Confocal microscopy of recurrent naevi and recurrent melanomas: a retrospective morphological study

Abstract

The integration of clinical, dermoscopic and RCM aspects offers the possibility to discern reliably the nature in cases of repigmentation on a scar.

Discriminating Nevi from Melanomas

“…In the absence of atypical RCM features, such as pagetoid infiltration of the epidermis or atypical nucleated cells at the DEJ, the likelihood of melanoma becomes exceeding remote. 38 …”

Recurrent halo nevus: Dermoscopy and confocal microscopy features

“…In melanoma, the pigmentation intersects the scar limits, but in RN, pigmentation is limited to the scar 8, 10. In our case, the lesion was confined to the scar but worrisome dermoscopic features and doubtful RCM findings lead us to investigate histopathology further.…”

“…RN are frequently referred to as pseudomelanomas because of their often challenging appearance on clinical and dermoscopy evaluation 8 . RN and HN concomitantly affecting a single lesion has never been described before.…”

Recognizing the benefits and pitfalls of reflectance confocal microscopy in melanoma diagnosis

“…If we were to formulate the best indications for using RCM as an add-on test to dermatoscopy, we would need to better point-out which lesions are included in this group of 608 benign lesions that are dermatoscopically equivocal, but RCM negative. In this editorial, we can only attest to our own impression and experience, as well as some literature reports, that this group of lesions could encompass the following examples: nevi with irregular pigment pattern (e.g., irregular network, complex pattern) on dermatoscopy showing a regular pattern (e.g., ringed or meshwork patterns) on RCM (Figures 1,2);nevi with a hyperpigmented structureless pattern on dermatoscopy that display on RCM a cobblestone pattern of the epidermis (reflecting pigmented keratinocytes at the basal and suprabasal epidermis) or a dense infiltrate of melanophages in the dermis;a dermatoscopically-equivocal lesion on sun-damaged skin with a differential diagnosis between solar lentigo and melanoma on sun-damaged skin, that presents a straightforward pattern of solar lentigo on RCM, without any findings concerning for melanoma;a pink macule revealing only a vascular pattern on dermatoscopy, while RCM demonstrates a straightforward pattern of nevus;a macule or patch displaying granularity or blue-gray hue on dermatoscopy, while showing on RCM features of lichen planus-like keratosis with melanophages and remnants of solar lentigo, in the absence of suspicious findings for melanoma [4];recurrent pigmentation in a scar, whereby RCM helps discriminate between a benign reactive pigmentation and an atypical melanocytic proliferation which would require a biopsy to exclude melanoma [5]. …”

“…recurrent pigmentation in a scar, whereby RCM helps discriminate between a benign reactive pigmentation and an atypical melanocytic proliferation which would require a biopsy to exclude melanoma [5]. …”