Reflectance confocal microscopy proves effective for real-life practice

Key takeaways:

• Reflectance confocal microscopy (RCM) has not been extensively studied in real-life practice.
• In a real-life study, RCM spared biopsies in 50.6% of patients.

Reflectance confocal microscopy can be integrated into the daily workflow of dermatology practices, sparing unnecessary biopsies, according to a study.

“[Reflectance confocal microscopy (RCM)] has been extensively studied for use in the evaluation of cutaneous melanocytic and non-melanocytic neoplasms,” Marion Stefanski, MD, of the department of oncodermatology at Reims University Hospital and the department of dermatology at Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille in France, and colleagues wrote. “However, little is known about the use of RCM in the present-day clinical practice.

To evaluate the use of RCM in real-life clinical practice, the authors conducted a multicenter, prospective study. The study took place across 10 university dermatology departments in France and included 410 patients (mean age, 60.2 years; 245 women) with 424 lesions.

Most patients were referred for a diagnosis (84.9%) of skin lesions that were located on the face (62%), arms and legs (14.9%) or trunk (13.6%), whereas the remainder needed pre-surgical mapping (13%) almost exclusively of facial lesions (90.9%).

After being evaluated through RCM, 50.6% of patients were spared unnecessary biopsies. Of all the lesions that RCM indicated needed surgery, 72.7% were revealed to be malignant through histopathology.

The study concluded that the correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73.

‘This study shows that RCM can be integrated in the workflow of a public private network, including a high participation of private dermatologists for patient referral,” the authors wrote. “Integration of RCM enables a less invasive diagnostic procedure of skin tumors for patients.”