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Alon Scope - One of the best experts on this subject based on the ideXlab platform.
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Reflectance Confocal Microscopy Can Help the Dermatopathologist in the Diagnosis of Challenging Skin Lesions.
American Journal of Dermatopathology, 2019Co-Authors: Andrew Kelsey, Harold S. Rabinovitz, Jane M. Grant-kels, Margaret Oliviero, Alon ScopeAbstract:: Despite the successful assignment of Current Procedural Terminology codes, there are barriers to incorporating in vivo Reflectance Confocal Microscopy (RCM) into daily practice. Importantly, the dermatopathologist can play a key role in interpreting RCM images and can use these images to correlate with histopathology. Herein, we describe, using a case series, how RCM can be incorporated into the dermatopothalogist's practice. We also summarize the criteria for RCM diagnosis of common neoplasms.
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In vivo Reflectance Confocal Microscopy image interpretation for the dermatopathologist.
Journal of Cutaneous Pathology, 2018Co-Authors: Neda Shahriari, Jane M. Grant-kels, Harold S. Rabinovitz, Margaret Oliviero, Alon ScopeAbstract:: Reflectance Confocal Microscopy (RCM) is a technology utilized for bedside diagnosis of cutaneous pathology by non-invasive, in vivo, cellular-level imaging. With the recent establishment of reimbursement codes by the US Centers for Medicaid and Medicare Services, RCM is now likely to be employed by clinical dermatologists and impact decision making on skin cancer management. Dermatopathologists, therefore, would benefit from learning how to interpret RCM images and how RCM findings correlate with histopathological criteria of diagnosis. This review briefly explains the principles behind RCM image acquisition, describes the key RCM features of normal skin, and delineates the RCM characteristics of frequently observed benign and malignant neoplasms.
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In vivo Reflectance Confocal Microscopy features of a melanoacanthoma.
Dermatology practical & conceptual, 2016Co-Authors: Neda Shahriari, Jane M. Grant-kels, Harold S. Rabinovitz, Margaret Oliviero, Alon ScopeAbstract:: Efforts have been expended to evaluate the Reflectance Confocal Microscopy (RCM) features of different clinical entities in order to more thoroughly delineate benign versus malignant features. In this way, RCM can help clinicians to be more selective in regard to undertaking appropriate skin biopsies and improving their benign to malignant ratio. Herein, we report a case of a histopathologically proven melanoacanthoma, a variant of seborrheic keratosis. There are scarce reports describing the RCM features of melanoacanthoma. Our case demonstrated RCM features that were suspicious for melanoma. More RCM images of this benign entity are needed to establish definitive diagnostic criteria.
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In vivo Reflectance Confocal Microscopy features of a large cell acanthoma: report of a case.
Dermatology practical & conceptual, 2016Co-Authors: Neda Shahriari, Jane M. Grant-kels, Harold S. Rabinovitz, Margaret Oliviero, Alon ScopeAbstract:Reflectance Confocal Microscopy (RCM) is an FDA approved noninvasive optical imaging technique that acquires cellular level-resolution skin images in vivo. Herein, we report a case of histopathologically proven large cell acanthoma (LCA) whose RCM features simulate those of squamous cell carcinoma in situ.
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through the looking glass basics and principles of Reflectance Confocal Microscopy
Journal of The American Academy of Dermatology, 2015Co-Authors: Naiara Fragabraghiroli, Alon Scope, Harold S. Rabinovitz, Margaret Oliviero, Jane M GrantkelsAbstract:Reflectance Confocal Microscopy (RCM) offers high-resolution, noninvasive skin imaging and can help avoid obtaining unnecessary biopsy specimens. It can also increase efficiency in the surgical setting by helping to delineate tumor margins. Diagnostic criteria and several RCM algorithms have been published for the differentiation of benign and malignant neoplasms. We provide an overview of the basic principles of RCM, characteristic RCM features of normal skin and cutaneous neoplasms, and the limitations and future directions of RCM.
Salvador Gonzalez - One of the best experts on this subject based on the ideXlab platform.
