Abstract
In vivo reflectance confocal microscopy is a novel technique which enables the visualization of the skin at quasi-histologic resolution up to the papillary dermis. Since the melanin and small organelles are a strong source of contrast, this technique revealed to be useful in skin cancer diagnosis. Through confocal microscopy it is possible to in vivo visualize the architecture and the cytology of a skin tumor. In melanocytic lesion, it is possible to detect aggregates of melanocytes at the junction and in superficial dermis and to distinguish between a regular benign proliferation and malignant cells in the epidermis and superficial dermis. It is also useful for the diagnosis of epithelial tumors, such as basal cell carcinoma and squamous cell carcinoma, and in the identification of benign epithelial proliferation, like seborrheic keratosis and solar lentigo.
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- AK:
-
Actinic keratosis
- BCC:
-
Basal cell carcinoma
- LPLK:
-
Lichen planus-like keratosis
- RCM:
-
In vivo reflectance confocal microscopy
- SCC:
-
Squamous cell carcinoma
References
Rajadhyaksha M, Grossman M, Esterowitz D, Webb RH, Anderson RR (1995) In vivo confocal scanning laser microscopy of human skin: melanin provides strong contrast. J Invest Dermatol 104:946–952
Rajadhyaksha M, Gonzalez S, Zavislan JM, Anderson RR, Web RH (1999) In vivo confocal laser microscopy of human skin II: advances in instrumentation and comparison with histology. J Invest Dermatol 113:293–303
Scope A, Benvenuto-Andrade C, Agero AL, Malvehy J, Puig S, Rajadhyaksha M, Busam KJ, Marra DE, Torres A, Propperova I, Langley RG, Marghoob AA, Pellacani G, Seidenari S, Halpern AC, Gonzalez S (2007) In vivo reflectance confocal microscopy imaging of melanocytic skin lesions: consensus terminology glossary and illustrative images. J Am Acad Dermatol 57:644–658
Ahlgrimm-Siess V, Massone C, Koller S, Fink-Puches R, Richtig E, Wolf I, Gerger A, Hofmann-Wellenhof R (2008) In vivo confocal scanning laser microscopy of common naevi with globular, homogeneous and reticular pattern in dermoscopy. Br J Dermatol 158(5):1000–1007
Pellacani G, Scope A, Ferrari B, Pupelli G, Bassoli S, Longo C, Cesinaro AM, Argenziano G, Hofmann-Wellenhof R, Malvehy J, Marghoob AA, Puig S, Seidenari S, Soyer HP, Zalaudek I (2009) New insights into nevogenesis: in vivo characterization and follow-up of melanocytic nevi by reflectance confocal microscopy. J Am Acad Dermatol 61(6):1001–1013
Pellacani G, Longo C, Malvehy J, Puig S, Carrera C, Segura S, Bassoli S, Seidenari S (2008) In vivo confocal microscopic and histopathologic correlations of dermoscopic features in 202 melanocytic lesions. Arch Dermatol 144(12):1597–1608
Pellacani G, Farnetani F, Gonzalez S, Longo C, Cesinaro AM, Casari A, Beretti F, Seidenari S, Gill M (2012) In vivo confocal microscopy for detection and grading of dysplastic nevi: a pilot study. J Am Acad Dermatol 66(3):e109–e121
Pellacani G, Longo C, Ferrara G, Cesinaro AM, Bassoli S, Guitera P, Menzies SW, Seidenari S (2009) Spitz nevi: in vivo confocal microscopic features, dermatoscopic aspects, histopathologic correlates, and diagnostic significance. J Am Acad Dermatol 60(2):236–247
Gerger A, Koller S, Weger W, Richtig E, Kerl H, Samonigg H, Krippl P, Smolle J (2006) Sensitivity and specificity of confocal laser-scanning microscopy for in vivo diagnosis of malignant skin tumors. Cancer 107:193–200
