The value of reflectance confocal microscopy in diagnosis of flat pigmented facial lesions: a prospective study

Wurm, Elisabeth M. T.; Pellacani, Giovanni; Longo, Caterina; Soyer, H. Peter; González, Salvador; Hofmann‐Wellenhof, Rainer; Ahlgrimm‐Siess, Verena; Guitera, Pascale; Sinz, Christoph; Kittler, Harald

doi:10.1111/jdv.14171

Cited by 25 publications

(46 citation statements)

References 32 publications

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“…RCM has been associated with improved diagnostic accuracy compared to dermoscopy alone of melanocytic lesions compared to NMSNs, although dendritic cells were reported also in PAK . Nascimento et al suggested that “dendritic cells sparing the area surrounding the follicular openings” associated with “atypical honeycomb pattern” are characteristic features for PAK, whereas De Carvalho et al described folliculotropism as suggestive for LM/LMM.…”

Section: Discussionmentioning

confidence: 99%

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Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy

Persechino

Carvalho

Ciardo

et al. 2018

Experimental Dermatology

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Pigmented facial macules are common on sun damage skin. The diagnosis of early stage lentigo maligna (LM) and lentigo maligna melanoma (LMM) is challenging. Reflectance confocal microscopy (RCM) has been proven to increase diagnostic accuracy of facial lesions. A total of 154 pigmented facial macules, retrospectively collected, were evaluated for the presence of already‐described RCM features and new parameters depicting aspects of the follicle. Melanocytic nests, roundish pagetoid cells, follicular infiltration, bulgings from the follicles and many bright dendrites and infiltration of the hair follicle (ie, folliculotropism) were found to be indicative of LM/LMM compared to non‐melanocytic skin neoplasms (NMSNs), with an overall sensitivity of 96% and specificity of 83%. Concerning NMSNs, solar lentigo and lichen planus‐like keratosis resulted better distinguishable from LM/LMM because usually lacking malignant features and presenting characteristic diagnostic parameters, such as epidermal cobblestone pattern and polycyclic papillary contours. On the other hand, distinction of pigmented actinic keratosis (PAK) resulted more difficult, and needing evaluation of hair follicle infiltration and bulging structures, due to the frequent observation of few bright dendrites in the epidermis, but predominantly not infiltrating the hair follicle (estimated specificity for PAK 53%). A detailed evaluation of the components of the folliculotropism may help to improve the diagnostic accuracy. The classification of the type, distribution and amount of cells, and the presence of bulging around the follicles seem to represent important tools for the differentiation between PAK and LM/LMM at RCM analysis.

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Section: Discussionmentioning

confidence: 99%

“…Reflectance confocal microscopy (RCM) is a novel noninvasive imaging technique, which provides horizontal sections of the skin with a high cellular resolution and has proved to enhance the diagnostic accuracy of LM/LMM compared to dermoscopy evaluation alone …”

Section: Introductionmentioning

confidence: 99%

Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy

Persechino

Carvalho

Ciardo

et al. 2018

Experimental Dermatology

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“…RCM provides the capability for direct, noninvasive, serial optical sectioning of intact tissue at a cellular resolution that is comparable to that of pathology . RCM has become established as a practical diagnostic tool for the noninvasive evaluation of skin diseases while minimizing unnecessary skin biopsies .…”

Section: Discussionmentioning

confidence: 99%

“…Because of the strong contrast provided by melanin and the features of optical sections, an increasing number of dermatologists are exploring the diagnostic accuracy of equivocal melanocytic skin lesions and melanoma to obtain important additional diagnostic information . As an effective diagnostic technique for pigmentation at a clinical level, RCM addresses this dilemma well . However, there are few systematic descriptions of RCM features of facial hyperpigmented dermatoses.…”

Section: Introductionmentioning

confidence: 99%

In vivo reflectance confocal microscopy for evaluating common facial hyperpigmentation

Zeng

Qiu

Xiang

2019

Skin Research and Technology

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Background In clinical settings, atypical facial hyperpigmentation such as nevus of Ota, acquired bilateral nevus of Ota‐like macules (ABNOM), melasma, and café‐au‐lait spots are often missed and misdiagnosed. Summarizing in vivo reflectance confocal microscopy (RCM) features of the hyperpigmentation is helpful in the diagnosis of ambiguous lesions. Methods We recruited 196 patients referred for unequivocal facial hyperpigmentation, including 55 patients with nevus of Ota, 45 patients with ABNOM, 62 patients with melasma, and 34 patients with café‐au‐lait spots. The RCM images were evaluated at the epidermis, the dermis‐epidermis junction (DEJ), and the upper papillary dermis from both hyperpigmented patches and normal skin. Results In the superficial and middle dermis, 41 of 55 patients (74.5%) with nevus of Ota were characterized by a cord‐like or lumpy structure between the collagen fibers. And there was no melanin deposition detected in the dermis in 14 of 55 (25.5%) patients. In ABNOM, 37 of 45 (82.2%) patients were characterized by a cord‐like or lumpy structure in the superficial dermis and 8 of 45 patients (17.8%) was no melanin deposition detected in the dermis. The epidermis was no difference between nevus of Ota, ABNOM, and the normal skin. Melasma was detected increased cobblestone pattern in the epidermis of all patients, branching architecture in 21 of 62 patients (33.9%), and focally aggregated round to triangular cells in the upper dermis of 18 of 62 patients (29.0%). In all patients with afé‐au‐lait spots, increased cobblestone pattern in the epidermis and regular and increased density of ringed pattern in the DEJ were visualized. Conclusions Our findings indicate that RCM may be useful in the auxiliary diagnosis of nevus of Ota, ABNOM, melasma, and café‐au‐lait spots.

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“…The enterprise flat management mode is based on the enterprise's practical situation to remove the unnecessary management level existing in the pyramid management mode, which aims to improve the administrative efficiency by enlarging span of control, braking the boundaries between different departments and concentrating efforts to solve difficulties [12]. Based on the aforementioned flat management mode concept, the enterprise flat management "five targets" mode is presented in this study, based on which the enterprise manager level can enlarge the span of control, decrease the manage steps and plan the enterprise sources to achieve the rapid and efficient management mode.…”

Section: Enterprise Flat Management Modementioning

confidence: 99%

Research on Enterprise Flat Management Mode under the Network Economy circumstance

Zhao¹

2017

Proceedings of the 2017 9th International Economics, Management and Education Technology Conference (IEMETC 2017)

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Abstract. With the continuous improvement of the network environmental circumstance, the enterprise is expected to exchange the information rapidly and effectively. Based on this actual background, the enterprise flat mode has been researched in this study, to replace the traditional pyramid management mode. As referred to the definition of the enterprise flat mode, the "five targets" mode is presented in this study, based on which the enterprise manager level can enlarge the span of control, decrease the manage steps and plan the enterprise sources to achieve the rapid and efficient management.

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The value of reflectance confocal microscopy in diagnosis of flat pigmented facial lesions: a prospective study

Cited by 25 publications

References 32 publications

Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy

Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy

In vivo reflectance confocal microscopy for evaluating common facial hyperpigmentation

Research on Enterprise Flat Management Mode under the Network Economy circumstance

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