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Reflectance Confocal Microscopy of Pigmented Bowen's Disease: A Case Series of Difficult to Diagnose Lesions.
Case Reports in Dermatology, 2020Co-Authors: Sara Mazzilli, Elena Campione, Monia Di Prete, Reyes Gamo-villegas, Ana Pampín‐franco, Jose Luis Lopez Estebaran, Fernando Pinedo, Laura Vollono, Salvador GonzalezAbstract:Pigmented Bowen's disease is a rare variant of in situ squamous skin cell carcinoma. It mainly affects patients between 60 and 70 years of age. Its clinical features include well-demarcated, pigmented plaque arising in photo-exposed areas of the body. The best-characterized feature of the disease by histological examination is the presence of atypical keratinocytes, hyperpigmentation of the epidermis with trans-epidermal elimination of melanin and dermal melanophages. Precise diagnosis is often difficult, both clinically and dermoscopically, as Bowen's disease is often mistaken with keratinocyte tumors such as solar lentigines, seborrheic keratosis, Bowenoid papulosis, pigmented basal cell carcinoma, pigmented actinic keratosis; or even melanocytic lesions such as melanocytic nevus, pigmented epithelioid melanocytoma, and melanoma. Precise diagnosis often requires biopsy and histopathological examination of the tissue. Reflectance Confocal Microscopy is a noninvasive technique to diagnose pigmented skin lesions. To date, not much data are available regarding its use in the diagnosis of pigmented Bowen's disease. Herein, we report a well-represented case series of pigmented Bowen's disease imaged using dermoscopy and Reflectance Confocal Microscopy.
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Lichenoid Keratosis: A Clinical Trap without Secrets for Reflectance Confocal Microscopy.
Case Reports in Dermatology, 2020Co-Authors: Sara Mazzilli, Salvador Gonzalez, Terenzio Cosio, Elena Campione, Caterina Lanna, Monia Di Prete, Virginia Velasco, Luca BianchiAbstract:: Lichenoid keratosis, also defined as benign lichenoid keratosis, was reclassified as lichen planus-like keratosis by Shapiro and Ackerman. Clinical and dermoscopic features of lichen planus-like keratosis can vary, often not providing useful and necessary information to perform an accurate diagnosis without performing a biopsy or histological examination. We describe 2 difficult to detect lichen planus-like keratosis cases in which we performed Reflectance Confocal Microscopy. We underline the usefulness of this noninvasive diagnostic tool in the unclear cases of lichen planus-like keratosis.
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In-vivo assessment of a case of cutaneous sarcoidosis using Reflectance Confocal Microscopy.
Anais Brasileiros De Dermatologia, 2019Co-Authors: Paola Pasquali, Salvador Gonzalez, Angeles Fortuño, Azael Freites-martinezAbstract:: Reflectance Confocal Microscopy (RCM) is a noninvasive imaging technique that allows visualization of the epidermis and papillary dermis with cellular-level resolution. Granulomatous reactions such as sarcoidosis could be assessed using RCM. The identification of bright beaded-like structures that could correspond to reticulin fibers overlying granulomas, in association with dermoscopy, may be a very useful approach in the diagnosis of sarcoidosis and for the differentiation of this granulomatous entity with superficial cutaneous metastasis.
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In Vivo Reflectance Confocal Microscopy in Dermatology
Imaging in Dermatology, 2016Co-Authors: I. Alarcon, Caterina Longo, Salvador GonzalezAbstract:Abstract Imaging techniques capable of noninvasive, high-resolution, skin imaging in vivo have been the focus of recent attention in the dermatology field. These efforts are directed to improve the diagnostic accuracy of skin cancer, especially cutaneous melanoma. Reflectance Confocal Microscopy (RCM) is an innovative imaging tool that allows the analysis of the skin horizontally with a nearly histological resolution. Similar to dermoscopy images, real-time images obtained by RCM are oriented horizontal to the skin surface (optical transversal sections). Melanin provides strong contrast because of its high refractive index (1.7) relative to the surrounding epidermis. It has been applied in the clinical arena for the diagnosis of melanocytic and nonmelanocytic lesions where it has been proven to increase greatly the diagnostic accuracy when coupled with dermoscopy. Beyond its application in skin oncology, Confocal Microscopy can be useful to delineate the overall aspect of inflammatory skin disease and infectious ones. The main limitation of RCM is its relatively low penetration through the dermis; a maximum depth of 250–300 μm can currently be achieved, preventing imaging of structures located in the deep dermis and hypodermis. The main challenge is the interpretation of images. Specific photographic atlas, courses, and further development of teledermatology may solve this problem.
