{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:46:39Z","timestamp":1785836799388,"version":"3.56.0"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background\/objectives<\/jats:bold>\n                    : Organ transplant recipients (OTRs) face an elevated risk of keratinocyte carcinomas (KC), leading to a lower threshold for biopsy. Line\u2010field confocal optical coherence tomography (LC\u2010OCT) is a non\u2010invasive imaging technique capable of visualizing malignant skin changes, yet its role in the management of OTRs remains unexplored. The objective was to investigate the potential of LC\u2010OCT for triage of skin lesions in OTRs.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Patients and methods<\/jats:bold>\n                    : Clinically equivocal lesions in OTRs (n\u00a0=\u00a075) were scanned using LC\u2010OCT before biopsy. Scans were assessed retrospectively for predefined LC\u2010OCT criteria (i.e., image\u2010markers) for KC and premalignant\/in\u2010situ lesions (Bowen's disease and actinic keratosis). The most high\u2010yield criteria were identified and combined into a decision\u2010tree.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : A 4\u2010step decision\u2010tree for lesion triage with five LC\u2010OCT criteria was developed, with a sensitivity of 87.5 % for squamous cell carcinoma (n\u00a0=\u00a08), 94.4 % for basal cell carcinoma (n\u00a0=\u00a018), 83.3 % for Bowen's disease (n\u00a0=\u00a012), and 72.7 % for actinic keratosis (n\u00a0=\u00a022). This triage is based on\n                    <jats:italic>severe dysplasia, broad strands<\/jats:italic>\n                    and\n                    <jats:italic>keratin pearls<\/jats:italic>\n                    for SCC,\n                    <jats:italic>lobules<\/jats:italic>\n                    for BCC, and\n                    <jats:italic>severe<\/jats:italic>\n                    or\n                    <jats:italic>mild\u2010moderate<\/jats:italic>\n                    dysplasia for premalignant lesions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : This study designed an LC\u2010OCT decision\u2010tree for use in immunocompromised patients to assist in triage of equivocal skin lesions with potential for improving clinical\u2010decision making.\n                  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