Reflectance confocal microscopy for margin assessment and management of lentigo maligna Journal Article


Authors: Menge, T. D.; Hibler, B. P.; Cordova, M.; Rossi, A. M.
Article Title: Reflectance confocal microscopy for margin assessment and management of lentigo maligna
Abstract: Purpose of Review Lentigo maligna (LM) is a form of melanoma in situ and represents a diagnostic and therapeutic challenge due to its poorly defined, irregular borders; propensity for subclinical extension; and location on the background of severely sun-damaged skin. Reflectance confocal microscopy (RCM) is a non-invasive optical imaging tool that allows clinicians to detect LM and assess margin status in vivo. Recent Findings RCM is very accurate for diagnosing LM and guiding biopsies, with sensitivities ranging from 93 to 100% and specificities 71-82%. It has also been used preoperatively to map lesions, intra-operatively for real-time evaluation of surgical margins, and post treatment to monitor for recurrence. Summary The advent of newer technologies, including RCM, has advanced our ability to better diagnose and manage LM. RCM offers clinicians the ability to guide biopsies, accurately detect subclinical disease, and readily map LM margins. Future research is aimed at using RCM to allow clinicians to better spare healthy tissue and to reduce disease recurrence without subjecting patients to the lost time, cost, and potential morbidity associated with multiple surgeries.
Keywords: melanoma; dermoscopy; reflectance confocal microscopy; imiquimod; lentigo maligna; diagnosis; imaging; margins; diseases; surgical margins; mapping; monitor; skin in-vivo; spaghetti technique; macules
Journal Title: Current Dermatology Reports
Volume: 6
Issue: 3
ISSN: 2162-4933
Publisher: Springer  
Date Published: 2017-09-01
Start Page: 222
End Page: 229
Language: English
ACCESSION: WOS:000413583100008
DOI: 10.1007/s13671-017-0194-5
PROVIDER: wos
Notes: Article -- Source: Wos
Altmetric Score
MSK Authors
  1. Anthony Rossi
    84 Rossi
  2. Miguel A Cordova
    42 Cordova
  3. Brian Phillip Hibler
    40 Hibler