Cost–benefit of reflectance confocal microscopy in the diagnostic performance of melanoma

Abstract

The systematic use of RCM was dramatically affecting the number of benign lesions excised, and this can be translated in a significant cost-benefit advantage.

Reinterpreting dermoscopic pigment network with reflectance confocal microscopy for identification of melanoma‐specific features

“…However, when the thin pigmented network was detected in melanoma, the lesion was usually characterized in RCM, by a proliferation of dendritic cells in the epidermis. Moreover, the DEJ commonly showed an irregular ringed pattern with non‐edged papillae, corresponding to an atypical infiltrate of dendritic cells in the majority of cases, as other authors have already highlighted . The analysis of our data showed that a statistically significant presence of structureless area (50% of cases) corresponded with epidermal flattening with basal proliferation of malignant cells at histopathology examination.…”

“…Moreover, the DEJ commonly showed an irregular ringed pattern with nonedged papillae, corresponding to an atypical infiltrate of dendritic cells in the majority of cases, as other authors have already highlighted. [9][10][11][12] The analysis of our data showed that a statistically significant presence of structureless area (50% of cases) corresponded with epidermal flattening with basal proliferation of malignant cells at histopathology examination. This feature has already been identified as an early diagnostic sign for melanoma.…”

“…Reflectance confocal microscopy allows the observation of in vivo cytological and architectural structures at close to histological resolution, proven to assist in early differential diagnosis, reducing excisions …”

“…8 Reflectance confocal microscopy allows the observation of in vivo cytological and architectural structures at close to histological resolution, proven to assist in early differential diagnosis, reducing excisions. [9][10][11][12][13][14][15][16] The aim of our study was to identify RCM features for differential diagnosis between melanocytic lesions (nevi or melanoma) detectable in the context of thin, thick and mixed pigment networks to improve diagnostic accuracy, correlated with histological confirmation.…”

Advances in the use of Reflectance Confocal Microscopy in Melanoma

“…A retrospective study conducted in the Province of Modena (Italy) by Pellacani  et al . evaluated the cost-benefit value of adding RCM to assist in melanoma diagnosis [23]. A decrease in the number of benign lesions needed to excise a melanoma from 19.41 (dermatologists using dermoscopy alone in nontertiary centres) to 6.25 (in university-based dermatologists using combination of dermoscopy and RCM) was found, corresponding to a decrease in 70% of unnecessary excisions.…”