Volume 28, Issue 8 pp. 1069-1078
Original Article

Non-invasive in vivo dermatopathology: identification of reflectance confocal microscopic correlates to specific histological features seen in melanocytic neoplasms

M. Gill

M. Gill

Dobbs Ferry, Skin Medical Research and Diagnostics, New York, NY, USA

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C. Longo

Corresponding Author

C. Longo

Dermatology and Skin Cancer Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy

Correspondence: C. Longo. E-mail: [email protected]Search for more papers by this author
F. Farnetani

F. Farnetani

Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy

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A.M. Cesinaro

A.M. Cesinaro

Department of Pathology, University of Modena and Reggio Emilia, Modena, Italy

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S. González

S. González

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

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G. Pellacani

G. Pellacani

Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy

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First published: 23 October 2013
Citations: 25

Conflicts of interest

Dr M. Gill and Dr S. González were previously investigators for an NCI-funded study granted to Lucid Inc., original manufacter of the device for this study. Dr S. González serves as consultant for Lucid. Inc. Dr M. Gill was paid a nominal fee directly from the study funds to participate as one of several investigators. G. Pellacani received honoraria for courses and acted as consult for MAVIG gmbh and Caliber ID.

Funding sources

This study is supported by the Grant of the Istituto Superiore di Sanità (ISS), Italy (project nr. 527/B/3A/4).

Abstract

Background

Reflectance confocal microscopy (RCM) allows for non-invasive, in vivo evaluation of skin lesions and it has been extensively applied in skin oncology although systematic studies on nevi characterization are still lacking.

Objective

The aim of this study was to determine whether reliable RCM correlates to histological features used to diagnose melanocytic neoplasms exist.

Methods

We blindly evaluated the RCM and histological features of 64 melanocytic neoplasms (19 non-dysplastic nevi, 27 dysplastic nevi, 14 melanomas) and analysed the data using Spearman's rho calculation.

Results

Many histological features can be identified using RCM. Elongated rete ridges corresponded on RCM to edge papillae, whereas flattened rete ridges to several features which involve dermal–epidermal junction disruption. Bridging of junctional nesting (JN) corresponded on RCM to both JN with irregular size/shape and JN with short interconnections. While we could reliably identify dermal melanocytes, the RCM features did not reliably distinguish between benign and concerning dermal melanocytic arrangements, suggesting further refinement of dermal melanocytic RCM features is needed.

Conclusion

Reliable correlates for epidermal and junctional histological features used to diagnose melanocytic neoplasms are identifiable on RCM, suggesting harnessing histological criteria may be a reasonable method to move beyond the algorithmic approach.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.