Pellacani G, Guitera P, Longo C, Avramidis M, Seidenari S, Menzies S (2007) The impact of in vivo reflectance confocal microscopy for the diagnostic accuracy of melanoma and equivocal melanocytic lesions. J Invest Dermatol 127:2759–2765
Pellacani G, Cesinaro AM, Seidenari S (2005) Reflectance-mode confocal microscopy for the in vivo characterization of pagetoid melanocytosis in melanomas and nevi. J Invest Dermatol 125:532–537
Guitera P, Pellacani G, Crotty KA, Scolyer RA, Li LX, Bassoli S, Vinceti M, Rabinovitz H, Longo C, Menzies SW (2010) The impact of in vivo reflectance confocal microscopy on the diagnostic accuracy of lentigo maligna and equivocal pigmented and nonpigmented macules of the face. J Invest Dermatol 130(8):2080–2091
Longo C, Rito C, Beretti F, Cesinaro AM, Piñeiro-Maceira J, Seidenari S, Pellacani G (2011) De novo melanoma and melanoma arising from pre-existing nevus: in vivo morphologic differences as evaluated by confocal microscopy. J Am Acad Dermatol 65(3):604–614
Segura S, Pellacani G, Puig S, Longo C, Bassoli S, Guitera P, Palou J, Menzies S, Seidenari S, Malvehy J (2008) In vivo microscopic features of nodular melanomas: dermoscopy, confocal microscopy, and histopathologic correlates. Arch Dermatol 144(10):1311–1320
Pellacani G, Cesinaro AM, Seidenari S (2005) In vivo confocal reflectance microscopy for the characterization of melanocytic nests and correlation with dermoscopy and histology. Br J Dermatol 152:384–386
Langley RG, Burton E, Walsh N, Propperova I, Murray SJ (2006) In vivo confocal scanning laser microscopy of benign lentigines: comparison to conventional histology and in vivo characteristics of lentigo maligna. J Am Acad Dermatol 55:88–97
Bassoli S, Rabinovitz HS, Pellacani G, Porges L, Oliviero MC, Braun RP, Marghoob AA, Seidenari S, Scope A (2012) Reflectance confocal microscopy criteria of lichen planus-like keratosis. J Eur Acad Dermatol Venereol 26(5):578–590
Moscarella E, Zalaudek I, Pellacani G, Eibenschutz L, Catricalà C, Amantea A, Panetta C, Argenziano G (2011) Lichenoid keratosis-like melanomas. J Am Acad Dermatol 65(3):e85–e87
Nori S, Rius-Díaz F, Cuevas J, Goldgeier M, Jaen P, Torres A, González S (2004) Sensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma: a multicenter study. J Am Acad Dermatol 51:923–930
Agero AL, Busam KJ, Benvenuto-Andrade C, Scope A, Gill M, Marghoob AA, González S, Halpern AC (2006) Reflectance confocal microscopy of pigmented basal cell carcinoma. J Am Acad Dermatol 54:638–643
Ulrich M, Roewert-Huber J, González S, Rius-Diaz F, Stockfleth E, Kanitakis J (2011) Peritumoral clefting in basal cell carcinoma: correlation of in vivo reflectance confocal microscopy and routine histology. J Cutan Pathol 38(2):190–195
Ulrich M, Krueger-Corcoran D, Roewert-Huber J, Sterry W, Stockfleth E, Astner S (2010) Reflectance confocal microscopy for noninvasive monitoring of therapy and detection of subclinical actinic keratoses. Dermatology 220(1):15–24
Rishpon A, Kim N, Scope A, Porges L, Oliviero MC, Braun RP, Marghoob AA, Fox CA, Rabinovitz HS (2009) Reflectance confocal microscopy criteria for squamous cell carcinomas and actinic keratoses. Arch Dermatol 145(7):766–772
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Longo, C., De Pace, B., Piana, S., Pellacani, G. (2014). In Vivo Confocal Microscopy in Skin Oncology. In: Berardesca, E., Maibach, H., Wilhelm, KP. (eds) Non Invasive Diagnostic Techniques in Clinical Dermatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32109-2_6
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DOI: https://doi.org/10.1007/978-3-642-32109-2_6
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