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Reflectance confocal microscopy margin mapping and monitoring of an amelanotic melanoma <i>in situ</i> of the ear
摘要： In situ amelanotic melanoma represents a diagnostic challenge for clinicians. Poor demarcation of these lesions often results in repeated therapeutic intervention until appropriate clearance has been achieved. Reflectance confocal microscopy (RCM) is a noninvasive bedside imaging modality which allows real-time visualisation, to a near-histological level, of the epidermis and reticular dermis. We present a case of an amelanotic melanoma in situ in which reflectance confocal microscopy margin mapping allowed for demarcation of the melanocytic proliferation and targeted therapeutic intervention with topical imiquimod. Reflectance confocal microscopy was further utilised for noninvasive assessment of therapeutic response.
关键词： margin mapping,reflectance confocal microscopy,amelanotic melanoma
更新于2025-09-23 15:23:52
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A miniaturized, tethered, spectrally-encoded confocal endomicroscopy capsule
摘要： The tethered spectrally-encoded confocal endomicroscopy (SECM) capsule is an imaging device that once swallowed by an unsedated patient can visualize cellular morphologic changes associated with gastrointestinal (GI) tract diseases in vivo. Recently, we demonstrated a tethered SECM capsule for counting esophageal eosinophils in patients with eosinophilic esophagitis (EoE) in vivo. Yet, the current tethered SECM capsule is far too long to be widely utilized for imaging pediatric patients, who constitute a major portion of the EoE patient population. In this paper, we present a new tethered SECM capsule that is 33% shorter, has an easier and repeatable fabrication process, and produces images with reduced speckle noise.
关键词： spectrally encoded confocal microscopy,confocal endomicroscopy,eosinophilic esophagitis,reflectance confocal microscopy,esophageal imaging,tethered capsule endomicroscopy
更新于2025-09-23 15:22:29
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Cutaneous erysipeloid metastasis of cholangiocarcinoma and evaluation by in?vivo reflectance confocal microscopy
摘要： Cutaneous metastases are relatively uncommon, occurring in only 0.7% to 9% of all internal malignancies. Cholangiocarcinoma is a rare bile duct neoplasm that accounts for less than 2% of malignancies. Although it is well known that cholangiocarcinoma metastasizes to the lungs, liver, peritoneum, and retroperitoneal lymph nodes, a retrospective review of the literature from 1978 to 2014 indicates only 30 cases of cutaneous cholangiocarcinoma, with 17 cases presenting without concurrent metastasis in other sites. Among these patients, the cutaneous metastatic disease occurred evenly at adjacent and distant sites, presenting as 0.3-cm to 4-cm erythematous papules or nodules with or without ulceration. The median overall survival after diagnosis of cutaneous cholangiocarcinoma metastasis is 4 months. Paradoxically, single-site metastases carry a significantly worse prognosis than multiple-site metastases and may be attributed to difficulty in identifying a singular lesion. In vivo reflectance confocal microscopy (RCM) is a novel, noninvasive diagnostic alternative to skin biopsy with comparable insurance reimbursement that captures real-time, high-resolution, cellular-level images from the skin surface down to the reticular dermis (up to 300 μm depth). This modality forgoes traumatic biopsy and has been used for diagnosis and monitoring of skin cancers and inflammatory dermatoses.