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Reflectance Confocal Microscopy for scarring and non-scarring alopecia real-time assessment
Archives of Dermatological Research, 2016Co-Authors: Marco Ardigò, Marina Agozzino, Chiara Franceschini, Carlo Donadio, Leonardo Spagnol Abraham, Luca Barbieri, Isabella Sperduti, Enzo Berardesca, Salvador GonzalezAbstract:Clinical management of alopecia represents one of the major issues in dermatology. Scalp biopsies are not easily accepted because of the high bleeding and sensitive anatomical area. Trichoscopy is routinely used for diagnosis of alopecia, but in several cases lack to provide sufficient information on the status of the disease. Recently, Reflectance Confocal Microscopy demonstrated its usefulness for the evaluation of several inflammatory skin condition and preliminary reports about alopecia have been proposed in the literature. The aim was to identify the Confocal features characterizing scarring and non-scarring alopecia. Reflectance Confocal Microscopy from 86 patients affected by scarring (28 lichen planopilaris and 9 lupus erythematosus) and non-scarring alopecia (30 androgenic alopecia and 19 alopecia areata), were retrospectively, blinded evaluated. Good concordance between different readers on the Confocal criteria has been assessed. Statistical significant features, specific for scarring alopecia and non-scarring alopecia have been identified. In this study, data on Reflectance Confocal Microscopy features useful for the differential diagnosis between scarring and non-scarring alopecia have been identified. Further studies focusing on the use of this non-invasive technique in the therapeutic follow-up and distinction of sub-entities of alopecia are still required.
Giovanni Pellacani - One of the best experts on this subject based on the ideXlab platform.
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Reflectance Confocal Microscopy for Skin Diseases - Reflectance Confocal Microscopy for skin diseases
2020Co-Authors: Rainer Hofmann-wellenhof, Giovanni Pellacani, Joseph Malvehy, Hans Peter SoyerAbstract:This book focuses on the use and significance of in vivo Reflectance Confocal Microscopy (RCM) for non-invasive high-resolution imaging of the skin. All of the chapters in this hands-on guide are generously illustrated with numerous Confocal images and structured in a reader-friendly way. The contents include detailed information on the most relevant and up-to-date aspects of RCM, schematic drawings summarizing and explaining the most important RCM criteria, and a chapter specifically devoted to bridging the gap between dermoscopy, RCM, and histopathology. At the end of each chapter, core messages recapitulate the most pertinent aspects. Reflectance Confocal Microscopy for Skin Diseases will be a valuable resource for all physicians involved in the diagnosis and treatment of neoplastic and inflammatory skin diseases.
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Comprar Reflectance Confocal Microscopy For Skin Diseases | Rainer Hofmann-Wellenhof | 9783642219962 | Springer
2020Co-Authors: Rainer Hofmann-wellenhof, Giovanni Pellacani, Joseph Malvehy, Hans Peter SoyerAbstract:Tienda online donde Comprar Reflectance Confocal Microscopy For Skin Diseases al precio 159,55 € de Rainer Hofmann-Wellenhof | Giovanni Pellacani | Josep Malvehy | H. Peter Soyer, tienda de Libros de Medicina, Libros de Dermatologia y Venerologia - Dermatologia clinica
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Seborrheic keratoses mimicking melanoma unveiled by in vivo Reflectance Confocal Microscopy.
