Funding sources This work is supported in part by grants from Lyon 1 University (to L.T.), the Hospices Civils de Lyon (to L.T.) and the ligue contre le cancer du Rhone (to L.T.).
Clinical and Laboratory Investigations
Reflectance confocal microscopy of mucosal pigmented macules: a review of 56 cases including 10 macular melanomas
Article first published online: 19 JUN 2014
© 2013 British Association of Dermatologists
British Journal of Dermatology
Volume 170, Issue 6, pages 1276–1284, June 2014
How to Cite
Debarbieux, S., Perrot, J.L., Erfan, N., Ronger-Savlé, S., Labeille, B., Cinotti, E., Depaepe, L., Cardot-Leccia, N., Lacour, J.P., Thomas, L., Bahadoran, P. and the Groupe d'Imagerie Cutanée Non Invasive de la Société Française de Dermatologie (2014), Reflectance confocal microscopy of mucosal pigmented macules: a review of 56 cases including 10 macular melanomas. British Journal of Dermatology, 170: 1276–1284. doi: 10.1111/bjd.12803
Conflicts of interest None declared.
- Issue published online: 19 JUN 2014
- Article first published online: 19 JUN 2014
- Accepted manuscript online: 20 DEC 2013 08:11AM EST
- Manuscript Accepted: 16 DEC 2013
- Lyon 1 University
- Hospices Civils de Lyon
- ligue contre le cancer du Rhone
Although most mucosal pigmented macules are benign, it can be clinically challenging to rule out an early melanoma. Reflectance confocal microscopy (RCM) is a noninvasive imaging technique useful in discriminating between benign and malignant skin lesions.
To describe the confocal aspects of benign and malignant mucosal pigmented macules with histopathological correlations.
We retrospectively reviewed the confocal images of 56 labial or genital pigmented macules including 10 macular melanomas. According to the retrospective nature of the study, we evaluated the recorded images chosen by the physicians that performed the RCM examination for each case.
In benign macules, the most frequently observed pattern was a ringed pattern characterized by round or polycyclic papillae, with a hyper-reflective basal layer; another pattern was characterized by sparse bright dendritic cells in the basal layer, the basal epithelial cells being otherwise less reflective. Roundish cells, a high density of dendritic cells with atypias and intraepithelial bright cells were clues to the presence of malignancy.
Reflectance confocal microscopy seems to be a valuable tool to noninvasively differentiate benign from malignant mucosal pigmented macules and target biopsies in cases of equivocal features.