{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:29:13Z","timestamp":1790357353052,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Skin Research and Technology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bullous pemphigoid (BP) is a common autoimmune blistering dermatosis often difficult to distinguish from other inflammatory conditions. Timely diagnosis is crucial for appropriate management. Line\u2010field confocal optical coherence tomography (LC\u2010OCT), a noninvasive imaging technique that uses an 800nm laser to generate high\u2010resolution vertical and horizontal cross\u2010sectional images of the skin, is evaluated as a diagnostic tool for BP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A prospective, single\u2010center study was conducted on 26 patients with suspected BP. LC\u2010OCT imaging, histopathology, and direct immunofluorescence (DIF) were performed. LC\u2010OCT images were assessed for the presence of key diagnostic features, including subepidermal cleavage and eczema criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on histopathology, DIF, indirect immunofluorescence (IIF), and ELISA, the final diagnoses were 15 BP cases and 11 non\u2010BP cases. LC\u2010OCT correctly identified 12 of 15 BP cases and all 11 non\u2010BP cases, demonstrating a sensitivity of 0.8 and a specificity of 1.0. The presence of subepidermal cleavage was a key diagnostic criterion for BP (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.000). The absence of alternating hypo\u2010 and hyper\u2010reflective layers (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.000), thickened and disrupted stratum corneum (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.014), spongiosis (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.036), and thickened epidermis (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.043), which occurred significantly less frequently in BP cases, further supported the diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LC\u2010OCT demonstrates high sensitivity and specificity in diagnosing BP, offering a rapid, point\u2010of\u2010care diagnostic approach. LC\u2010OCT can be used to evaluate unclear inflammatory skin conditions and guide further investigations. However, LC\u2010OCT has limitations in diagnosing non\u2010bullous stages of BP; thus, histology and DIF remain the gold standard for definitive diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/srt.70235","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T10:25:44Z","timestamp":1758709544000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real\u2010Time, Noninvasive Diagnosis of Bullous Pemphigoid: Diagnostic Performance of Line\u2010Field Confocal Optical Coherence Tomography"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2164-4644","authenticated-orcid":false,"given":"Frank Friedrich","family":"Gellrich","sequence":"first","affiliation":[{"name":"Department of Dermatology Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"Skin Cancer Center at the University Cancer Center National Center for Tumor Diseases (NCT\/UCC)  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samal","family":"Rakhmetova","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4330-1861","authenticated-orcid":false,"given":"Claudia","family":"G\u00fcnther","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8327-8475","authenticated-orcid":false,"given":"Stefan","family":"Beissert","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5703-324X","authenticated-orcid":false,"given":"Sarah","family":"Hobelsberger","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine and University Hospital Carl Gustav Carus Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"Skin Cancer Center at the University Cancer Center National Center for Tumor Diseases (NCT\/UCC)  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57101061"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00220"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555\u20100819"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2011.03.005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.01.006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016\u2010017\u20108633\u20104"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a180"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.25259\/JSSTD_35_2021"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011592"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.2310\/7750.2014.14004"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.IJD_196_17"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403\u2010016\u20101631\u20101"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13343"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806\u20104841.20199007"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.23736\/S2784\u20108671.23.07639\u20109"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14161821"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbio.202000449"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JBO.23.10.106007"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16857"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/srt.13833"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.23736\/S2784\u20108671.23.07607\u20107"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18293"},{"key":"e_1_2_9_24_1","volume-title":"Diagnostic Pathology: Nonneoplastic Dermatopathology","author":"Hall B. 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