Photo Credit: vshivkova
The following is a summary of “Remote cutaneous confocal microscopy: A multicentric prospective study evaluating diagnostic accuracy for melanoma and keratinocyte carcinoma in tertiary settings,” published in the October 2024 issue of Dermatology by Ho et al.
Cutaneous confocal microscopy (CCCM) enables in-vivo cellular-level skin visualization, while remote CCM via “store and forward” may increase access to non-invasive diagnosis.
Researchers conducted a retrospective study to assess the diagnostic accuracy and safety of remote-CCM.
They recruited biopsy-selected skin malignancy lesions across 5 Australian tertiary dermatology centers. Pre-biopsy CCM, clinical, and dermoscopy images were acquired and accessed via cloud-based platform for interpretation by CCM readers, and the CCM diagnoses were compared with histopathology results.
The results showed melanoma as the most common malignancy (34/72, 47.2%) among the 201 lesions of the 89 lesions (44.8%) potentially ‘saved’ from biopsy, 80 (90%) were benign, and 9 (10.1%) missed malignant lesions of melanoma in-situ (MIS) (n=7) and squamous cell carcinoma (SCC) (n=2). Melanomas which were not invasive were missing. Remote-CCM’s sensitivity for detecting malignancy was 89% (95%CI 79-95%), and specificity was 64% (95% CI 55-73%).
They concluded that remote CCM has comparable accuracy to bedside CCM and safely reduces unnecessary biopsies, but it is unsuitable for potential SCCs with follow-up recommendations of borderline melanocytic lesions.
Source: jaad.org/article/S01v90-9622(24)02956-6/fulltext
