Funding sources None.
CLINICAL AND LABORATORY INVESTIGATIONS
Reflectance confocal microscopy allows in vivo real-time noninvasive assessment of the outcome of methyl aminolaevulinate photodynamic therapy of basal cell carcinoma
Article first published online: 21 DEC 2012
© 2012 The Authors. BJD © 2012 British Association of Dermatologists
British Journal of Dermatology
Volume 168, Issue 1, pages 99–105, January 2013
How to Cite
Venturini, M., Sala, R., Gonzàlez, S. and Calzavara-Pinton, P.G. (2013), Reflectance confocal microscopy allows in vivo real-time noninvasive assessment of the outcome of methyl aminolaevulinate photodynamic therapy of basal cell carcinoma. British Journal of Dermatology, 168: 99–105. doi: 10.1111/bjd.12052
Conflicts of interest None declared.
- Issue published online: 21 DEC 2012
- Article first published online: 21 DEC 2012
- Accepted manuscript online: 26 SEP 2012 12:10PM EST
- Accepted for publication 13 September 2012
Background Photodynamic therapy (PDT) with methyl aminolaevulinate (MAL) is an approved noninvasive treatment option for basal cell carcinoma (BCC). In vivo reflectance confocal microscopy (RCM) is a noninvasive imaging technique that has proved useful for in vivo real-time cytomorphological analysis of BCC cells infiltrating the epidermis.
Objectives To investigate the use of in vivo RCM to assess the persistence of BCC cells surviving MAL-PDT.
Methods In vivo RCM images of 20 biopsy-proven BCCs were taken before patients underwent a treatment cycle with MAL-PDT. Follow-up after 3 months was performed using clinical examination, RCM and conventional dermoscopy. Treated areas also underwent a targeted 3-mm punch biopsy for standard haematoxylin and eosin histology stain to establish the clinical and instrumental correlation of the treatment outcome.
Results Three months after PDT, clinical examination established that two out of 20 BCCs were persistent; dermoscopy found three out of 20 residual BCCs, but RCM showed that one of these lesions was a false positive, and showed persistent BCC foci in five out of 20 lesions. Histological analysis of targeted biopsies confirmed these results.
Conclusions RCM provided noninvasive, early detection of incipient recurrences of BCC after MAL-PDT. RCM findings steered targeted biopsies and surgical removal, or a new MAL-PDT, of these subclinical recurrences with minimal invasiveness.