Diagnostic Accuracy of Non-melanocytic Pink Flat Skin Lesions on the Legs: Dermoscopic and Reflectance Confocal Microscopy Evaluation

Context.— Histopathology is the current standard to diagnose skin disease. However, biopsy may not always be feasible, such as in patients with multiple nevi, a patient with a lesion on an aesthetically significant site, or in children. Recently, noninvasive techniques, including reflectance confocal microscopy (RCM), optical coherence tomography, and Raman spectroscopy, have enabled dermatologists to manage skin lesions in real time without the need for biopsy. Objective.— To report the updated diagnostic accuracy of RCM for equivocal skin lesions. Design.— In this study, we retrospectively reviewed our data of clinically suspicious lesions from 2010 to 2017 that were evaluated by RCM. Results.— Our results showed an overall sensitivity of 98.2% and specificity of 99.8%. Conclusions.— In conclusion, RCM is a noninvasive real-time tool with the potential to diagnose skin lesions with high accuracy and without biopsy.

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Melanocytic or Not? Dermoscopy and Reflectance Confocal Microscopy for Lesions Difficult to Diagnose: A Cross-Sectional Diagnostic Accuracy Study

Dermatology Practical & Conceptual ◽

10.5826/dpc.1104a127 ◽

2021 ◽

pp. e2021127

Author(s):

Camila Scharf ◽

Giuseppe Argenziano ◽

Gabriella Brancaccio ◽

Gaetano Licata ◽

Andrea Ronchi ◽

...

Keyword(s):

Differential Diagnosis ◽

Confocal Microscopy ◽

Diagnostic Accuracy ◽

High Specificity ◽

Skin Lesions ◽

Reflectance Confocal Microscopy ◽

Melanocytic Lesion ◽

Cross Sectional ◽

Present Sample ◽

Melanocytic Lesions

Background: Different techniques for non-invasive skin examination and early diagnosis of skin lesions are available nowadays, being dermoscopy and reflectance confocal microscopy (RCM) the most diffused ones. Several studies supported the complementary use of dermoscopy and RCM that improves diagnostic accuracy when dealing with melanocytic lesions. Objectives: To analyze RCM diagnostic accuracy in the differential diagnosis between melanocytic and non-melanocytic lesions. Methods: This is a cohort selected cross-sectional study conducted at the Dermatology Unit of the University of Campania L. Vanvitelli, Naples, Italy, from 2012 to 2020. We searched the image database for all excised lesions for which the clinical and dermatoscopic differential diagnosis was between melanocytic and non-melanocytic and for which an RCM examination was performed. Sensitivity, specificity, and diagnostic accuracy values were estimated. Results: The study included 53 cases that were found to have disagreement between clinical, histological and RCM diagnosis, of which, in 31 cases the differential diagnosis was melanocytic vs non-melanocytic lesion. The RCM reached a specificity of 87% (95% CI: 0.73-1) and a sensitivity of 62.5% (95% CI: 0.29-0.96) in the present sample. Diagnostic accuracy was 80.6% (95% CI: 0.67-0.94). Conclusion: RCM has a high specificity in differentiating between difficult-to-diagnose melanocytic and non-melanocytic lesions.

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Reflectance Confocal Microscopy as an Aid to Dermoscopy to Improve Diagnosis on Equivocal Lesions: Evaluation of Three Bluish Nodules

Dermatology Research and Practice ◽

10.1155/2010/168248 ◽

2010 ◽

Vol 2010 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Sara Bassoli ◽

Stefania Seidenari ◽

Giovanni Pellacani ◽

Caterina Longo ◽

Anna Maria Cesinaro

Keyword(s):

Confocal Microscopy ◽

Diagnostic Accuracy ◽

Correct Diagnosis ◽

Skin Lesions ◽

Confocal Imaging ◽

Reflectance Confocal Microscopy ◽

Diagnostic Features ◽

Nodular Lesions

Nodular lesions can be difficult to diagnose under dermoscopy alone, since they often lack specific diagnostic features. Confocal microscopy can be used as an aid to dermoscopy, to increase the diagnostic accuracy on equivocal skin lesions. We report three cases of bluish nodular lesions, difficult to diagnose under dermoscopy alone. Confocal features were very useful in these cases to lead us to the correct diagnosis, recognizing benign versus malignant entities. Histopathology is also reported, with high correspondence compared to the confocal imaging.

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