Diagnostic Accuracy of Reflectance Confocal Microscopy for Diagnosis of Skin Lesions: An Update

Abstract

Context.— Histopathology is the current standard to diagnose skin disease. However, biopsy may not always be feasible, such as in patients with multiple nevi, a patient with a lesion on an aesthetically significant site, or in children. Recently, noninvasive techniques, including reflectance confocal microscopy (RCM), optical coherence tomography, and Raman spectroscopy, have enabled dermatologists to manage skin lesions in real time without the need for biopsy. Objective.— To report the updated diagnostic accuracy of RCM for equivocal skin lesions. Design.— In this study, we retrospectively reviewed our data of clinically suspicious lesions from 2010 to 2017 that were evaluated by RCM. Results.— Our results showed an overall sensitivity of 98.2% and specificity of 99.8%. Conclusions.— In conclusion, RCM is a noninvasive real-time tool with the potential to diagnose skin lesions with high accuracy and without biopsy.

The first report of diagnosing of keratoacanthoma in Chinese Han patients using dermoscopy and reflectance confocal microscopy

“…RCM is a widely used tool that enables real‐time, visualization of skin layers on a horizontal plane, and serial optical sections of the lesions from the epidermis to the depth of 200‐300 µm 6 . Its high cellular resolution is close to that of conventional histology 7 . This feature is particularly useful in head and neck examinations, where it potentially avoids surgical operations in anatomically dangerous areas and areas that affect aesthetics.…”

Reflectance confocal microscopic presentation of paraneoplastic pemphigus

“…4 Meanwhile, RCM is horizontal imaging, enabling a more clear and comprehensive observation of the interface layer. 4 Previous studies have shown that the characteristics of RCM images in interface dermatitis were highly consistent with the pathological changes under light microscopy 5 and RCM was able to detect intraepidermal and sub-epidermal blisters, respectively, in 50% and 75% of the patients affected by pemphigus and bullous pemphigoid. 6 Therefore, we tried to observe PNP lesions with RCM and achieved satisfactory results.…”

Reflectance confocal microscopy decreases the cost of skin lesion diagnosis: A single institution retrospective chart review

“…To the Editor: Sex and race concordance between physicians and patients is associated with improved perceptions of clinical care. 1 In 2017, 48.9% and 64.5% of dermatology attendings and residents, respectively, were female. 2 Academic dermatology leadership positions are underrepresented in sex and ethnic diversity.…”

“…To the Editor: Reflectance confocal microscopy (RCM) is a noninvasive imaging technique used to assess skin lesions. 1 Although it has been shown to identify skin cancer with high levels of diagnostic accuracy, 1,2 little is known about its impact on health care costs.…”