In vivo reflectance confocal microscopy study to identify dysplasia of melanocytic nevus.

As morbidity of skin melanoma increases, its early diagnosis and treatment become a most important goal. According to the data from clinical studies, dysplastic nevus is associated with elevated melanoma risks in three aspects: it shares similar features with melanoma, it is a melanoma risk marker and it is a possible precursor of melanoma. An accurate diagnosis of dysplastic nevus and skin melanoma is important to lower mortality and morbidity rates of skin melanoma. The progress of medical science provides new non-invasive diagnostic possibilities. In vivo reflectance confocal microscopy offers live examination of skin morphology at the cellular level. Hence, the aim of this study is to define the accuracy of in vivo reflectance confocal microscopy in the diagnosis of dysplastic melanocytic nevus and skin melanoma. The results of the study confirmed that features of melanocytic skin lesions examined by in vivo reflectance confocal microscopy correspond to features of cellular atypia in an histological examination. Sensitivity and specificity of in vivo reflectance confocal microscopy in the diagnosis of dysplastic nevi is insufficient to distinguish dysplastic nevi from common nevi, but the accuracy of in vivo reflectance confocal microscopy is significant in diagnosis of skin melanoma. Since the in vivo reflectance confocal microscopy examination improves the accuracy of skin melanoma diagnosis, it should be used when atypia of nevus is detected or skin melanoma is suspected

In vivo konfokalios atspindžio mikroskopijos tyrimas nustatant melanocitų kilmės apgamo displaziją

As morbidity of skin melanoma increases, its early diagnosis and treatment become a most important goal. According to the data from clinical studies, dysplastic nevus is associated with elevated melanoma risks in three aspects: it shares similar features with melanoma, it is a melanoma risk marker and it is a possible precursor of melanoma. An accurate diagnosis of dysplastic nevus and skin melanoma is important to lower mortality and morbidity rates of skin melanoma. The progress of medical science provides new non-invasive diagnostic possibilities. In vivo reflectance confocal microscopy offers live examination of skin morphology at the cellular level. Hence, the aim of this study is to define the accuracy of in vivo reflectance confocal microscopy in the diagnosis of dysplastic melanocytic nevus and skin melanoma. The results of the study confirmed that features of melanocytic skin lesions examined by in vivo reflectance confocal microscopy correspond to features of cellular atypia in an histological examination. Sensitivity and specificity of in vivo reflectance confocal microscopy in the diagnosis of dysplastic nevi is insufficient to distinguish dysplastic nevi from common nevi, but the accuracy of in vivo reflectance confocal microscopy is significant in diagnosis of skin melanoma. Since the in vivo reflectance confocal microscopy examination improves the accuracy of skin melanoma diagnosis, it should be used when atypia of nevus is detected or skin melanoma is suspected

Nevomelanocytic atypia detection by in vivo reflectance confocal microscopy

Background and objective In vivo reflectance confocal microscopy (RCM) is a promising novel technology for non-invasive early diagnostics of cutaneous melanoma. However, the possibility to detect melanocytic atypia in nevi by means of in vivo RCM remains unknown. The aim of the study was to evaluate the significance of in vivo RCM features of melanocytic atypia for the diagnosis of melanocytic nevi, dysplastic nevi and cutaneous melanoma. Materials and methods A total of 138 melanocytic skin lesions comprising 25 melanocytic nevi, 69 dysplastic nevi and 44 melanomas were analyzed by means of dermoscopy, in vivo RCM and routine histopathology. In vivo RCM images were analyzed for the arrangement of keratinocytes in epidermis, pagetoid cells and junctional melanocytic nests and correlated refractivity aspects of nests with histopathology. Results Separately and all together taken the in vivo RCM features of melanocytic atypia were significant in differential diagnosis of benign and malignant melanocytic skin lesions, though none of the features was significant in discriminating nevi without cytologic atypia of dysplastic nevi. In vivo RCM feature of dense cell clusters corresponded with melanin containing nevomelanocytes on histopathology though exact correspondence of non-homogeneous and atypical sparse cell clusters remained questionable. Conclusions Nevus with histopathologically confirmed nevomelanocytic atypia (dysplastic nevus) could not be distinguished from nevus without atypia using analyzed in vivo RCM features of melanocytic atypia. More accurate diagnostics by means of in vivo RCM needs further investigation on reflectance of single and nested cutaneous melanocytes in benign and malignant skin lesions