Bedside diagnosis of lentigo maligna with reflectance confocal microscopy

Abstract

Early diagnosis of lentigo maligna (LM) is both critical and challenging.Attiya Haroon

Line‐field confocal optical coherence tomography of lentigo maligna with horizontal and vertical histopathologic correlations

“…In our case, LC‐OCT was able to detect in vivo, in both horizontal and vertical imaging, the main microscopic features typical of LM by showing, in the epidermis and around the hair follicles, the presence of large, bright, roundish, or dendritic atypical cells, with evident nuclei, corresponding to atypical melanocytes with a tendency toward folliculotropism. From our results, some considerations follow: the features observed by LC‐OCT in the horizontal sections are similar to those normally obtained by RCM, 3 , 4 , 5 , 6 , 7 which has been demonstrated to be useful in the non‐invasive diagnosis of LM by showing the characteristic atypical melanocytes mainly distributed around the hair follicles. Compared with RCM, LC‐OCT has a slightly lower resolution (1.3 vs. 0.8 μm, respectively) and a higher penetration depth (~500 vs. ~200 μm).…”

“…In the past years, the introduction of innovative imaging techniques, especially dermoscopy and reflectance confocal microscopy (RCM), has made a significant contribution in the differential diagnosis of these lesions. [1][2][3][4][5][6][7] Such techniques are able to improve the LC-OCT systems have recently been marketed, and preliminary studies have reported its use in selected cutaneous disorders, including malignant and benign neoplasms [8][9][10][11][12][13][14] and some inflammatory and infectious diseases. [15][16][17][18] We herein present the LC-OCT features of a case of LM involving the nose along with their horizontal and vertical histopathological correlations.…”

“…The diagnosis of pigmented facial lesions, mainly including LM, pigmented actinic keratosis, and solar lentigo, is challenging and may require a timely recognition in order to define the most correct approach. In the past years, the introduction of innovative imaging techniques, especially dermoscopy and reflectance confocal microscopy (RCM), has made a significant contribution in the differential diagnosis of these lesions 1–7 . Such techniques are able to improve the diagnostic accuracy and allow a prompt diagnosis by reducing invasive procedures at critical sites on the face.…”

“…In the past years, the introduction of innovative imaging techniques, especially dermoscopy and reflectance confocal microscopy (RCM), has made a significant contribution in the differential diagnosis of these lesions. 1 , 2 , 3 , 4 , 5 , 6 , 7 Such techniques are able to improve the diagnostic accuracy and allow a prompt diagnosis by reducing invasive procedures at critical sites on the face. Dermoscopy is easy to use and extensively and routinely used in clinical practice; on the other hand, RCM, being more costly and time consuming, has a higher specificity and sensitivity and is mainly used in dermatology centers with advanced technologies.…”

Reflectance Confocal Microscopy in Dermatology

“…Overall, RCM has roughly the same diagnostic power as conventional histology, in addition to the benefits of being completely noninvasive, and allowing repetitive imaging of the same site. Furthermore, some pathologies benefit from the different reflectance of specific structures to facilitate the differential diagnosis of specific pathologies (Zubair et al 2018).…”