| Affiliation: | 1. Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy;2. Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium;3. Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy;4. Department of Pathology, University Hospital of Saint-Etienne, Saint Etienne, France;5. Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium;6. Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France;7. Dermatology department, AP-HM, Aix-Marseille University, Marseille, France;8. Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain |
| Abstract: | Autoimmune bullous diseases (AIBDs) still represent a considerable a source of morbidity and mortality: early identification of a specific AIBD is often difficult due to overlapping clinical and/or laboratory features and time-consuming invasive laboratory tests. We aimed to investigate the potential role of a new imaging technology, line-field confocal optical coherence tomography (LC-OCT), in the non-invasive diagnosis of AIBDs. LC-OCT was performed at lesional, perilesional and contralateral healthy sites in 30 patients, before histology and direct immunofluorescence. LC-OCT examination was able to identify the level of split (subcorneal/suprabasal/subepidermal/sublamina densa), to provide detailed images of the bulla roof morphology and content (eg, erythrocytes/acantholytic cells/polymorphonucleates). Areas of intra/subepidermal detachment were also detected also at clinically normal perilesional skin sites. LC-OCT can support physicians, real time and at bed-site, in the differential diagnosis of various AIBDs and their mimickers. Moreover, it can be used for the identification of subclinical lesions and therapy tapering. |
