The value of reflectance confocal microscopy in diagnosis of flat pigmented facial lesions: a prospective study
| Autor: | Salvador González, Harald Kittler, Rainer Hofmann-Wellenhof, Caterina Longo, Elisabeth M. T. Wurm, Hans Peter Soyer, Pascale Guitera, Christoph Sinz, Giovanni Pellacani, Verena Ahlgrimm-Siess |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Confocal Physical examination Dermoscopy Dermatology Sensitivity and Specificity Skin Diseases law.invention 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Infectious Diseases Confocal microscopy law Medicine Humans Prospective Studies Medical diagnosis Overdiagnosis Prospective cohort study Aged Aged 80 and over Dermatoscopy Microscopy Confocal medicine.diagnostic_test business.industry Actinic keratosis Middle Aged medicine.disease 030220 oncology & carcinogenesis Face Female Radiology business Pigmentation Disorders |
| Zdroj: | Journal of the European Academy of Dermatology and Venereology : JEADV. 31(8) |
| ISSN: | 1468-3083 |
| Popis: | Background: Flat pigmented facial lesions are difficult to diagnose even with dermatoscopy. It is controversial how additional information obtained by in vivo reflectance confocal microscopy (RCM) impacts the diagnosis and management. Objective: To examine what in vivo reflectance confocal microscopy of flat pigmented facial lesions adds to clinical examination using dermatoscopy including digital dermatoscopic monitoring. Methods: We prospectively collected 70 cases of flat pigmented facial lesions and recorded diagnoses and management decisions by experts based on direct clinical examination aided by dermatoscopy including digital dermatoscopic monitoring and by remote experts who reviewed the corresponding confocal images. The expert confocal readers were blinded to the clinical and dermatoscopic appearance of the lesion. Results: The sensitivity of dermatoscopy plus digital dermatoscopic monitoring was 95.0% (95% CI 75.13% to 99.87%) and the specificity was 84.0% (95% CI 70.89% to 92.83%). The sensitivity of RCM was 95.0% (95% CI 75.13% to 99.87%) and the specificity was 82.0% (95% CI 68.56% to 91.42%). Conclusion: Although most flat pigmented facial lesions can be managed by clinical examination and dermatoscopy alone, confocal microscopy is a useful adjunct in selected lesions. If RCM is not correlated with clinical and dermatoscopic information, there is risk of overdiagnosis of actinic keratosis, however. |
| Databáze: | OpenAIRE |
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