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Reflectance confocal microscopic evaluation of nonmelanocytic lip lesions

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Abstract

Lips display various benign and malignant lesions. Considering their functional and cosmetic importance, noninvasive diagnostic methods are required. In vivo reflectance confocal microscopy (RCM) has already been reported to be useful in the evaluation of various skin lesions. The aim of this study was to define the RCM features of nonmelanocytic lip lesions, compare them with healthy lip, and demonstrate the applicability of RCM as a noninvasive diagnostic method for nonmelanocytic lip lesions. Sixty-seven patients with premalignant/malignant, inflammatory, and infectious lip lesions and twenty-one healthy volunteers were included in the study. Following clinical and RCM examination, histopathological confirmation was obtained in all lesions except herpes labialis, verrucae, and aphthae. RCM features of individual lesions and corresponding groups were evaluated and compared. Pleomorphism was the common feature of premalignant/malignant lesions. Dermal invasion of dyskeratotic keratinocytes was visualized in all squamous cell carcinoma lesions. Spongiosis and inflammatory cells were the common features of inflammatory lesions. Hypergranulosis and necrotic keratinocytes were highly specific for lichen planus. The most specific features for discoid lupus erythematosus were irregular pattern, follicular plugs, and perifollicular inflammatory cells. Virus-infected keratinocytes were visualized in herpes and verrucae. RCM features showed high sensitivity and specificity to detect nonmelanocytic lip lesions. Although the penetration is limited to the papillary dermis in nonmucosal skin, imaging down to the mid-dermis with satisfactory resolution was possible on the lips.

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Abbreviations

AC:

Actinic cheilitis

DEJ:

Dermal-epidermal junction

DLE:

Discoid lupus erythematosus

LP:

Lichen planus

RCM:

Reflectance confocal microscopy

SCC:

Squamous cell carcinoma

SG:

Stratum granulosum

SS:

Stratum spinosum

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Authors and Affiliations

  1. Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany

    Işın Sinem Bağcı

  2. Department of Dermatology, Ankara 29 Mayıs Government Hospital, Ankara, Turkey

    Işın Sinem Bağcı

  3. Department of Dermatology, İstanbul Medeniyet University, İstanbul, Turkey

    Mehmet Salih Gürel

  4. Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey

    Ayşe Esra Koku Aksu & Aslı Turgut Erdemir

  5. Department of Dermatology, Diyarbakır Training and Research Hospital, Diyarbakır, Turkey

    Esma İnan Yüksel

  6. Department of Dermatology, Süleymaniye Gynecology and Maternity Training and Research Hospital, İstanbul, Turkey

    Yeliz Karakoca Başaran

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  1. Işın Sinem Bağcı
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  2. Mehmet Salih Gürel
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  3. Ayşe Esra Koku Aksu
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Correspondence to Işın Sinem Bağcı.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Bağcı, I.S., Gürel, M.S., Aksu, A.E.K. et al. Reflectance confocal microscopic evaluation of nonmelanocytic lip lesions. Lasers Med Sci 32, 1497–1506 (2017). https://doi.org/10.1007/s10103-017-2270-2

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  • DOI: https://doi.org/10.1007/s10103-017-2270-2

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