title: First identification of the herpes simplex virus by skin-dedicated ex vivo fluorescence confocal microscopy during herpetic skin infections.
abstract: BACKGROUND
  Skin-dedicated ex vivo fluorescence confocal microscopy (FCM) has so far been used to identify cutaneous tumours on freshly excised samples using acridine orange as fluorochrome.
  
  
  OBJECTIVE
  To use FCM for a new indication, namely, the identification of the herpes simplex virus (HSV) in skin lesions, using fluorescent antibodies.
  
  
  METHODS
  Six roof samples from skin vesicles suspicious for HSV lesions were incubated with anti-HSV-1 and anti-HSV-2 antibodies coupled with fluorescein isothiocyanate, and examined under skin-dedicated ex vivo FCM. The positive controls were swabs taken from the floor of each vesicle and observed under conventional direct fluorescence assay (DFA) and by viral cultures. Roof samples from three bullae of bullous pemphigoid were the negative controls.
  
  
  RESULTS
  Using ex vivo FCM, the samples from the lesions clinically suspicious for HSV infection were seen to be fluorescent after incubation with anti-HSV-1, and were negative after incubation with anti-HSV-2 antibodies. Conventional DFA with an optical microscope and cultures confirmed the presence of HSV-1 infection.
  
  
  CONCLUSIONS
  By using fluorescent antibodies to identify precise structures, ex vivo FCM can be used for indications other than tumour identification. More specifically, it can be an additional diagnostic tool for HSV infection.
authors.affiliation: Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: E
authors.initials: E
authors.lastname: Cinotti
authors.affiliation: Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Perrot
authors.affiliation: Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: B
authors.initials: B
authors.lastname: Labeille
authors.affiliation: Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne, France.|Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Jean Monnet University, Saint-Etienne, France.
authors.forename: N
authors.initials: N
authors.lastname: Campolmi
authors.affiliation: Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne, France.|Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Jean Monnet University, Saint-Etienne, France.|French University Institute, Boulevard Saint-Michel, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Thuret
authors.affiliation: Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Jean Monnet University, Saint-Etienne, France.
authors.forename: N
authors.initials: N
authors.lastname: Naigeon
authors.affiliation: Department of Virology, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: T
authors.initials: T
authors.lastname: Bourlet
authors.affiliation: Department of Virology, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: S
authors.initials: S
authors.lastname: Pillet
authors.affiliation: Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: F
authors.initials: F
authors.lastname: Cambazard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000276:immunology; D005260:Female; D016650:Fluorescein-5-isothiocyanate; D005455:Fluorescent Antibody Technique; D006561:Herpes Simplex / Q000175:diagnosis* / Q000276:immunology; D018259:Herpesvirus 1, Human / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*
chemical_list: D000914:Antibodies, Viral; D016650:Fluorescein-5-isothiocyanate