Reflectance-mode confocal microscopy of pigmented skin lesions–improvement in melanoma diagnostic specificity

摘要: Background In vivo confocal microscopy enables skin visualization with a quasihistopathologic resolution. Objective We sought to describe features in melanocytic lesions and evaluate their diagnostic significance for melanoma (MM) identification. Methods Thirty seven MMs, 49 acquired nevi, 16 Spitz/Reed presenting equivocal clinicodermoscopic aspects were investigated by microscopy. Results MMs nevi significantly differed some aspects. multivariate analysis, the presence of nonedged dermal papillae, atypical cells, isolated nucleated cells within papilla, pagetoid widespread infiltration, cerebriform clusters strongly correlated MM diagnosis. A receiver operating characteristic curve value 0.952 was obtained. Limitations represented pitfall diagnosis, owing frequent observation architectural disarray, cytologic atypia, impossibility evaluating cell maturation depth. Conclusion Characterization seems improve accuracy that are difficult diagnose.