关键词： cholangiocarcinoma,erysipeloid,cutaneous metastasis,reflectance confocal microscopy
更新于2025-09-23 15:21:21
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Apport de la microscopie confocale par réflectance et de l’OCT dans le diagnostic d’un carcinome basocellulaire nodulaire kystique
摘要： The role of reflectance confocal microscopy and OCT in the diagnosis of nodular kystic BCC
关键词： Basal cell carcinoma,Noninvasive imaging,Optical coherence tomography,In vivo confocal microscopy,Dermoscopy,In vivo reflectance confocal microscopy,Cystic basal cell carcinoma
更新于2025-09-19 17:15:36
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Microneedle fractional radiofrequency-induced micropores evaluated by in vivo reflectance confocal microscopy, optical coherence tomography, and histology
摘要： Background: Microneedle fractional radiofrequency (MNRF) is a minimally invasive technique that delivers radiofrequency (RF) energy into the skin via microneedles. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) enable the characterization of device-tissue interactions in in vivo skin. The aim of this study is to describe MNRF-induced micropores using RCM and OCT imaging. Materials and methods: Five healthy participants were treated with a 7 × 7 array of 1500 μm microneedles on two adjacent areas of the right hip. One area received MNRF using high RF energy while the other underwent MNRF at low RF energy. Micropore morphology was evaluated qualitatively and quantitatively with RCM and OCT. To relate imaging with histology, one participant underwent punch biopsy in both areas. Results: Reflectance confocal microscopy visualized shape, content, and thermal-induced coagulation zone (CZ) of MNRF micropores. At high RF energy, micropores showed concentric shape, contained hyperreflective granules, and coagulated tissue from epidermis to dermo-epidermal junction (diameter 63-85 μm). Micropores at low RF energy, presented with a stellate shape, no content and CZs that were visible only in epidermis (CZ thickness 9 μm, IQR 8-21 μm). Evaluating OCT, high RF energy showed deeper (150 μm), more easily identifiable micropores compared to low RF energy micropores (70 μm). Histology showed tissue coagulation to a depth of 1500 μm at high RF energy, while at low RF energy, disruption was only visible in epidermis. Conclusion: Microneedle fractional radiofrequency micropores show distinct characteristics in both RCM and OCT, depending on RF energy. These in vivo imaging modalities are complementary and allow combined, qualitative, and quantitative evaluation.
关键词： microneedle fractional radiofrequency,histology,optical coherence tomography,micropore,reflectance confocal microscopy
更新于2025-09-19 17:15:36
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The influence of MC1R dermal morphological features of photoexposed skin in women revealed by reflectance confocal microscopy and optical coherence tomography
摘要： Background: The melanocortin 1 receptor (MC1R) gene is one of the major determinants of skin pigmentation. It is a highly polymorphic gene and some of its polymorphisms, have been related to specific skin phenotypes, increased risk of skin cancers and skin photoaging. Currently, its contribution to changes in dermal features in photo-exposed skin is unknown. Objective: The main objective of this study is to evaluate the potential correlation between MC1R status and specific healthy photoexposed skin characteristics. Materials and methods: Skin facial features were estimated by evaluation with standard digital photography with automated features, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in 100 healthy women. Skin of the forearms was used as a control. Results: The study found an association between RHC MC1R polymorphisms and dermal features in photoexposed areas being represented by increased vessel density and pixel density in OCT (p=0.025 and p=0.001, respectively) and increased coarse collagen in RCM (p=0.034), as compared to non-RHC subjects. To our knowledge this is previously unreported. Additionally, previously reported correlations between light hair and skin color and pigmented spots with MC1R RHC polymorphisms have been confirmed. Conclusions: Our results suggest the role of RHC MC1R variants in dermal variations of facial skin, as compared to non-RHC variants. To our knowledge this is previously unreported.
关键词： MC1R,melanocortin 1 receptor,reflectance confocal microscopy,skin photoaging,dynamic-optical coherence tomography
更新于2025-09-19 17:13:59
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Application of reflectance confocal microscopy to investigate the non-ablative, micro-ablative, and ablative effects of CO2 fractional laser irradiation on skin
摘要： CO2 fractional laser, as an ablative fractional laser, is commonly used in cosmetic treatment. We applied CO2 fractional laser irradiation to skin in vitro and used reflectance confocal microscopy (RCM) to image and detect the presence of any non-ablative, micro-ablative and ablative effects, in order to better understand the features of a CO2 fractional laser. In vitro irradiation of foreskin was performed using a CO2 fractional laser. Foreskin specimens were divided into 4 groups that received different amounts of irradiation energy, based on the number of irradiation passes they received: 5, 10, 15, and 20 passes, respectively. This corresponds to fluence energy of 16.3, 32.6, 48.9, 65.3 J/cm2. Immediately after irradiation, digital microscopy (DM), RCM, and histopathology were performed to observe whether the non-ablative, micro-ablative, and ablative phenomenon occurred, and the injury features of MTZs. Immediately after CO2 fractional laser irradiation, RCM and DM showed that when the numbers of passes were 5 and 10, a micro-ablative column (MAC) could not be observed or was very small. We mainly observed a thicker thermal coagulation zone (TCZ), representing non-ablative or micro-ablative effects. When the number of passes were increased to 15 and 20, the MAC was significantly enlarged and surrounded by a TCZ of medium thickness, representing ablative effects. For the first time, this study used RCM and DM to demonstrate that a CO2 fractional laser could achieve non-ablative, micro-ablative, and ablative effects on irradiated skin via different energy levels.
