The use of in vivo reflectance confocal microscopy for the diagnosis of melanoma

ABSTRACT

Introduction: The use of reflectance confocal microscopy (RCM) for imaging the skin non-invasively raised constantly during the last decade. One of the main field of application is skin cancer diagnosis, and in particular melanoma diagnosis. Several studies have investigated the diagnostic accuracy of RCM as compared to dermoscopic examination, and its value in enhancing early diagnosis of dermoscopic difficult melanomas.

Areas covered: The purpose of this paper was to review the principles behind RCM image acquisition as well as to describe and discuss key RCM features of melanoma. Moreover, we conducted a literature search in order to highlight the current available evidence about RCM sensitivity and specificity in the diagnosis of melanoma.

Expert commentary: During the last decade, we assisted at the increasing interest in non invasive imaging tools for the diagnosis of skin cancer. RCM is one of the most studied of a series of diagnostic methods that are emerging in the field of melanoma imaging. Most probably in the future, RCM will be more frequently available in tertiary referral centres, thus the knowledge of the pros and contra of the tool and its clinical applicability is of upmost importance in order to allow correct referrals with the final aim of improving diagnostic accuracy.

KEYWORDS:

• Melanoma
• Reflectance Confocal Microscopy
• non-invasive diagnosis
• skin tumors
• nevi
• dermoscopy

Article highlights

• RCM is a non-invasive imaging technique useful for ‘in vivo’ evaluation of the skin from the epidermis to the upper dermis.

• RCM enables the ‘real-time’ evaluation of both the architectural and the cytological features of melanoma.

• The majority of RCM features for diagnosing melanoma are standardized and reproducible and correlate with dermoscopic features and histopathological substrate.

• RCM provided to be effective, increasing the early diagnosis of melanoma.

On RCM examination, melanoma subtypes (SSM, LM, NM, MM) exhibit specific features.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.