Introduction to reflectance confocal microscopy and its use in clinical practice

Centers for Medicare & Medicaid Services. Physician Fee Schedule Search. CMS website. Available at: https://www.cms.gov/apps/physician-fee-schedule/search/search-results.aspx?Y=0&T=0&HT=2&CT=3&H1=96931&H2=96936&M=5. Published 2016. Rajadhyaksha, 2017, Reflectance confocal microscopy of skin in vivo: from bench to bedside, Lasers Surg Med, 49, 7, 10.1002/lsm.22600 González, 2003, Changing paradigms in dermatology: confocal microscopy in clinical and surgical dermatology, Clin Dermatol, 21, 359, 10.1016/j.clindermatol.2003.08.007 Grant-Kels, 2016, In vivo diagnosis of skin cancer through reflectance, Clin Oncol, 1, 1021 Levine, 2017, In vivo reflectance confocal microscopy, Cutis, 99, 399 Shahriari, 2018, In vivo reflectance confocal microscopy image interpretation for the dermatopathologist, J Cutan Pathol, 45, 187, 10.1111/cup.13084 Longo, 2013, Is confocal microscopy a valuable tool in diagnosing nodular lesions? A study of 140 cases, Br J Dermatol, 169, 58, 10.1111/bjd.12259 Hashemi, 2012, Langerhans cells and melanocytes share similar morphologic features under in vivo reflectance confocal microscopy: a challenge for melanoma diagnosis, J Am Acad Dermatol, 66, 452, 10.1016/j.jaad.2011.02.033 Cinotti, 2018, Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna, J Eur Acad Dermatol Venereol, 10.1111/jdv.14791 Busam, 2005, Melanoma diagnosis by confocal microscopy: promise and pitfalls, J Invest Dermatol, 125, 10.1111/j.0022-202X.2005.23865.x Pellacani, 2012, In vivo confocal microscopy for detection and grading of dysplastic nevi: a pilot study, J Am Acad Dermatol, 66, e109, 10.1016/j.jaad.2011.05.017 Witkowski, 2017, Improving diagnostic sensitivity of combined dermoscopy and reflectance confocal microscopy imaging through double reader concordance evaluation in telemedicine settings: a retrospective study of 1000 equivocal cases, PLoS One, 12, 1, 10.1371/journal.pone.0187748 Edwards, 2016, Vivascope® 1500 and 3000 systems for detecting and monitoring skin lesions: a systematic review and economic evaluation, Health Technol Assess (Rockv), 20, 1, 10.3310/hta20580 Rao, 2013, In vivo confocal microscopy in clinical practice: comparison of bedside diagnostic accuracy of a trained physician and distant diagnosis of an expert reader, J Am Acad Dermatol, 69, 10.1016/j.jaad.2013.07.022 Guitera, 2009, In vivo reflectance confocal microscopy enhances secondary evaluation of melanocytic lesions, J Invest Dermatol, 129, 131, 10.1038/jid.2008.193 Xiong, 2016, A meta-analysis of reflectance confocal microscopy for the diagnosis of malignant skin tumours, J Eur Acad Dermatol Venereol, 30, 1295, 10.1111/jdv.13712 Borsari, 2016, Clinical indications for use of reflectance confocal microscopy for skin cancer diagnosis, JAMA Dermatol, 152, 1, 10.1001/jamadermatol.2016.1188 Alarcon, 2014, Impact of in vivo reflectance confocal microscopy on the number needed to treat melanoma in doubtful lesions, Br J Dermatol, 170, 802, 10.1111/bjd.12678 Xiong, 2017, Comparison of dermoscopy and reflectance confocal microscopy for the diagnosis of malignant skin tumours: a meta-analysis, J Cancer Res Clin Oncol, 143, 1627, 10.1007/s00432-017-2391-9 Stevenson, 2013, Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions, Dermatol Pract Concept, 3, 19, 10.5826/dpc.0304a05 Star, 2016, Lentigo maligna, macules of the face, and lesions on sun-damaged skin: confocal makes the difference, Dermatol Clin, 34, 421, 10.1016/j.det.2016.05.005 Somach, 1996, Pigmented lesions in actinically damaged skin: histopathologic comparison of biopsy and excisional specimens, Arch Dermatol, 132, 1297, 10.1001/archderm.1996.03890350035006 Guitera, 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, 2080, 10.1038/jid.2010.84 Carrera, 2016, Discriminating nevi from melanomas: clues and pitfalls, Dermatol