‘En face’ ex vivo reflectance confocal microscopy to help the surgery of basal cell carcinoma of the eyelid

Abstract

Ex vivo confocal microscopy in the reflectance mode with an 'en face' scanning can control tumour margins of eyelid basal cell carcinomas and optimize their surgical management. This procedure has the advantage on the fluorescent mode of not needing any contrast agent to examine the samples.

Ex vivo fluorescence confocal microscopy for intraoperative, real‐time diagnosis of cutaneous inflammatory diseases: A preliminary study

“…In the current study, acridine orange was selected because it has been proven to only stain DNA, providing a strong contrast between nuclear morphology and the surrounding background, without altering tissue morphology . To date, ex vivo FCM has been evaluated for its correlation with the histopathology in healthy skin, its application in diagnosis of basal cell carcinoma, squamous cell carcinoma, rare malignant adnexal tumors, such as the eccrine syringomatous carcinoma, and conjunctival lesion evaluation in ophthalmology, for assessment of tumor margins on fresh tissue excisions in Mohs surgery. Other application was the differential diagnosis of melanocytic lesions from healthy skin .…”

Simple 3‐criteria‐based ex vivo confocal diagnosis of basal cell carcinoma

“…The diagnosis of BCC seems to be the most frequent indication for ex vivo CLSM. Until now it has been examined with the use of ex vivo CLSM in several studies [12,[19][20][21][22][23]. In all of them, the researchers referred to the histological way of tumor classification and focused on the 3 most frequent BCC subtypes-superficial, nodular and infiltrating.…”

Immunofluorescence and confocal microscopy for ex‐vivo diagnosis of melanocytic and non‐melanocytic skin tumors: A pilot study

“…Ex‐vivo confocal imaging has been applied most commonly for visualization of BCC . In images taken with ex‐vivo CLSM, BCCs were displayed as highly fluorescent aggregates of pleomorphic nuclei with peripheral palisading and clefting arrangement with increased nuclear/cellular ratio.…”

“…In‐vivo CLSM is being widely used for diagnosis of melanocytic and non‐melanocytic tumors as well as in numerous inflammatory and infectious diseases . Not only preoperatively but also intra‐operatively ex‐vivo CLSM was described as a rapid detection method of residual basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) during Mohs surgery . Recently, ex‐vivo CLSM has been successfully introduced to ophthalmologic surgery and even esthetic dermatology when dealing with adverse events of a dermal filler .…”

“…Among these dyes, acridine orange is the most preferred one for the identification of tumors because of its affinity for cell nuclei. Studies performed with ex‐vivo CLSM in BCC reported high sensitivity and specificity (up to 96.6% and 89.2%, respectively) for the detection of residual tumor during Mohs surgery .…”