In Vivo Confocal Microscopy in Dermatology

Selkin, Bryan A.; Rajadhyaksha, Milind; González, Salvador; Langley, Richard

doi:10.1016/s0733-8635(05)70274-6

Cited by 56 publications

(44 citation statements)

References 20 publications

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“…Furthermore, confocal microscopy reveals a complete loss of dermal reflection in the MTZs immediately after FP. This is based most likely on the thermal denaturation and the resulting change of optical properties of dermal collagen [7,9,10].…”

Section: Discussionmentioning

confidence: 99%

Skin responses to fractional photothermolysis

et al. 2006

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Background and Objective: Fractional photothermolysis (FP) is a new concept using arrays of microscopic thermal damage patterns to stimulate a therapeutic response. We analyzed epidermal and dermal response to FP with the aim of correlating histological and clinical response. Study Design/Materials and Methods: Twelve subjects received a single treatment with a prototype diode laser emitting at a wavelength of 1,500 nm, delivering 5 mJ per microscopic treatment zone (MTZ), and a density of 1,600 MTZs/cm 2 on the forearm. Biopsies were procured over a period of 3 months. The biopsies were analyzed by two blinded dermatopathologists using hematoxylin and eosin (Hematoxylin and Eosin Stain), Elastica von Gieson, nitro-blue-tetrazolium-chloride (NBTC) viability, and immunohistochemistry stains. Furthermore, the treatment sites were evaluated in vivo by confocal microscopy. Results and Discussion: Twenty-four hours after fractional photothermolysis, the continuity of the epidermal basal cell layer is restored. Complete epidermal regeneration is obtained 7 days after the treatment. Microscopic epidermal necrotic debris (MENDs) are seen as early as 1 day after FP. MENDs contain melanin pigment, and are shed from the epidermis within 7 days. Evidence of increased collagen III production is shown with immunohistochemistry (IHC) staining 7 days after FP. IHC for heat shock protein 70 (HSP 70) shows the expression of HSP 1 day after FP, and IHC for alpha smooth muscle actin shows the presence of myofibroblasts 7 days after FP. These findings are concordant with the induction of a wound healing response by FP. There is no evidence of residual dermal fibrosis 3 months after treatment. Conclusion: A single treatment with fractional photothermolysis induces a wound healing response in the dermis. A mechanism for the precise removal of epidermal melanin is described, in which MENDs act as a melanin shuttle.

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Section: Discussionmentioning

confidence: 99%

Skin responses to fractional photothermolysis

et al. 2006

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“…The diagnostic accuracy of clinical examination is in the order of 64–80% [1,2,3], however, prompting the development of noninvasive technologies such as dermoscopy [4,5,6,7], image analysis [8] and more recently in vivoreflectance mode confocal scanning laser microscopy (CSLM) [9,10,11,12,13,14,15,16,17,18,19,20,21,22]. In addition, improved diagnostic accuracy could help reduce the unnecessary removal of benign lesions with the associated morbidity.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study

Langley

Walsh²,

Sutherland³

et al. 2007

Dermatology

111

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Background: The diagnosis of melanoma at an early, curable stage is an important challenge for clinicians. Confocal scanning laser microscopy (CSLM) is a high-resolution, noninvasive technology that may facilitate improved diagnostic accuracy over clinical examination. The aim of this study was to evaluate the diagnostic accuracy of CSLM compared to dermoscopy in a prospective examination of benign and malignant melanocytic lesions. Methods: 125 patients with suspicious pigmented lesions were prospectively recruited to undergo a clinical, dermoscopic and CSLM examination. A diagnosis was made preoperatively with each technique, and the lesion was then excised and diagnosed using histopathology. Results: 125 patients with 125 lesions were studied comprising 88 melanocytic nevi and 37 melanomas. Dermoscopy had a sensitivity of 89.2%, a specificity of 84.1%, a positive predictive value of 70.2% and a negative predictive value of 94.9%. CSLM was found to have a sensitivity of 97.3%, a specificity of 83.0%, a positive predictive value of 70.6% and a negative predictive value of 98.6%. No melanomas were misidentified when both techniques were used together. Conclusions: CSLM had a relatively higher sensitivity than dermoscopy; however, the specificity was similar with CSLM and dermoscopy. These results suggest that dermoscopy and CSLM are complementary.

