{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:29:10Z","timestamp":1790357350917,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,8,25]],"date-time":"2011-08-25T00:00:00Z","timestamp":1314230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Skin Research and Technology"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pemphigus is an autoimmune, bullous disease affecting the skin and mucous membranes. The aim of the study was to evaluate whether pemphigus vulgaris (<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content>) and pemphigus foliaceus (<jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>), may be diagnosed using reflectance confocal microscopy (<jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty patients (18 with <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> and 12 with <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>) were included into the study. In total, 36 <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> lesions and 29 <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> lesions were examined. Healthy\u2010appearing skin adjacent to skin lesions and not adjacent to skin lesions was also investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intraepidermal clefts (bullae) with acantholytic cells were observed in 47% of <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> lesions and 59% of <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> lesions. Multiple dilated blood vessels in the upper dermis were observed using <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> in 61% of <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> lesions and in 86% of <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> lesions. <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features of pemphigus also included presence of inflammatory infiltrates, loss of typical honeycomb pattern of the epidermis, and detachment of the outer root sheath in hair follicles. In 20\u201364% of cases, <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features, which are characteristic for <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content> lesions were also observed in the proximity of these lesions within the healthy\u2010appearing skin. Following criteria for <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> diagnosis of pemphigus were developed: (i) acantholytic clefts in <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> of a lesion, (ii) acantholytic clefts in <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> of healthy\u2010appearing skin adjacent to a lesion, (iii) multiple\u2010dilated blood vessels in <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> of a lesion. Fulfillment of two of these three criteria is sufficient to establish a <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> diagnosis of pemphigus. These criteria do not differentiate between PV and <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> is useful for rapid, non\u2010invasive, in\u2010office differential diagnosis of pemphigus. <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> does not replace immunologic and histopathologic examinations, which remain the gold standard for establishing the final diagnosis of <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1600-0846.2011.00574.x","type":"journal-article","created":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T02:39:26Z","timestamp":1314844766000},"page":"339-346","source":"Crossref","is-referenced-by-count":21,"title":["Criteria for diagnosing pemphigus vulgaris and pemphigus foliaceus by reflectance confocal microscopy"],"prefix":"10.1111","volume":"18","author":[{"given":"Marta","family":"Kurzeja","sequence":"first","affiliation":[{"name":"Department of Dermatology CSK MSWiA Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Rakowska","sequence":"additional","affiliation":[{"name":"Department of Dermatology CSK MSWiA Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Rudnicka","sequence":"additional","affiliation":[{"name":"Department of Dermatology CSK MSWiA Warsaw Poland"},{"name":"Faculty of Health Sciences Warsaw Medical University Warsaw Poland"},{"name":"Polish Academy of Sciences Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata","family":"Olszewska","sequence":"additional","affiliation":[{"name":"Department of Dermatology Warsaw Medical University Warsaw 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