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Introduction to reflectance confocal microscopy and its use in clinical practice
摘要： Re?ectance confocal microscopy (RCM) is a novel technology that provides noninvasive, in vivo imaging of the skin at nearly histologic resolution. In 2016, the US Centers for Medicare and Medicaid Services (CMS) established reimbursement codes for RCM image acquisition and for the reading and interpretation of images. The combination of RCM imaging with dermoscopy has improved the accuracy of skin cancer diagnosis while reducing the number of biopsies of benign skin lesions. With that, we are starting to see more dermatologists and dermatopathologists using RCM in clinical practice. This editorial is to serve as an introduction on RCM imaging with a focus on its usefulness in both the diagnosis and management of skin cancers. We end by brie?y describing the characteristic RCM features of normal skin to serve as a building block for later cases that will explore both the bene?ts and drawbacks of incorporating RCM imaging for benign and malignant lesions.
关键词： innovative technology,noninvasive imaging,skin cancer,melanoma,re?ectance confocal microscopy,lentigo maligna,nonmelanoma skin cancer
更新于2025-09-23 15:21:01
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Reflectance confocal microscopy-guided carbon dioxide laser ablation of low-risk basal cell carcinomas: A prospective study
摘要： Background: Basal cell carcinoma (BCC) treatment modalities can be strati?ed by tumor subtype and recurrence risk. The main limitation of nonsurgical treatment modalities is the lack of histopathologic con?rmation. Re?ectance confocal microscopy (RCM) is a noninvasive imaging device that provides quasihistologic images. Objective: To evaluate the feasibility and ef?cacy of RCM-guided carbon dioxide (CO2) laser ablation of low-risk BCCs. Methods: Prospective study with biopsy specimeneproven low-risk BCCs imaged with RCM. RCM was performed on these sites before and after ablation. If residual tumor was found, a new series of laser passes were performed. The patients were then monitored for recurrence clinically and with RCM. Results: Twenty-two tumor sites in 9 patients (5 men, 4 women) were imaged and treated. Median age was 59 6 12.9 years (range, 30-74 years). Mean tumor size was 7.7 mm (range, 5-10 mm). Residual tumor was identi?ed in 5 of 22 cases (22.7%) under RCM on immediate ?rst-pass postablation sites, prompting additional laser passes. Median follow-up was 28.5 months (range, 22-32 months) with no recurrences found. Conclusions: Addition of RCM to laser ablation work?ow can detect subclinical persistent tumor after initial ablation and may serve as an aid to increase the ef?cacy of laser ablation.
关键词： laser,basal cell carcinoma,carbon dioxide laser,ablation,diagnosis,follow-up,re?ectance confocal microscopy,treatment
更新于2025-09-19 17:13:59