Skin Research and Technology, 2018Co-Authors: Claudia Pezzini, Giovanni Pellacani, Johanna Chester, Victor Desmond Mandel, F. Persechino, S. Ciardo, Shaniko Kaleci, N. De Carvalho, Severino Persechino, Francesca FarnetaniAbstract:BACKGROUND: Seborrheic keratoses (SebK) with atypical dermoscopy presentation are increasingly reported. These lesions do not exhibit typical dermoscopy features of SebK and sometimes mimic melanoma, thus complicating the differential diagnosis. Reflectance Confocal Microscopy (RCM) is a non-invasive tool, which allows an in vivo imaging of the skin. The study objectives were to evaluate the agreement between RCM classification and histological diagnoses, and the reliability of well-known RCM criteria for SebK in the identification of SebK with atypical dermoscopy presentation. MATERIALS AND METHODS: We retrospectively analysed at RCM excised lesions presenting in dermoscopy ≥1 score at revisited 7-point checklist. The study population consisted of cases showing no melanocytic RCM findings. Lesions were investigated for distinct non-melanocytic RCM features, blinded from histopathology diagnoses. Histopathology matching was then performed before statistical analysis. RESULTS: The study consisted of 117 cases, classified at RCM as SebK (71 cases), dermatofibroma (18 cases), basal cell carcinoma (13 cases), squamous cell carcinoma (2 cases), and "non-specific" (13 cases). Overall K strength of agreement at histopathology matching proved 0.76. Of the 71 cases classified at RCM with SebK, agreement was achieved in 97%. CONCLUSION: Reflectance Confocal Microscopy classification proved high agreement with histopathology for SebK with atypical dermoscopy presentations, allowing an early differential diagnosis. RCM features in this group of lesions were similar to those described for typical cases of SebK, and may assist clinician therapy decision making, whilst avoiding unnecessary excisions.
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Role of in vivo Reflectance Confocal Microscopy in the analysis of melanocytic lesions
Acta Dermatovenerologica Croatica, 2018Co-Authors: Elena Daniela Serban, Giovanni Pellacani, Francesca Farnetani, Maria Magdalena ConstantinAbstract:: Worldwide melanoma incidence and mortality are increasing (1). Despite the ongoing research, advanced melanoma is still incurable; therefore, the most appropriate solution seems to be early detection combined with complete surgical excision (2). Since the diagnostic protocol of suspicious lesions includes a complete excision with safety margins (2), the problem of unnecessary scarring is significant. The real challenge in this case is to have a properly formulated diagnosis before acquiring a biopsy. Currently available non-invasive techniques are coherence tomography, digital dermoscopy, and Reflectance Confocal Microscopy. All these techniques allow for a presumptive diagnosis, but the most promising results are provided by Reflectance Confocal Microscopy. Reflectance Confocal Microscopy (RCM) is an optical imaging technique that uses a laser diode as a source of coherent monochromatic light which penetrates the tissue and illuminates a single point. Light from the stimulated section is reflected and passes through a filter, thereby forming the image on the detector. This filter enables selective excitation of a particular point on which focus is achieved and rejects reflection from the out-of-focus area, thus obtaining a "Confocal" image. Contrast is the result of differences in the refractive index of the cell organelles and microstructures, resulting in white structures on a black background. This technique allows, as opposed to conventional light Microscopy, the analysis of sections obtained at a bi- or tri-dimensional level and controlling the depth of the field, permitting out-of-focus artifacts to be eliminated. In dermatology, this technique is useful for both clinical and research purposes. It is the only technique that allows horizontal viewing of the skin up to the superficial dermis (approximately 300 mm, at a cellular level resolution (0.5-1.0 μm in the lateral dimension and 4.0-5.0 μm in the axial dimension) (3). It allows both in vivo and ex vivo diagnosis, while providing the possibility for long-term monitoring. It has proved to be especially valuable for in vivo examinations of melanocytic lesions, whereas melanin and melanosomes are a powerful source of contrast, allowing the individualization of melanocytic cells (4). We report the case of a 65-year-old Caucasian woman who presented to the Dermatology Department of University of Modena and Reggio Emilia, Italy, for the examination of an atypical lesion, of unknown history, localized in the right preauricular area. The patient's personal and family histories were negative for skin malignancies and for other significant medical history. The clinical presentation was highly indicative of malignancy, as it met all the ABCD clinical criteria: an asymmetric papule composed of two areas, one pigmented and another one hypopigmented, with ill-defined borders and a diameter of approximately 2 cm. The dermatoscopic examination revealed an asymmetric multicomponent pattern with atypical network, structureless areas, peripheral irregular globules, and a blue-white veil. Because clinical and dermatoscopic