Conflict of interest None. All authors declare that they have sufficiently participated in the submitted work to deserve authorship, all have had access to clinical material and have revised the manuscript before submission. Corresponding author (Dr Sébastien Debarbieux) endorses the scientific responsibility of the reported work herein.
Reflectance confocal microscopy accurately discriminates between benign and malignant melanocytic lesions exhibiting a ‘dermoscopic island’
Article first published online: 6 APR 2012
© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 27, Issue 2, pages e159–e165, February 2013
How to Cite
Debarbieux, S., Depaepe, L., Poulalhon, N., Balme, B., Dalle, S. and Thomas, L. (2013), Reflectance confocal microscopy accurately discriminates between benign and malignant melanocytic lesions exhibiting a ‘dermoscopic island’. Journal of the European Academy of Dermatology and Venereology, 27: e159–e165. doi: 10.1111/j.1468-3083.2012.04533.x
Funding sources This work is supported in part by grants from Lyon 1 University (to LT), the Hospices Civils de Lyon (to LT) and the ligue contre le cancer du Rhone (to LT). Administrative, technical or material support: L Thomas. Study supervision: S Debarbieux and L Thomas.
Statistical analysis Not applicable.
Ethical committee approval: waived (see underneath) This study has not been registered in a public trial registry because it does not ‘prospectively assigns human subjects to intervention or comparison groups to evaluate the cause and effect relationship between a medical intervention and a health outcome’.
- Issue published online: 22 JAN 2013
- Article first published online: 6 APR 2012
- Received: 13 January 2012; Accepted: 2 March 2012
Background The ‘dermoscopic island’ is a term that was recently proposed to design an area of a pigmented lesion with a uniform dermoscopic pattern different from the remainder of the lesion. The positive predictive value of this sign for the diagnosis of melanoma is about 50%.
Objective The purpose of our study was to see if reflectance confocal microscopy (RCM) permitted to accurately distinguish between nevi and melanoma in such lesions.
Methods Five lesions of five consecutive unselected patients, with a dermoscopic island but no feasible clear cut diagnosis on the basis of dermoscopy alone were examined by RCM before excision for histopathological evaluation.
Results Two lesions corresponded to nevi, and three lesions were early melanomas arising on a benign naevus in one case, and on a dysplastic naevus in two cases. In all five cases, RCM permitted to make the correct diagnosis, with a very good correlation with conventional histopathology.
Conclusion Reflectance confocal microscopy appears as a promising tool not only to enhance the early diagnosis of melanoma but also to avoid unnecessary excisions of lesions with a dermoscopic island.