TY - JOUR
T1 - Reflectance confocal microscopy of facial neoplasms
T2 - Follicular involvement as a clue to diagnosis
AU - Shahriari, Neda
AU - Grant-Kels, Jane M.
AU - Rabinovitz, Harold
AU - Oliviero, Margaret
AU - Scope, Alon
N1 - Publisher Copyright:
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2023/2
Y1 - 2023/2
N2 - Background: Facial skin is characterized by high density of follicles. Facial neoplasms may present overlapping clinical and dermoscopic findings. Our goal was to evaluate and compare, via reflectance confocal microscopy (RCM), follicular involvement in facial neoplasms. Methods: We retrospectively searched our image database, between January 2008 and December 2020, for all facial lesions with (1) a standardized set of clinical, dermoscopic, and RCM images, and (2) a biopsy-proven diagnosis of lentigo maligna/lentigo maligna melanoma (LM/LMM, n = 39), basal cell carcinoma (BCC, n = 51), squamous cell carcinoma in situ (SCCIS, n = 5), actinic keratosis (AK, n = 11), and lichen-planus-like keratosis (LPLK, n = 18). Two readers jointly evaluated the RCM images for a set of predefined features of follicular involvement. Results: Diffuse obliteration of follicles was frequent in BCC (88%), while follicular infiltration by refractile dendritic cells and/or by bright round nucleated cells was common in melanoma (90% and 44%, respectively). Extension of atypical keratinocytes down follicles was more prominent among SCCIS than AK (80% vs. 45%, p = 0.01). In most LPLK (89%), there was follicular sparing. Conclusions: Evaluation of RCM criteria centering on the follicles can be useful in the differential diagnosis between common facial neoplasms.
AB - Background: Facial skin is characterized by high density of follicles. Facial neoplasms may present overlapping clinical and dermoscopic findings. Our goal was to evaluate and compare, via reflectance confocal microscopy (RCM), follicular involvement in facial neoplasms. Methods: We retrospectively searched our image database, between January 2008 and December 2020, for all facial lesions with (1) a standardized set of clinical, dermoscopic, and RCM images, and (2) a biopsy-proven diagnosis of lentigo maligna/lentigo maligna melanoma (LM/LMM, n = 39), basal cell carcinoma (BCC, n = 51), squamous cell carcinoma in situ (SCCIS, n = 5), actinic keratosis (AK, n = 11), and lichen-planus-like keratosis (LPLK, n = 18). Two readers jointly evaluated the RCM images for a set of predefined features of follicular involvement. Results: Diffuse obliteration of follicles was frequent in BCC (88%), while follicular infiltration by refractile dendritic cells and/or by bright round nucleated cells was common in melanoma (90% and 44%, respectively). Extension of atypical keratinocytes down follicles was more prominent among SCCIS than AK (80% vs. 45%, p = 0.01). In most LPLK (89%), there was follicular sparing. Conclusions: Evaluation of RCM criteria centering on the follicles can be useful in the differential diagnosis between common facial neoplasms.
KW - AK
KW - BCC
KW - LPLK
KW - SCC
KW - clinicopathology correlation
KW - dermoscopy
KW - facial neoplasms
KW - hair follicle
KW - melanoma
KW - reflectance confocal microscopy
UR - http://www.scopus.com/inward/record.url?scp=85142459183&partnerID=8YFLogxK
U2 - 10.1111/cup.14353
DO - 10.1111/cup.14353
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C2 - 36321579
AN - SCOPUS:85142459183
SN - 0303-6987
VL - 50
SP - 178
EP - 184
JO - Journal of Cutaneous Pathology
JF - Journal of Cutaneous Pathology
IS - 2
ER -