features pointed towards a suspicious lesion which was situated on the face, where unnecessary scarring is unwanted, Reflectance Confocal Microscopy (RCM) examination was proposed and performed (VivaScope 3000; MAVIG GmBH, Munich, Germany) (5). It revealed the following features: the epidermis presented a disarranged pattern; the dermo-epidermal junction and superficial dermis presented a meshwork pattern with edged AND non-edged papillae, non-homogenous junctional clusters, dense nests, dense AND sparse nests, and atypical cells in a sparse distribution (Figure 1). Figure 1. (A) Clinical examination of an atypical melanocytic lesion situated at the right preauricular area. (B) Dermatoscopic examination. (C) Confocal examination of dermo-epidermal junction and superficial dermis which reveals a meshwork pattern (yellow circle) with edged AND non-edged papillae, non-homogenous junctional clusters (yellow star), dense nests, dense AND sparse nests (red star) and atypical cells in a sparse distribution (arrow). The clinical and Confocal data indicated a malignant melanocytic tumor, so an excisional biopsy with safety margins was performed. The histopathological report indicated superficial spreading melanoma with a Breslow of 0.55 mm and 0 mitosis/mm2. This case illustrates the important role Confocal Microscopy examination has in the management of melanocytic lesions situated in special areas like the face. Reflectance Confocal Microscopy is an imaging technique that allows viewing the layers of the skin up to the superficial dermis and therefore turns out to be extremely useful in obtaining a pertinent diagnosis before acquiring a biopsy. According to the data available so far, it was established that Reflectance Confocal Microscopy increases the diagnostic accuracy for melanocytic lesions in both pigmented and hypopigmented lesions. In a study conducted by Borsari et al., Reflectance Confocal Microscopy proved to have a sensibility and specificity of 95.3% and 83.9%, respectively (6). By improving the accuracy of clinical and dermatoscopic diagnosis, the Reflectance Confocal Microscopy technique contributes to increasing the confidence of the clinical and dermatoscopic diagnosis (7). In this regard, Confocal Reflectance Microscopy reduces unnecessary excisions, particularly in cases of damage to cosmetically important areas, such as the face or the neck, simultaneously detecting the malignant lesions that require a surgical approach, as seen in the case presented, where confirmation of the diagnosis by Confocal Microscopy allowed for a safe excision. In fact, the head and neck are the most appropriate body location for Reflectance Confocal examination, especially because RCM showed a high diagnostic accuracy for lesions located on sun-damaged skin, as these two areas frequently are (adjusted odds ratio (aOR), 2.13; 95% confidence interval (CI), 1.37-3.30; P=.001) (6). Reflectance Confocal Microscopy is very helpful in the management of special lesions, like facial lentigo maligna melanoma. This type of lesion is considered to be a real challenge for the dermatologist because of its clinical and morphological features that are similar to other lesions such as solar lentigines and pigmented actinic keratoses. In this case, Reflectance Confocal excels at specificity of the diagnosis, but also at to the ability to define the margins more accurately, permitting a pre-surgical mapping and for possibility of identifying the optimal site for biopsy (8,9). By improving diagnostic ability, Reflectance Confocal Microscopy technique may contribute to the selection of lesions that may be eligible for non-surgical treatment. Facial pigmented non-melanocytic macules like solar lentigo, flat seborrheic keratosis, lichen planus-like keratosis, and pigmented actinic keratosis can mimic a lentigo maligna, or even a lentigo maligna melanoma, but with the help of the RCM, an accurate diagnosis can be established, sparing the patient can be from unwanted facial scars using a non-surgical approach (laser, cryotherapy, imiquimod) (10,11). Furthermore, Reflectance Confocal Microscopy can be a valuable method for the monitoring of a skin lesion over time, especially melanocytic nevi, reducing unnecessary surgical excision, such as for patients with multiple atypical nevi that undergo multiple biopsies (12,13). Like all other diagnostic methods, RCM has its limitations: palmoplantar lesions (due to thickened epidermis), ulcers or crusts on a large lesion, lesions localized in inaccessible regions such as interdigital space, nasal wing (3). To summarize, Reflectance Confocal Microscopy can improve clinical and dermatoscopic diagnosis of melanocytic lesions, detecting the lesions that need an invasive approach and preventing unnecessary excision. It has proven to be very helpful in the management of lentigo maligna and lentigo maligna melanoma, achieving high specificity in the diagnosis and simultaneously allowing an optimal approach. This technique can be a reliable bridge between dermoscopy and histopathology, being able to provide an alternative to histopathological examination. Special mention must be made of the factors that may change the result to a false negative such as hyperkeratosis, ulceration, or bleeding, so any results should be integrated with the rest of the patient's data.