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“…[33][34][35][36] Konfokal mikroskopi, NMCK tanısında kullanılan bütün optik tekniklerden daha yüksek gö-rüntü kalitesi sağlamaktadır; ex vivo ve in vivo şartlarda, bazal hücreli karsinom ve skuamöz hüc-reli karsinom tanısında değerli bir yöntemdir. [37][38][39] NMCK tanısında alternatif yöntemler araştı-rılıp tanımlansa da altın standart hâlen histopatolojik tanıdır. Özellikle devlet hastanelerinde alternatif yöntem olanakları kısıtlı olduğundan, NMCK tanısında klinik olarak şüpheli lezyonlardan histopatolojik tanı amaçlı biyopsi yapılmak-tadır.…”

Section: Bulgularunclassified

Evaluation of the Cases Who Were Referred to Plastic Surgery Clinic Out of Suspicion of Non-melanoma Skin Cancer Localized at Head and Neck Region in Sivas Numune Hospital

Derebaşınlıoğlu¹,

Özkaya²,

Parlak³

2016

Turkiye Klinikleri J Dermatol

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Ö ÖZ ZE ET T A Am ma aç ç: : Sivas Numune Hastanesi Plastik Cerrahi Polikliniğine baş-boyun bölgesi yerleşimli nonmelanositik cilt kanseri ön tanısıyla konsülte edilen ve eksizyonel biyopsi uygulanan hastalarda yaş, tutulan bölge, lezyon türleri ve kullanılan rekonstrüksiyon tekniklerini belirleyebilmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : 1 Ocak 2013-1 Aralık 2014 tarihleri arasında Sivas Numune Hastanesi Plastik Rekonstrüktif ve Estetik Cerrahi Polikliniğine baş-boyun bölgesine yerleşimli nonmelanositik cilt kanseri ön tanısıyla konsülte edilen 163 hastaya yapılan 176 eksizyonel biyopsinin patolojik sonuçları incelenmiştir. B Bu ul lg gu ul la ar r: : Çalış-mamızda incelenen 163 hastanın 80 (%49,07)'ini erkekler, 83 (%50,9)'ünü ise kadınlar oluşturmakta idi. Ortalama yaş 60,4 olarak tespit edildi. Çalışmaya alınan 176 eksizyonel biyopsi sonucunun 105 (%59,6)'ini bazal hücreli karsinom, 14 (%7,9)'ünü skuamöz hücreli karsinom, 5 (%2,8)'ini bazoskuamöz hücreli karsinom, 25 (%14,2)'ini seboreik keratoz, 6 (%3,4)'sını aktinik keratoz, 18 (%10,2)'ini keratoakantom, 1 (%0,56)'ini rüptüre epidermal kist, 1 (%0,56)'ini inflamasyon, 1 (%0,56)'ini granülasyon dokusu oluştur-makta idi. Nonmelanositik cilt kanserinin en sık görülen lokalizasyonu burun idi. S So on nu uç ç: : Çalışmamızda toplam 163 baş-boyun bölgesine lokalize nonmelanositik cilt kanseri ön tanısyla dermatoloji kliniğinden konsülte edilen hastalardan yapılan 176 eksizyonel biyopsi sonucunda 124 (%70,4) adet nonmelanositik cilt kanseri tespit edilirken, 24 (%13,6) adet premalign lezyon saptanmıştır. En sık görülen nonmelanositik cilt kanseri bazal hücreli karsinom olurken, ikinci sıklıkla skuamöz hücreli karsinom görülmüştür. Sonuç olarak, nonmelanositik cilt kanserleri şüphesi olan lezyonlara %70,4 oranında klinik olarak doğru malignite tanısı konulmuştur.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Karsinom, bazal hücre; karsinom, skuamöz hücre; baş ve boyun neoplazileri; patoloji A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : We aimed to determine age, gender, localization area and types of lesions and reconstruction tecniques, suspicion of nonmelanoma skin cancer cases who were consulted from dermatology clinic localizated at head and neck. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Retrospective review of 163 patients undergoing exicion biopsy at the Sivas Numune Hospital Plastic Reconstructive Surgery Clinic for suspicion of nonmelanoma skin cancer localized at head and neck region, between January 2013 and December 2014 was undertaken. 176 excision material of 163 cases were searched. R Re es su ul lt ts s: : In this study 163 patients (80; 49.07% males, 83; 50,9% females) were evaluated. Average of year was 60,4. Of the 175 exision material; 105 (60 %) were basal cell carcinoma, 13 (14.2%) were squamous cell carcinoma, 5 (2.8%) were basosquamous cell carcinoma, 25 (14.2%) were seboreic keratosis, 18 (10.2%) were keratoacanthoma, 6 (3.4%) were actinic keratosis, 1 (0.57%) was ruptured epider...

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In Vivo Confocal Microscopy in Dermatology

Cited by 56 publications

References 20 publications

Skin responses to fractional photothermolysis

Skin responses to fractional photothermolysis

The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study

Evaluation of the Cases Who Were Referred to Plastic Surgery Clinic Out of Suspicion of Non-melanoma Skin Cancer Localized at Head and Neck Region in Sivas Numune Hospital

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