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BackgroundExtra facial lentigo maligna (EF‐LM) arises outside the head and neck area. EF‐LM presents the classic histological features of lentigo maligna. The dermoscopic aspects of EF‐LM have been poorly studied.ObjectiveThe primary aims of our study were to analyse and describe the clinical, dermoscopic and confocal microscopy features of a series of histologically confirmed EF‐LM.MethodWe conducted a retrospective and multicentric study. From our database, we selected 48 cases of thin melanomas on photodamaged skin with histological features of EF‐LM of which clinical, dermoscopic and confocal microscopy images were available, and a control group of 45 lesions, that can be subjected to differential diagnosis such as solar lentigo, lichenoid keratosis, seborrheic keratosis and melanocytic nevi, of which dermoscopic and confocal microscope images were available.ResultsExtra facial lentigo maligna had a higher prevalence of lentigo‐like pigment patterns, angulated lines and zigzag structures. At confocal microscopy, LM‐EF cases showed a higher prevalence of pagetoid spreading, round cells, dendritic cells in the epidermis, atypical cells at the dermo‐epidermal junction, dendritic cells at the junction, meshwork pattern and elastosis. Our study shows that reflectance confocal microscopy (RCM) has a sensitivity of 90% and a specificity of 97% for the differential diagnosis of this type of melanoma.ConclusionsExtra facial lentigo maligna does not have the classic dermoscopic features of superficial spreading melanoma, the most observed dermoscopic criteria are angulated lines and lentigo‐like pigment patterns without lentigo‐like border. RCM can be a valuable imaging tool for the evaluation of all those suspicion skin lesions at dermoscopy highlighting cellular atypia suggestive for melanoma.

Dear Editor, Reflectance confocal microscopy (RCM) and line-field confocal optical coherence tomography (LC-OCT) are non-invasive imaging techniques that can help the clinical diagnosis of basal cell carcinoma (BCC). [1][2][3][4][5][6] Although LC-OCT and RCM have been compared for the identification of squamous cell carcinomas, 4 no comparative studies on BCC diagnostic criteria are available. Our study aimed to compare BCC features under RCM and LC-OCT. For this purpose, a retrospective multicentre study was conducted. BCCs of 72 patients (39 males and 33 females with a mean age of 68.8 ± 13.8 years) were collected from the Dermatology Departments of the University Hospital of Siena (Italy), Brussels (Erasme Hospital, Belgium) and Saint-Etienne (France). All lesions were imaged with LC-OCT (DAMAE Medical) and RCM (VivaScope 3000® camera, MAVIG

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