TY - JOUR
T1 - The significance of reflectance confocal microscopy in the assessment of solitary pink skin lesions
AU - Braga, Juliana Casagrande Tavoloni
AU - Scope, Alon
AU - Klaz, Itay
AU - Mecca, Patricia
AU - González, Salvador
AU - Rabinovitz, Harold
AU - Marghoob, Ashfaq A.
N1 - Funding Information:
Disclosure: Dr Rabinovitz is an investigator in a study coordinated by Lucid Inc, manufacturer of a commercial confocal microscope. He has received funding for a fellowship program and equipment from Lucid Inc. He is also a consultant and has received equipment from 3-Gen, manufacturer of a polarized dermatoscope. Drs Casagrande Tavoloni Braga, Scope, Klaz, Mecca, González, and Marghoob have no conflicts of interest to declare.
PY - 2009/8
Y1 - 2009/8
N2 - Background: Solitary pink lesions often manifest nondescript clinical and dermatoscopic primary morphologic features. The differential diagnosis for pink lesions tends, therefore, to be broad, ranging from inflammatory processes to malignancy. In vivo reflectance confocal microscopy (RCM) may help in the evaluation of pink lesions. Objective: We sought to demonstrate the use of RCM as an adjunct to the bedside diagnosis of pink lesions. Methods: We describe a series of patients with clinically and dermatoscopically equivocal pink lesions for which RCM examination allowed for a rapid and accurate diagnosis. All lesions were excised for histopathologic evaluation. Integrating the findings in the case series with a literature review, we present RCM diagnostic criteria for pink lesions. Results: Lesions included basal cell carcinoma, squamous cell carcinoma, amelanotic melanoma, and inflamed seborrheic keratosis. RCM shows distinctive findings for each diagnostic entity when stratified by anatomic level into suprabasal epidermis, dermoepidermal junction, and papillary dermis. In the cases presented RCM allowed for a rapid and accurate noninvasive diagnosis. Limitations: The study is descriptive and does not test accuracy of RCM criteria in a prospective series of pink lesions. Conclusion: RCM may add useful diagnostic features to the clinical evaluation of solitary pink lesions.
AB - Background: Solitary pink lesions often manifest nondescript clinical and dermatoscopic primary morphologic features. The differential diagnosis for pink lesions tends, therefore, to be broad, ranging from inflammatory processes to malignancy. In vivo reflectance confocal microscopy (RCM) may help in the evaluation of pink lesions. Objective: We sought to demonstrate the use of RCM as an adjunct to the bedside diagnosis of pink lesions. Methods: We describe a series of patients with clinically and dermatoscopically equivocal pink lesions for which RCM examination allowed for a rapid and accurate diagnosis. All lesions were excised for histopathologic evaluation. Integrating the findings in the case series with a literature review, we present RCM diagnostic criteria for pink lesions. Results: Lesions included basal cell carcinoma, squamous cell carcinoma, amelanotic melanoma, and inflamed seborrheic keratosis. RCM shows distinctive findings for each diagnostic entity when stratified by anatomic level into suprabasal epidermis, dermoepidermal junction, and papillary dermis. In the cases presented RCM allowed for a rapid and accurate noninvasive diagnosis. Limitations: The study is descriptive and does not test accuracy of RCM criteria in a prospective series of pink lesions. Conclusion: RCM may add useful diagnostic features to the clinical evaluation of solitary pink lesions.
KW - basal cell carcinoma
KW - melanoma
KW - reflectance confocal microscopy
KW - seborrheic keratosis
KW - squamous cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=67650145256&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2009.02.036
DO - 10.1016/j.jaad.2009.02.036
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C2 - 19398144
AN - SCOPUS:67650145256
SN - 0190-9622
VL - 61
SP - 230
EP - 241
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 2
ER -