A novel technique for non- invasive diagnosis of different skin conditions herpes virus-related.

Background: Line-field confocal optical coherence tomography (LC-OCT) is a new noninvasive imaging technique that provides high-resolution skin imaging close to histopathology.

Objectives: The aim of this study was to evaluate the usefulness of LC-OCT in the diagnosis of herpes virus skin infections.

Methods: Patients with a clinical or anamnestic suspicion of herpes virus infection underwent LC-OCT evaluation followed by Tzanck test. The examinations were performed in a blinded manner by different dermatologists.

Results: A total of 72 patients (M: 38; F: 34; age range: 13-84) were evaluated. In 57 cases, LC-OCT allowed the recognition of the typical herpetic intraepidermal vesicles containing giant, ballooning/multinucleated cells, as confirmed by Tzanck test. The final diagnosis was herpes simplex in 16 cases, herpes zoster in 31 cases, chickenpox in 8 cases, and Kaposi varicelliform eruption in 2 cases. In the remaining 15 cases, both LC-OCT and Tzanck test excluded the diagnosis of herpetic infections.

Conclusions: Although the diagnosis of herpes virus skin infections is generally clinical, in minimal and/or atypical cases, LC-OCT could be a rapid and valid alternative to semi-invasive/invasive and time-consuming procedures, such as Tzanck test, viral cultures, PCR, or histopathology.