One of the emerging and intriguing applications of reflectance confocal microscopy is the evaluation of 'dynamic' processes of the skin that cannot be otherwise analysed using histopathology that offers a picture of the tissue at one time point. This is nicely illustrated by recent article by Wolberink et al. in the current issue of Exp Dermatol, in which the Authors evaluated patterns and time interval of polymorphonuclear neutrophil (PMN) migration in psoriatic plaques by means of reflectance confocal microscopy (RCM). This example underscores that a new era of confocal microscopy is starting, which promises to reveal a dynamic in vivo understanding of the pathophysiology of human skin diseases.