{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:12:40Z","timestamp":1787015560291,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T00:00:00Z","timestamp":1521763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2018,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Diagnosis of bullous pemphigoid (\n BP<\/jats:styled-content>\n ) and pemphigus is based on clinical features, histology, immunofluorescence and laboratory data.\n <\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n To evaluate features of\n BP<\/jats:styled-content>\n and pemphigus at reflectance confocal microscopy (\n RCM<\/jats:styled-content>\n ) and optical coherence tomography (\n OCT<\/jats:styled-content>\n ) in order to provide a rapid non\u2010invasive bed\u2010side diagnosis. Secondary objective was to evaluate the detectability of clinically non\u2010visible lesions.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was an observational, retrospective, multicentre study in which patients with suspicious lesions for\n BP<\/jats:styled-content>\n or pemphigus underwent clinical assessment,\n RCM<\/jats:styled-content>\n ,\n OCT<\/jats:styled-content>\n , blood tests and skin biopsy for histological and direct immunofluorescence examinations from January 2014 to December 2015. A total of 72 lesions in 24 selected patients were evaluated. Additionally, apparently unaffected skin at two different distances [near (1\u20132 cm) and far (2\u20133 cm)] from each lesion was examined to test subclinical lesion detectability.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n RCM was able to detect subepidermal and intra\u2010epidermal blisters, respectively, in 75% and 50% of the patients affected by\n BP<\/jats:styled-content>\n and pemphigus. At\n OCT<\/jats:styled-content>\n , the exact blister level was identified in all patients. Acantholytic cells were observed only at\n RCM<\/jats:styled-content>\n in pemphigus (62.5%). Fibrin deposition inside the blisters was only found in\n BP<\/jats:styled-content>\n , evidenced both at\n RCM<\/jats:styled-content>\n and\n OCT<\/jats:styled-content>\n . Among patients with\n BP<\/jats:styled-content>\n , subclinical blisters were detected in nine (9.4%) clinically healthy skin, while among patients with pemphigus were observed in 10 (20.8%) apparently unaffected skin.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n RCM and\/or\n OCT<\/jats:styled-content>\n provide useful information for a rapid diagnosis of\n BP<\/jats:styled-content>\n and pemphigus and for the identification of biopsy site. Combined use of\n RCM<\/jats:styled-content>\n and\n OCT<\/jats:styled-content>\n is optimal because associates the higher resolution of\n RCM<\/jats:styled-content>\n with the greater penetration depth of\n OCT<\/jats:styled-content>\n .\n OCT<\/jats:styled-content>\n could be an optimal tool for treatment monitoring, especially in the cases of subclinical lesions. However, histopathologic and immunologic examinations remain the gold standard for establishing the final diagnosis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jdv.14795","type":"journal-article","created":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T18:56:39Z","timestamp":1516128999000},"page":"1562-1569","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Reflectance confocal microscopy and optical coherence tomography for the diagnosis of bullous pemphigoid and pemphigus and surrounding subclinical lesions"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-6148","authenticated-orcid":false,"given":"V.D.","family":"Mandel","sequence":"first","affiliation":[{"name":"Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4009-0659","authenticated-orcid":false,"given":"E.","family":"Cinotti","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Saint\u2010\u00c9tienne Saint\u2010\u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Benati","sequence":"additional","affiliation":[{"name":"Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Labeille","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Saint\u2010\u00c9tienne Saint\u2010\u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ciardo","sequence":"additional","affiliation":[{"name":"Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Vaschieri","sequence":"additional","affiliation":[{"name":"Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Cambazard","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Saint\u2010\u00c9tienne Saint\u2010\u00c9tienne 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