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Organ culture and Reflectance Confocal Microscopy as new integrated tools for barrier rescue studies in inflammatory skin diseases.
Experimental Dermatology, 2015Co-Authors: Tiziana Petrachi, Giovanni Pellacani, Roberta Lotti, Elisabetta Palazzo, Francesca Truzzi, Annalisa Saltari, Paolo Morandi, Silvana Ciardo, Carlo Pincelli, Alessandra MarconiAbstract:Keywords: barrier repair; Reflectance Confocal Microscopy; skin barrier; sodium dodecyl sulphate; tape stripping
Marco Ardigò - One of the best experts on this subject based on the ideXlab platform.
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In Vivo Reflectance Confocal Microscopy for Inflammatory Diseases
Technology in Practical Dermatology, 2020Co-Authors: Marco Ardigò, Chiara Franceschini, Flavia PersechinoAbstract:In vivo Reflectance Confocal Microscopy (RCM) is a relatively novel noninvasive tool for real-time microscopic evaluation of the skin. The device is used prevalently for the diagnosis and management of skin tumor as melanoma and non-melanoma skin cancer.
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Reflectance Confocal Microscopy as a new diagnostic tool in transformed mycosis fungoides.
Australasian Journal of Dermatology, 2020Co-Authors: Bruna Melhoranse Gouveia, Marco Ardigò, Jillian Wells, Germana Consuegra, Olaya Suárez Magdalena, Pablo Fernandez-penasAbstract:: Patients with mycosis fungoides typically experience an indolent disease. In some cases, the disease undergoes a process of large cell transformation which often heralds a more aggressive course with shortened overall survival. In order to rule out large cell transformation, biopsy specimens are often collected from patients with established disease who develop new papules, plaques or tumours. In some cases, multiple biopsies are needed and scar, infection and sampling error can occur. Our aim was to evaluate lesions suggestive of large cell transformation using in vivo Reflectance Confocal Microscopy and to correlate Confocal features with histopathologic findings in three patients with biopsy-proven mycosis fungoides who developed new lesions during follow-up. A total of six lesions, two lesions per patient, were examined. Reflectance Confocal Microscopy demonstrated large bright roundish pleomorphic cells in the epidermis, dermoepidermal junction, dermis and hair follicle in 5 of 6 lesions. The same 5 lesions were confirmed as large cell transformation by histopathology. Dermoepidermal junction obscuration, Pautrier microabscesses, epidermal disarray, spongiosis and dendritic cells were also detected by Reflectance Confocal Microscopy and correlated to histopathology. In conclusion, Reflectance Confocal Microscopy is useful in identifying large cell transformation within mycosis fungoides lesions. Reflectance Confocal Microscopy can therefore be of value in targeting the biopsy site, thereby reducing the chance of a false-negative histopathological finding.
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Dermatoscopy and Reflectance Confocal Microscopy Correlations in Nonmelanocytic Disorders.
