Reflectance confocal microscopy as a diagnostic tool for mastocytoma in children

An, Xiangjie; Al-Muriesh, Maher; Abdul‐fattah, Bilal; Gao, Yingying; Tao, Juan; Yang, Jing; Huang, Changzheng

doi:10.1016/j.jaad.2020.03.091

Cited by 4 publications

(4 citation statements)

References 6 publications

(1 reference statement)

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“…Further studies with RCM of mastocytoma at the DEJ show a clod pattern and dermal papillae reveal reflective cells within a nest formation partitioned by rete ridges (Figure 8A). 19,20 Dense infiltrations of imperfectly demarcated cells with bright granules correlate well with mastocytoma histological characteristics (Figure 8B). 19,20 Pimenta et al utilized RCM to characterize juvenile xanthogranuloma features involving dilated dermal papillae at the DEJ that are packed with roundish, large, multinucleated, and hyper-refractile atypical cells, corresponding to Touton cells in the superficial dermis.…”

Section: Rcm Find Ing S: Non -Mel Ano C Y Ti C Le S Ionsmentioning

confidence: 55%

“…Dense infiltrations of imperfectly demarcated cells with bright granules correlate with mastocytoma histological characteristics. [18][19][20] Juvenile xanthogranuloma There are dilated dermal papillae at the dermoepidermal junction which are packed with roundish, large, multinucleated, and hyper-refractile atypical cells, corresponding to Touton cells in the superficial dermis. Additional findings include roundish discoid cells accompanied by peripheral bright rings linked to foamy histiocytes and inflammatory cells displaying round bright structures.…”

Section: Mastocytosismentioning

confidence: 99%

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Reflectance confocal microscopy in pediatric dermatology: A state‐of‐the‐art review

Smidt

Durkin

2021

Pediatric Dermatology

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Performing a skin biopsy for histopathologic analysis is considered the gold standard to diagnose skin disease. However, this may prove to be difficult in the pediatric population depending on the patient age and the anatomic location of the skin lesion, necessitating a different approach for the pediatric dermatologist. 1 Children may be less likely to undergo a skin biopsy if a provider does not feel comfortable performing this procedure on a pediatric patient. Further, if a child is unable to reasonably tolerate a biopsy in the outpatient clinic setting, sedation or general anesthesia is occasionally considered. Both scenarios carry potentially significant risk and are also associated with increased time and cost. Additionally, skin biopsies leave scars.Reflectance confocal microscopy (RCM) is an innovative imaging modality, which can serve as an alternative to a biopsy, providing a noninvasive production of an optical image to aid in the diagnosis of skin lesions. 2 RCM renders in vivo imaging of the epidermis and superficial dermis, coined an "optical skin biopsy." Especially when combined with dermoscopy, this allows for expedited detection, diagnosis, and routine surveillance of skin diseases when analyzed by a provider trained in this technique. This is an ideal technique for use with children due to potential obstacles in performing a skin biopsy as above. 2 Further, RCM is superior to dermoscopy alone in adults, and it is our group's belief this is just as applicable in children.A meta-analysis by the Cochrane Library of 18 studies and 2838 lesions found RCM to be more sensitive and specific when compared to dermoscopy. 3 Presuming a fixed sensitivity of 90% for both RCM and dermoscopy, specificities were 82% and 42%, respectively, for lesions suspicious for melanoma in adults. 3,4 There are two in vivo devices commercially available in the United States: the wide-range RCM device VivaScope 1500 (Caliber Imaging & Diagnostics [ID]), which can capture mosaic images, and a flexible handheld RCM device VivaScope 3000 (Caliber ID

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Section: Rcm Find Ing S: Non -Mel Ano C Y Ti C Le S Ionsmentioning

confidence: 55%

Section: Mastocytosismentioning

confidence: 99%

Reflectance confocal microscopy in pediatric dermatology: A state‐of‐the‐art review

Smidt

Durkin

2021

Pediatric Dermatology

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“…RCM has been described in paediatric patients in isolated case reports and case series, as for xanthogranuloma, 5 mastocitosis 6 and infectious conditions such as dermatophytosis, 7 scabies 8 and molluscum contagiosum 9 . Moscarella et al 10 described the use of RCM for the assessment of a solitary red nodule, and even if the latter study was not specific for the paediatric population, it included common conditions seen in this population, such as pyogenic granuloma, Spitz nevus and dermatofibroma.…”

Section: Discussionmentioning

confidence: 99%

Reflectance confocal microscopy in paediatric patients: Applications and limits

Scharf

Brizzi

Licata

et al. 2022

Experimental Dermatology

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“…In the future, 3D total body photography may be applied for assessing skin lesions in patients with CM in a more precise way [ 105 ]. Moreover, new diagnostic tools, such as reflectance confocal microscopy and two-photon fluorescence lifetime imaging, may become useful in children in whom non-invasive procedures are of major importance [ 106 , 107 ].…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Diffuse Cutaneous Mastocytosis: A Current Understanding of a Rare Disease

Rydz,

Lange,

Ługowska-Umer

et al. 2024

IJMS

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Mastocytosis is a heterogeneous disease characterized by the expansion and accumulation of neoplastic mast cells in various tissues. Diffuse cutaneous mastocytosis (DCM) is a rare and most severe form of cutaneous mastocytosis, which typically occurs in childhood. There have been reports of a familial DCM with specific gene mutations, indicating both sporadic and hereditary factors involved in its pathogenesis. DCM is associated with severe MC mediator-related symptoms and an increased risk of anaphylaxis. The diagnosis is based on the appearance of skin lesions, which typically show generalized thickening, erythroderma, blistering dermographism, and a positive Darier’s sign. Recognition, particularly in infants, is challenging due to DCMs resemblance to other bullous skin disorders. Therefore, in unclear cases, a skin biopsy is crucial. Treatment focuses on symptom management, mainly including antihistamines and mast cell stabilizers. In extremely severe cases, systemic steroids, tyrosine kinase inhibitors, phototherapy, or omalizumab may be considered. Patients should be equipped with an adrenaline autoinjector. Herein, we conducted a comprehensive review of literature data on DCM since 1962, which could help to better understand both the management and prognosis of DCM, which depends on the severity of skin lesions, intensity of mediator-related symptoms, presence of anaphylaxis, and treatment response.

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Reflectance confocal microscopy as a diagnostic tool for mastocytoma in children

Cited by 4 publications

References 6 publications

Reflectance confocal microscopy in pediatric dermatology: A state‐of‐the‐art review

Reflectance confocal microscopy in pediatric dermatology: A state‐of‐the‐art review

Reflectance confocal microscopy in paediatric patients: Applications and limits

Diffuse Cutaneous Mastocytosis: A Current Understanding of a Rare Disease

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