Microscopy

Microscopy Diagnostic Procedure Followed By Skin Surgeons

In recent decades, the dermatoscope has been thought to be an essential tool for skin cancer diagnosis, and it is currently referred as the “dermatologist’s stethoscope.”1-3 However, in some cases the diagnosis of malignant abnormalities is still challenging in a subset of difficult-to-diagnose melanomas (MMs) and nonmelanoma skin cancers. To narrow this gray zone, reflectance confocal microscopy (RCM), a second-level in vivo imaging technique, has proven to be a useful tool in saving unnecessary excisions of benign lesions that can look dermoscopically suspicious for skin cancer while catching MMs that are dermoscopically inconspicuous.

Microscopy improves diagnostic accuracy in skin cancer detection when combined with dermoscopy; however, little evidence has been gathered regarding its real impact on routine clinical workflow, and, to our knowledge, no studies have defined the terms for its optimal application. The objective is to identify lesions on which microscopy performs better in terms of diagnostic accuracy and consequently to outline the best indications for use of RCM.