Clin, 34, 395, 10.1016/j.det.2016.05.003 Guitera, 2016, Dermoscopy and in vivo confocal microscopy are complimentary techniques for the diagnosis of difficult amelanotic and light colored skin lesions, Br J Dermatol, 175, 1311, 10.1111/bjd.14749 Losi, 2014, Hyporeflective pagetoid cells: a new clue for amelanotic melanoma diagnosis by reflectance confocal microscopy, Br J Dermatol, 171, 48, 10.1111/bjd.12781 Busam, 2001, Detection of clinically amelanotic malignant melanoma and assessment of its margins by in vivo confocal scanning laser microscopy, Arch Dermatol, 137, 923 Pellacani, 2014, Reflectance confocal microscopy as a second-level examination in skin oncology improves diagnostic accuracy and saves unnecessary excisions: a longitudinal prospective study, Br J Dermatol, 171, 1044, 10.1111/bjd.13148 Guitera, 2012, In vivo confocal microscopy for diagnosis of melanoma and basal cell carcinoma using a two-step method: analysis of 710 consecutive clinically equivocal cases, J Invest Dermatol, 132, 2386, 10.1038/jid.2012.172 Pellacani, 2016, Cost-benefit of reflectance confocal microscopy in the diagnostic performance of melanoma, J Eur Acad Dermatol Venereol, 30, 413, 10.1111/jdv.13408 Segura, 2011, Non-invasive management of non-melanoma skin cancer in patients with cancer predisposition genodermatosis: a role for confocal microscopy and photodynamic therapy, J Eur Acad Dermatol Venereol, 25, 819, 10.1111/j.1468-3083.2010.03871.x Lovatto, 2015, In vivo reflectance confocal microscopy of equivocal melanocytic lesions detected by digital dermoscopy follow-up, J Eur Acad Dermatol Venereol, 29, 1918, 10.1111/jdv.13067 Stanganelli, 2015, Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy, Br J Dermatol, 172, 365, 10.1111/bjd.13373 Başaran, 2015, Evaluation of the response to treatment of psoriasis vulgaris with reflectance confocal microscopy, Skin Res Technol, 21, 18, 10.1111/srt.12150 Cinotti, 2016, Reflectance confocal microscopy for cutaneous infections and infestations, J Eur Acad Dermatol Venereol, 30, 754, 10.1111/jdv.13254 Ardigo, 2016, Multicentre study on inflammatory skin diseases from The International Confocal Working Group: specific confocal microscopy features and an algorithmic method of diagnosis, Br J Dermatol, 175, 364, 10.1111/bjd.14516 Cinotti, 2016, Reflectance confocal microscopy for the diagnosis of vulvar naevi: six cases, Eur Acad Dermatol Venereol, 30, 30, 10.1111/jdv.12924 Debarbieux, 2014, Reflectance confocal microscopy of mucosal pigmented macules : a review of 56 cases including 10 macular melanomas, Br J Dermatol, 170, 1276, 10.1111/bjd.12803 Guitera, 2013, Improving management and patient care in lentigo maligna by mapping with in vivo confocal microscopy, JAMA Dermatol, 149, 1, 10.1001/jamadermatol.2013.2301 Pan, 2012, In vivo reflectance confocal microscopy of basal cell carcinoma: feasibility of preoperative mapping of cancer margins, Dermatol Surg, 38, 1945, 10.1111/j.1524-4725.2012.02587.x Scope, 2016, An evolving approach to the detection of melanoma and other skin cancers using in vivo reflectance confocal microscopy, JAMA Dermatol, 152, 1085, 10.1001/jamadermatol.2016.1966 Maier, 2013, Reflectance confocal microscopy in the diagnosis of partially and completely amelanotic melanoma: report on seven cases, J Eur Acad Dermatol Venereol, 27, 42, 10.1111/j.1468-3083.2012.04465.x Braga, 2009, The significance of reflectance confocal microscopy in the assessment of solitary pink skin lesions, J Am Acad Dermatol, 61, 230, 10.1016/j.jaad.2009.02.036 Kadouch, 2017, One-stop-shop with confocal microscopy imaging vs. standard care for surgical treatment of basal cell carcinoma: an open-label, noninferiority, randomized controlled multicentre trial, Br J Dermatol, 177, 735, 10.1111/bjd.15559 Ulrich, 2012, The use of reflectance confocal microscopy for monitoring response to therapy of skin