关键词： Microscopic treatment zone (MTZ),Non-ablative,Digital microscopy (DM),Micro-ablative,Reflectance confocal microscopy (RCM),CO2 fractional laser
更新于2025-09-12 10:27:22
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Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy
摘要： Background: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. Objectives: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). Methods: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the revisited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. Results: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p < 0.001), tumor islands located in the epidermis (100%, p < 0.001), smaller vascular diameter (100%, p < 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p < 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p < 0.001) with a larger vascular diameter (50%, p < 0.001). Conclusions: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.
关键词： Melanoma,Basal cell carcinoma,Reflectance confocal microscopy,Dermoscopy,Noninvasive diagnosis
更新于2025-09-10 09:29:36
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Reflectance confocal microscopy features of labial melanotic macule: Report of three cases
摘要： The term labial melanotic macule of the lips (MML) is used to describe a flat-pigmented lesion on the vermilion border, with an estimated prevalence of up to 3% of the population. Most MMLs are located on the lower lip and are more common in female patients. MMLs are mostly associated with hyperpigmentation of the basal keratinocytes with normal to a slightly increased density of melanocytes; an infiltrate of melanophages in the superficial dermis can also contribute to the pigmented appearance of MMLs. These benign lesions may raise concern for melanoma or may be confused with other labial pigmentary disorders. Dermoscopy is widely used for the diagnosis of pigmented and nonpigmented lesions on the skin. Reflectance confocal microscopy (RCM) is an in vivo, noninvasive imaging technique that allows horizontal optical sectioning of skin at cellular-level resolution, from the surface to a depth of about 200 μm. Although the lips are amenable for hand-held RCM examination, publications about the RCM findings in MMLs are limited. To improve the recognition of MML under RCM, we report on 3 cases of biopsy-proven MMLs.
关键词： dermoscopy,labial melanotic macule,reflectance confocal microscopy
更新于2025-09-10 09:29:36
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Confocal Microscopy and Lentigo Maligna: An in vivo Pilot Study for the Assessment of Response to Imiquimod Therapy
摘要： Background: Reflectance confocal microscopy (RCM) is a noninvasive technique that provides real-time in vivo images of the epidermal layer. Imiquimod has been recommended as an alternative treatment in lentigo maligna (LM) when surgical excision is not the treatment of choice. In the present study we compare the results of in vivo RCM to the histopathological examination before and after treatment of LM with topical imiquimod. Methods: Thirty-four patients with confirmed LM were included. Imiquimod 5% was applied until a weeping erosion appeared in the LM-affected skin. Evaluation was performed by clinical examination, dermatoscopy, histopathology and RCM. Results: During the follow-up, 27 of 34 patients (79.42%) demonstrated a total tumor clearance by imiquimod treatment. In the treated area, a significant decrease of atypical cells was detected using RCM (p < 0.0001). Furthermore, a significant positive correlation in the detected atypical cells was shown using confocal microscopy and histology (p = 0.0001, r = 0.7335, respectively). Conclusion: In patients not suitable for surgical intervention imiquimod treatment is an appropriate treatment alternative. Thereby, in vivo RCM was demonstrated to be an excellent examining device, which not only allows diagnosis of LM, but also therapy and follow-up examinations. An important benefit of RCM, in contrast to conventional histopathology, is the simple handling with in vivo examination of epidermal skin without any pain for the patient.
关键词： Imiquimod therapy,Lentigo maligna,Noninvasive follow-up,Reflectance confocal microscopy
更新于2025-09-04 15:30:14