Reflectance confocal microscopy is a useful non‐invasive tool in the <i>in vivo</i> diagnosis of pigmented basal cell carcinoma in <scp>A</scp>sians

Chuah, Sai Yee; Tee, Shang Ian; Tan, Wee Ping; Lee, Siong See Joyce; Ng, See Ket; Chua, Sze Hon; Thng, Tien Guan Steven

doi:10.1111/ajd.12401

Cited by 7 publications

(10 citation statements)

References 16 publications

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“…RCM is a rapidly developing optical microscope, which exhibits different expressions in different degree of brightness through different refractive indexes of different tissues or cells, thus forming in vivo three‐dimensional imaging, and making it possible to observe cell morphology and arrangement directly 7 . It is in good agreement with histopathology.…”

Section: Discussionmentioning

confidence: 99%

“…It is in good agreement with histopathology. It has been used to evaluate a variety of skin diseases, including BCC, 7 SK, 8 melanoma, 9 psoriasis, 10 and acne 11 . Gerger et al 12 and Langley et al 13 evaluated the diagnostic ability of RCM in melanoma tumors, verified the applicability of RCM in differential diagnosis of benign nevus and melanoma, and demonstrated that RCM was more sensitive than dermoscope.…”

Section: Discussionmentioning

confidence: 99%

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Application and challenge of reflectance confocal microscopy in the diagnosis of pigmented nevus

Tang

Huang

et al. 2020

Skin Research and Technology

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Pigmented nevus is a benign tumor composed of nests of melanocytes. From infants to the elderly, almost everyone has it. It can grow in any part of normal people. Based on different locations of melanocytes in the skin, pigmented nevus can be classified into junctional nevus, compound nevus, and intradermal nevus. Some grow on the head and face or the limbs which affect the appearance, while some grow in such friction-prone parts as the palm, sole, neck or back. If the pigmented nevus increases significantly in a short period of time, or leads to itching, burning, inflammation, bleeding, ulceration, etc, it indicates the nevus has a certain tendency for deterioration or may have turned canceration. Clinically, it should be distinguished from many other diseases such as seborrheic keratosis (SK), warts, basal cell carcinoma (BCC), and malignant melanoma (MM), 1 and its diagnosis is usually based on histological examination of skin biopsy. Reflectance confocal microscopy (RCM) is a new non-invasive method based on optical confocal principle with advantages of in situ, in vivo, non-invasive, dynamic, etc. 2 Some studies have described the characteristics of RCM images of pigmented nevus. It usually shows a clear and symmetrical border of the lesion, regular arrangement of the

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Application and challenge of reflectance confocal microscopy in the diagnosis of pigmented nevus

Tang

Huang

et al. 2020

Skin Research and Technology

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“…While the diagnostic accuracy will vary with assessor capabilities, RCM is a useful tool when it is challenging to examine pigmented lesions with a dermatoscope. RCM is a helpful add-on to dermoscopy to increase the diagnostic sensitivity and aid in the clinical decision making around referring to surgery and it allows clinicians to avoid biopsying lesions unnecessarily ( 74 – 76 ).…”

Section: Ir-based Imaging Modalitiesmentioning

confidence: 99%

Ultrasound and Infrared-Based Imaging Modalities for Diagnosis and Management of Cutaneous Diseases

et al. 2018

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Non-invasive bedside imaging tools are becoming more prevalent for assessing cutaneous lesions. Ultrasound used at specific frequencies allows us to assess margins of lesions to minimize the extent of the biopsy that is performed and improve cosmetic outcomes. Vascularity, seen on Doppler ultrasound and contrast-enhanced ultrasound, and stiffness, assessed on tissue elastography, can help differentiate between benign and malignant lesions for clinicians to be more judicious in deciding whether to biopsy. Moreover, research has shown the efficacy in using ultrasound in monitoring flares of hidradenitis suppurativa, a disease affecting apocrine gland-rich areas of the body, for which the current gold standard involves examining and scoring inflammatory lesions with the naked eye. Infrared-based modalities have also been on the uptrend to aid in clinical decision-making regarding suspiciousness of lesions. Reflectance confocal microscopy has lateral resolution that is comparable to histopathology and it has been shown to be an appropriate adjunctive tool to dermoscopy, specifically when evaluating melanomas. Optical coherence tomography has utility in determining lesion thickness because of its depth penetration, and spectrophotometric intracutaneous analysis is becoming more popular as a tool that can be used by general practitioners to know when to refer to dermatology regarding worrisome pigmented lesions. Strides have been made to incorporate electrical impedance spectroscopy alongside dermoscopy in decision-making regarding excision, although the evidence for its use in the clincial setting remains inconclusive. This paper reviews the efficacy and drawbacks of these techniques in the field of dermatology and suggests future directions.

