Confocal features of equivocal facial lesions on severely sun-damaged skin: Four case studies with dermatoscopic, confocal, and histopathologic correlation

Dermoscopic difficult lesions: an objective evaluation of reflectance confocal microscopy impact for accurate diagnosis

“…) strengthen the value of combined use of the two techniques in lesions with only weak clinical and/or dermoscopic clues of malignancy . Moreover, these data stress to carefully look for junctional alterations, that may be sometimes subtle, to identify early form of melanomas characterized by single‐cell proliferation that may lack of the common melanoma patterns ( 7 ), but may present characteristic clues, such as the presence of tangled filaments/dendrites crossing the papillae …”

Reflectance confocal microscopy correlates of dermoscopic patterns of facial lesions help to discriminate lentigo maligna from pigmented nonmelanocytic macules

“…In our study, blue pseudonetwork (also called 'rhomboidal structure'), black pseudonetwork and blue and/or black blotches were almost exclusively seen in LMs/LMMs, supporting the data from previous studies. [7][8][9][10][11][12] Interestingly, an unusual 'Medusaheadlike' feature characterized by elongated buddings bulging from the hair follicle and populated by dendritic/pleomorphic cells 15 was also observed in some LMs/LMMs, which usually corresponded to an asymmetric follicular pigmentation or pseudonetwork. Thus, the differential diagnosis derived from an early LM and an SL, or early SK, or LPLK may prove to be particularly challenging in some cases.…”

“…When carried out by trained users, dermoscopy markedly improves diagnostic accuracy compared with naked-eye examination. [7][8][9][10][11] As benign pigmented lesions of the face share several dermoscopic features with LM, we sought to evaluate the possibility of detecting different RCM substrates underlying the dermoscopic features of LM and other facial pigmented macules, in order to identify pattern-characteristic indicators for LM diagnosis. 2,3 However, LM still remains a challenging diagnosis in some cases because of a lack of specific individuating features and the overlap of diagnostic indicators with other benign nonmelanocytic lesions, such as lichenplanus-like keratosis (LPLK), solar lentigo (SL), flat seborrhoeic keratosis (SK), pigmented actinic keratosis (AK) and others.…”

Assessment of changes in lentigo maligna during radiotherapy byin-vivoreflectance confocal microscopy: a pilot study

“…Dermoscopy, as an additional diagnostic tool, has been shown to be valuable in early diagnosis of this malignancy but still leaves the clinician with diagnostic challenges . After the introduction of in‐vivo reflectance confocal microscopy (RCM) in early diagnosis, the method has been shown to have diagnostic accuracy with high sensitivity and specifity . In recurrent LM, as well as in presurgical mapping, RCM was used as an adjunctive method …”