Original articleConcordance of handheld reflectance confocal microscopy (RCM) with histopathology in the diagnosis of lentigo maligna (LM): A prospective study
Section snippets
Study design
We designed a prospective study involving participants being seen in consultation by the dermatology service at Memorial Sloan Kettering Cancer Center in New York, NY. Eligible participants included men and women seen for evaluation of known or suspected LM between August 1, 2014, and August 31, 2015. Cases included primary lesions and possible recurrent and/or previously treated lesions. Both pigmented and amelanotic lesions were included. The study was approved by the Memorial Sloan Kettering
Participant and lesion characteristics
Seventeen participants were included in our study (9 male, 8 female; average age 71 years, range 35-90 years). Ten of the 17 lesions for evaluation occurred on the cheek, 3 on the forehead or scalp, and 1 each on the nose, lip, chin, and neck. The average lesion size was 2.5 cm (range 0.5-11 cm, SD 2.6 cm). Fifteen participants had lesions that were at least LM as determined by histopathology, including 4 participants with LM melanoma. Two participants had lesions that were clinically
Discussion
In this study, we show that RCM demonstrates excellent sensitivity and performed at least as well as conventional histopathology in detecting LM. The achieved sensitivity of 100% included cases of recurrent and/or previously treated lesions, which can be particularly difficult to diagnose clinically because of frequent nonspecific pigmentation or treatment-induced inflammation present in these lesions. Two other groups have previously reported sensitivities of 100% using RCM to detect LM,
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Supported in part by the Memorial Sloan Kettering Cancer Center Support Grant/Core Grant (P30 CA008748).
Conflicts of interest: None declared.