Hunting for Early Melanomas With a Maximum Clinical Surface Diameter up to 6 mm: A Prospective Study of Reflectance Confocal Microscopy Features in 68 Consecutive Cases
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Early diagnosis of melanoma and prompt effective therapy optimizes prognosis. Reflectance confocal microscopy (RCM) facilitates diagnosis by providing immediate 3D single cell resolution down into the papillary dermis. METHODS: Consecutive cases were examined using a Vivascope 1500 confocal microscope at a single referral medical practice in Sydney, Australia 2019-2023. Melanoma clinical surface diameters were recorded by 0.1 mm increments up to 6.0 mm. The RCM features recorded were: pagetoid single cells or nests, pleomorphic cell shape, atypical dendritic cells, non-edged papillae, variation in melanocyte size and confluent sheets of cells. All cases required diagnostic agreement by two dermatohistopathologists using hematoxylin and eosin staining followed by SOX 10 and/or PRAME stains if required. RESULTS: Total cases were 68: 38 males (mean age 57) and 30 females (mean age 64). Melanoma in situ (n = 65) compared to invasive melanoma (n = 3), all males, invasion depth (0.4-0.5 mm). Most frequent RCM features found in 50% or more of cases within all diameter increments were: pagetoid single cells n = 64/68 (94%), pleomorphic cell shape n = 63/68 (93%), epidermal disarray n = 58/68 (85%), and atypical dendritic cells n = 45/68 (66%). Non-edged dermal papillae were n = 42/68 (62%). CONCLUSION: Melanoma RCM features were found throughout the diameter ranges. Confocal examination may facilitate early melanoma recognition in these ranges.
Source: Journal of Cutaneous Pathology
DOI: 10.1111/cup.14731
Institution: UNSW Sydney
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,400
OpenAlex ID: W4403355471