Ex vivo confocal laser scanning microscopy (CLSM) provides rapid, high-resolution
imaging, fluorescence detection and digital haematoxylin-eosin (H&E)-like staining.
We aimed to assess the performance of ex vivo CLSM in identifying histomorphology
and immunoreactivity in lichen planus (LP) and comparing its accuracy with conventional
histopathology and direct immunofluorescence (DIF). Thirty-three sections of 17 LP
patients stained with acridine orange (AO) and FITC-labelled anti-fibrinogen antibody
and 21 control samples stained with AO were examined using ex vivo CLSM. Ex vivo CLSM
was in perfect agreement with conventional histopathology in identifying interface
dermatitis, vacuolar degeneration and band-like infiltration. ROC analysis showed
that the presence of vacuolar degeneration, interface dermatitis and band-like infiltration
was useful to distinguish LP sections from controls (p < .0001). The detection rates
of fibrinogen deposition using DIF and in conclusion ex vivo CLSM were 93.8% and 62.5%,
respectively. ex vivo CLSM enables histopathological and immunofluorescence examination
in LP with the advantage of digital H&E-like staining.