malignancies, Dermatol Pract Concept, 2, 202a10, 10.5826/dpc.0202a10 Ulrich, 2010, Reflectance confocal microscopy for noninvasive monitoring of therapy and detection of subclinical actinic keratoses, Dermatology, 220, 15, 10.1159/000254893 Hibler, 2016, Carbon dioxide laser ablation of basal cell carcinoma with visual guidance by reflectance confocal microscopy: a proof-of-principle pilot study, Br J Dermatol, 174, 1359, 10.1111/bjd.14414 Sierra, 2016, Confocal imaging of carbon dioxide laser-ablated basal cell carcinomas: An ex-vivo study on the uptake of contrast agent and ablation parameters, Lasers Surg Med, 48, 133, 10.1002/lsm.22415 Venturini, 2013, Reflectance confocal microscopy allows in vivo real-time noninvasive assessment of the outcome of methyl aminolaevulinate photodynamic therapy of basal cell carcinoma, Br J Dermatol, 168, 99, 10.1111/bjd.12052 Longo, 2012, Confocal microscopy insights into the treatment and cellular immune response of basal cell carcinoma to photodynamic therapy, Dermatology, 225, 264, 10.1159/000345106 Chen, 2014, Confocal microscopy-guided laser ablation for superficial and early nodular basal cell carcinoma: a promising surgical alternative for superficial skin cancers, JAMA Dermatol, 150, 994, 10.1001/jamadermatol.2013.10225 Malvehy, 2016, Treatment monitoring of 0.5% 5-fluorouracil and 10% salicylic acid in clinical and subclinical actinic keratoses with the combination of optical coherence tomography and reflectance confocal microscopy, J Eur Acad Dermatol Venereol, 30, 258, 10.1111/jdv.13445 Couzan, 2018, Reflectance confocal microscopy identification of subclinical basal cell carcinomas during and after vismodegib treatment, J Eur Acad Dermatol Venereol, 32, 763, 10.1111/jdv.14650 Maier, 2014, Noninvasive monitoring of basal cell carcinomas treated with systemic hedgehog inhibitors: pseudocysts as a sign of tumor regression, J Am Acad Dermatol, 71, 725, 10.1016/j.jaad.2014.04.007 Batta, 2015, Reflectance confocal microscopy: an overview of technology and advances in telepathology, Cutis, 95, E39 Levine, 2017, Imaging in cutaneous surgery, Futur Oncol, 13, 2329, 10.2217/fon-2017-0277 Que, 2015, Through the looking glass: basics and principles of reflectance confocal microscopy, J Am Acad Dermatol, 73, 276, 10.1016/j.jaad.2015.04.047 Rajadhyaksha, 1995, In vivo confocal scanning laser microscopy of human skin: melanin provides strong contrast, J Invest Dermatol, 104, 946, 10.1111/1523-1747.ep12606215 Corcuff, 2001, Skin optics revisited by in vivo confocal microscopy: melanin and sun exposure, J Cosmet Sci, 52, 91 Gonzalez, 2014, Confocal microscopy patterns in nonmelanoma skin cancer and clinical applications, Actas Dermosifiliogr, 105, 446 Kang, 2010, Reflectance confocal microscopy for pigmentary disorders, Exp Dermatol, 19, 233, 10.1111/j.1600-0625.2009.00983.x Huzaira, 2001, Topographic variations in normal skin, as viewed by in vivo reflectance confocal microscopy, J Invest Dermatol, 116, 846, 10.1046/j.0022-202x.2001.01337.x Hofmann-Wellenhof, 2012, Reflectance Confocal Microscopy for Skin Diseases, 10.1007/978-3-642-21997-9 2017 Kurugol, 2015, Automated delineation of dermal-epidermal junction in reflectance confocal microscopy image stacks of human skin, J Invest Dermatol, 135, 710, 10.1038/jid.2014.379 Xiang, 2016, In vivo visualization of honeycomb pattern, cobblestone pattern, ringed pattern, and dermal papillae by confocal laser scanning microscopy, Ski Res Technol, 22, 32, 10.1111/srt.12225 Pellacani, 2007, The impact of in vivo reflectance confocal microscopy for the diagnostic accuracy of melanoma and equivocal melanocytic lesions, J Invest Dermatol, 127, 2759, 10.1038/sj.jid.5700993 Busam, 2001, Morphologic features of melanocytes, pigmented keratinocytes, and melanophages by in vivo confocal scanning laser microscopy, Mod Pathol, 14, 862, 10.1038/modpathol.3880402