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

Muzumdar, Sonal; Wu, Rong; Rothe, Marti Jill; Grant‐Kels, Jane M.

doi:10.1016/j.jaad.2021.01.071

Journal of the American Academy of Dermatology

2022

DOI: 10.1016/j.jaad.2021.01.071

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

Sonal Muzumdar

Rong Wu

Marti Jill Rothe

et al.

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Cited by 7 publications

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“…6 RCM as an adjunct with biopsies has preliminarily shown to be costeffective, effectively decreasing 48% of healthcare costs at a single institution when compared to the cost of biopsying 529 lesions altogether. 7…”

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

Smidt

Durkin

2021

Pediatric Dermatology

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Cutaneous Imaging Techniques

Khattab,

Hijaz,

Semenov

2024

Hematology/Oncology Clinics of North America

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Trends in utilization of reflectance confocal microscopy in the United States, 2017-2019

Gronbeck

Grant‐Kels

Alessi‐Fox

et al. 2022

Journal of the American Academy of Dermatology

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

Cited by 7 publications

References 5 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

Cutaneous Imaging Techniques

Trends in utilization of reflectance confocal microscopy in the United States, 2017-2019

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