Reflectance confocal microscopy as a non-invasive diagnostic tool for Hailey–Hailey disease
Article first published online: 17 FEB 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Skin Research and Technology
Volume 20, Issue 4, pages 503–509, November 2014
How to Cite
Kurzeja, M., Czuwara, J., Rakowska, A., Sicińska, J., Maj, M., Nasierowska-Guttmejer, A., Rudnicka, L. and Olszewska, M. (2014), Reflectance confocal microscopy as a non-invasive diagnostic tool for Hailey–Hailey disease. Skin Research and Technology, 20: 503–509. doi: 10.1111/srt.12146
- Issue published online: 9 OCT 2014
- Article first published online: 17 FEB 2014
- Manuscript Accepted: 5 JAN 2014
- National Science Center. Grant Number: N N402371538
- reflectance confocal microscopy;
- familial benign chronic pemphigus;
- Hailey–Hailey disease;
Reflectance confocal microscopy (RCM) is a non-invasive method for high-resolution, in vivo imaging of the epidermis and upper dermis. The purpose of the study was to evaluate the potential usefulness of RCM as a non-invasive diagnostic tool for Hailey–Hailey disease (familial benign chronic pemphigus).
Four patients with Hailey–Hailey disease were examined by RCM. Subsequently, punch biopsies were taken to compare RCM images with corresponding histopathologic findings.
On RCM images, the most sticking feature was acantholysis at the level of the granular and spinous layer, resembling a ‘dilapidated brick wall’. We suggest the term ‘dilapidated brick wall RCM sign’ to describe this feature and to distinguish from the corresponding histopathology finding. Other RCM features included: epidermal disarray, intraepidermal clefts, inflammatory cells in the epidermis and in the superficial dermis. These RCM abnormalities correlated with analogous histopathology findings.
Reflectance confocal microscopy is a promising non-invasive diagnostic tool for Hailey–Hailey disease. The method may also be considered useful for choosing the best site for biopsy, which may aid pathology evaluation and spare time needed to establish the diagnosis.