/><\/jats:p>","DOI":"10.1002\/jbio.202000328","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T04:54:50Z","timestamp":1602046490000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Immunofluorescence and histopathological assessment using ex vivo confocal laser scanning microscopy in lichen planus"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9254-8588","authenticated-orcid":false,"given":"I\u015f\u0131n Sinem","family":"Ba\u011fc\u0131","sequence":"first","affiliation":[{"name":"Department of Dermatology Stanford University School of Medicine  Stanford California USA"},{"name":"Ludwig\u2010Maximilians\u2010Universit\u00e4t  M\u00fcnchen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7968-9821","authenticated-orcid":false,"given":"Sebastian","family":"Krammer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Vladimirova","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ruzicka","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"S\u00e1rdy","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU  Munich Germany"},{"name":"Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine Semmelweis University  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars E.","family":"French","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbio.201500124"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbio.201500335"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2016.06.002"},{"key":"e_1_2_7_5_1","volume":"11","author":"Hartmann D.","year":"2018","journal-title":"J. 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