Diving into the blue: In vivo microscopic characterization of the dermoscopic blue hue

In Vivo Confocal Microscopic and Histopathologic Correlations of Dermoscopic Features in 202 Melanocytic Lesions

“…Tight correspondence between network holes and dermal papillae, network meshes and interpapillary spaces, and pigment globules and cell clusters was confirmed. [14][15][16][17][18][19][20] Cytologic and architectural atypia on RCM was predominantly present in MMs and strongly correlated with histologic features. Otherwise, the observation of large cells within dense clusters in dermal nevi should not be interpreted as cytologic atypia, corresponding to larger melanocytes in the upper portion of the dermal nests or cords.…”

“…2,4,27 As recently demonstrated, RCM was particularly useful for the interpretation of the bluish pigmentation, enabling the distinction between inflammatory infiltrate, predominantly constituted by plump bright cells within dermal papillae corresponding to melanophages, and malignant melanocytic cells, which singularly or in clusters infiltrate the dermis in invasive MMs. 20 On the other hand, within regression areas, RCM failed to identify MM-specific aspects in most cases.…”

Blue Lesions

“…[20][21][22][23] In this scenario, confocal microscopy may support the clinical decision making process because it can enable the detection of subtle remnants of the melanocytic proliferation; for example, confocal observation of a proliferation of single atypical melanocytes or even aggregates of cells interspersed within a florid inflammatory infiltrate, is suggestive of the diagnosis of melanoma (Fig. 2).…”

Development of a two-step method for the diagnosis of melanoma by reflectance confocal microscopy

“…In a few studies the correspondence of confocal features with dermatoscopy and histopathology has been evaluated. [12][13][14][15][16] Other studies suggest that RCM as an adjuvant technique to dermatoscopy may improve diagnostic accuracy in the differentiation of benign and malignant melanocytic lesions (ML) 17,18 Recently a standard RCM terminology was published with the aim of establishing a glossary of terms for RCM evaluation of ML 19 A few reports describe systematic evaluation of nonmelanocytic tumors using RCM. 11,20,21 Nori et al 20 first included melanocytic and nonmelanocytic tumors to determine the sensitivity and specificity of RCM for the diagnosis of basal cell carcinoma (BCC).…”