Dermatologic Clinics, 2018Co-Authors: Francesco Lacarrubba, Marco Ardigò, Anna Elisa Verzi, Alessandro Stefani, Giuseppe MicaliAbstract:Dermatoscopy and in vivo Reflectance Confocal Microscopy are noninvasive techniques that provide a horizontal approach, with an en face view of the skin structures. Both techniques assist in the clinical diagnosis of a variety of inflammatory and infectious cutaneous disorders. In many cases, they have shown concordance. Their combined use represents, in several instances, a promising option to reach the final diagnosis without the need for invasive procedures.
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Reflectance Confocal Microscopy algorithms for inflammatory and hair diseases
Dermatologic Clinics, 2016Co-Authors: Marco Ardigò, Marina Agozzino, Chiara Franceschini, Francesco LacarrubbaAbstract:Reflectance Confocal Microscopy (RCM) allows real-time, noninvasive microscopic view of the skin at nearly histologic resolution serially over time. RCM increases the sensibility and sensitivity of the diagnosis of skin tumours. RCM evaluates descriptive features of psoriasis, lupus erythematosus, contact dermatitis, and others. Three groups of optical histology have been described: psoriasiform, spongiotic, and interface dermatitis. In a multicenter study, RCM patterns of spongiotic, hyperkeratotic, and interface dermatitis have been analyzed and an algorithmic method of analysis for fast application in the clinical setting based on a multivariate analysis has been proposed. A tree decision diagram has been also established.
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Reflectance Confocal Microscopy for scarring and non-scarring alopecia real-time assessment
Archives of Dermatological Research, 2016Co-Authors: Marco Ardigò, Marina Agozzino, Chiara Franceschini, Carlo Donadio, Leonardo Spagnol Abraham, Luca Barbieri, Isabella Sperduti, Enzo Berardesca, Salvador GonzalezAbstract:Clinical management of alopecia represents one of the major issues in dermatology. Scalp biopsies are not easily accepted because of the high bleeding and sensitive anatomical area. Trichoscopy is routinely used for diagnosis of alopecia, but in several cases lack to provide sufficient information on the status of the disease. Recently, Reflectance Confocal Microscopy demonstrated its usefulness for the evaluation of several inflammatory skin condition and preliminary reports about alopecia have been proposed in the literature. The aim was to identify the Confocal features characterizing scarring and non-scarring alopecia. Reflectance Confocal Microscopy from 86 patients affected by scarring (28 lichen planopilaris and 9 lupus erythematosus) and non-scarring alopecia (30 androgenic alopecia and 19 alopecia areata), were retrospectively, blinded evaluated. Good concordance between different readers on the Confocal criteria has been assessed. Statistical significant features, specific for scarring alopecia and non-scarring alopecia have been identified. In this study, data on Reflectance Confocal Microscopy features useful for the differential diagnosis between scarring and non-scarring alopecia have been identified. Further studies focusing on the use of this non-invasive technique in the therapeutic follow-up and distinction of sub-entities of alopecia are still required.
Jeanpaul Ortonne - One of the best experts on this subject based on the ideXlab platform.
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Reflectance Confocal Microscopy for pigmentary disorders
Experimental Dermatology, 2010Co-Authors: Hee Young Kang, Philippe Bahadoran, Jeanpaul OrtonneAbstract:Please cite this paper as: Reflectance Confocal Microscopy for pigmentary disorders. Experimental Dermatology 2010; 19: 233–239. Abstract: In vivo Reflectance Confocal Microscopy (RCM) is a non-invasive, repetitive imaging tool that provides real-time images at nearly cellular histological resolution. Application of this technology to skin imaging during the last decade has been a great advance in dermatology. As melanin is the strongest endogenous contrast in human skin, pigmentary disorders caused by abnormal amounts of melanin in the skin could be the most suitable candidates for RCM examination. This article reviewed the RCM applications in the characterization and management of pigmentary disorders. The application of RCM in pigmentary disorders has been expanded to describe hyper- and hypopigmentary disorders as well as pigmented skin tumors. The great advantages of non-invasive and repetitive examination of RCM may provide its usefulness not only in the diagnosis and management of pigmentary disorders, but also in researching pathogenesis of pigmentary disorders.