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“…Modern optical imaging modalities such as wide-field fluorescence imaging 9 , confocal microscopy 10 , optical coherence tomography (OCT) 11–13 , polarization-sensitive OCT 14,15 , OCT-based angiography (OCA) 16,17 and photoacoustic imaging 18 and their combinations 19,20 offer new possibilities for detection and visualization of human skin tumor structure and microvascular network in real time. OCT is particularly promising as it offers non-invasive structural and functional 3D imaging of biological tissues with high spatial resolution 11 , in particular for BCC 9,13,21 .…”

Section: Introductionmentioning

confidence: 99%

Optical coherence angiography for pre-treatment assessment and treatment monitoring following photodynamic therapy: a basal cell carcinoma patient study

Gubarkova

Feldchtein

Zagaynova

et al. 2019

Sci Rep

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Microvascular networks of human basal cell carcinomas (Bcc) and surrounding skin were assessed with optical coherence angiography (ocA) in conjunction with photodynamic therapy (pDt). ocA images were collected and analyzed in 31 lesions pre-treatment, and immediately/24 hours/3-12 months posttreatment. Pre-treatment OCA enabled differentiation between prevalent subtypes of BCC (nodular and superficial) and nodular-with-necrotic-core BCC subtypes with a diagnostic accuracy of 78%; this can facilitate more accurate biopsy reducing sampling error and better therapy regimen selection. Post-treatment OCA images at 24 hours were 98% predictive of eventual outcome. Additional findings highlight the importance of pre-treatment necrotic core, vascular metrics associated with hypertrophic scar formation, and early microvascular changes necessary in both tumorous and peri-tumorous regions to ensure treatment success. Basal cell carcinoma (BCC) is the most common slow-growing locally invasive malignant epidermal skin tumor, with majority of the lesions localized on the head and neck 1. There are many different classification schemes for the BCC types and subtypes including nodular, superficial, infundibulocystic, fibroepithelial and the aggressive growth variants such as infiltrative, micronodular and morpheaform (sclerosing) plus some combinations 2,3. BCC treatment management starts with accurate diagnosis, including histopathology 4,5 and the development of reliable and non-invasive techniques for its diagnosis is crucial. Currently such non-invasive technologies have limited reliability and more development and validation work is needed 6. Dermatoscopy is a useful tool in the preoperative prediction of the BCC subtype 7. However, the evidence of its clinical diagnostic efficacy is somewhat limited and in ambiguous lesions, the BCC subtype has to be assessed histopathologically 8. Modern optical imaging modalities such as wide-field fluorescence imaging 9 , confocal microscopy 10 , optical coherence tomography (OCT) 11-13 , polarization-sensitive OCT 14,15 , OCT-based angiography (OCA) 16,17 and photoacoustic imaging 18 and their combinations 19,20 offer new possibilities for detection and visualization of human skin tumor structure and microvascular network in real time. OCT is particularly promising as it offers non-invasive structural and functional 3D imaging of biological tissues with high spatial resolution 11 , in particular for BCC 9,13,21. For the first time in this study, we used spectral domain OCT/OCA system to assess the after-treatment effects following photodynamic therapy (PDT) in patients with different BCC subtypes. PDT involves administration of photosensitizes which preferentially accumulate in malignant tissues, followed by local light activation at appropriate wavelength, producing oxygen free radicals and singlet oxygen 22. The generation of these reactive oxygen species subsequently causes tumor cell death by apoptosis, necrosis

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Reflectance confocal microscopy is a useful non‐invasive tool in the in vivo diagnosis of pigmented basal cell carcinoma in Asians

Cited by 7 publications

References 16 publications

Application and challenge of reflectance confocal microscopy in the diagnosis of pigmented nevus

Application and challenge of reflectance confocal microscopy in the diagnosis of pigmented nevus

Ultrasound and Infrared-Based Imaging Modalities for Diagnosis and Management of Cutaneous Diseases

Optical coherence angiography for pre-treatment assessment and treatment monitoring following photodynamic therapy: a basal cell carcinoma patient study

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