Background: Confocal microscopy is a second-level examination for dermoscopically equivocal melanocytic lesions. However, the number of false-negative cases on confocal microscopy and the scenarios in which confocal microscopy may fail have not been fully elucidated. Objective: To calculate the percentage of false-negative melanomas upon reflectance confocal microscopy examination in a large series of cases. Methods: A retrospective analysis on 201 melanomas, evaluated for dermoscopic/confocal criteria of melanoma, was carried out. Results: Twenty-three melanomas out of 201 cases (11.4%) revealed a low 7-point checklist score. On confocal examination, 22 out of 23 lesions have been diagnosed correctly as melanomas. Only 1 lesion did not display melanoma features, neither upon dermoscopy nor upon confocal microscopy examination. Seven lesions out of 201 cases (3.5%) were judged as negative on confocal examination, even if 6 of them were diagnosed as melanomas by clinical and/or dermoscopic evaluation. After histopathological revision, these cases were grouped into 5 categories: (1) amelanotic melanoma (n = 1), (2) hyperkeratotic melanomas (n = 2), (3) lentiginous melanomas (n = 2), (4) melanoma with small pagetoid cells (n = 1), (5) spitzoid melanoma (n = 1). Conclusion: Confocal and dermoscopic examination, along with patient-related information and clinical history, can lead to an optimal patient management.

Coco, V., Farnetani, F., Cesinaro, A. M., Ciardo, S., Argenziano, G., Peris, K., Pellacani, G., Longo, C., False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal, <<DERMATOLOGY>>, 2016; 232 (2): 189-197. [doi:10.1159/000443637] [http://hdl.handle.net/10807/92531]

False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal

Coco
Primo
;
Giuseppe; Peris;
2016

Abstract

Background: Confocal microscopy is a second-level examination for dermoscopically equivocal melanocytic lesions. However, the number of false-negative cases on confocal microscopy and the scenarios in which confocal microscopy may fail have not been fully elucidated. Objective: To calculate the percentage of false-negative melanomas upon reflectance confocal microscopy examination in a large series of cases. Methods: A retrospective analysis on 201 melanomas, evaluated for dermoscopic/confocal criteria of melanoma, was carried out. Results: Twenty-three melanomas out of 201 cases (11.4%) revealed a low 7-point checklist score. On confocal examination, 22 out of 23 lesions have been diagnosed correctly as melanomas. Only 1 lesion did not display melanoma features, neither upon dermoscopy nor upon confocal microscopy examination. Seven lesions out of 201 cases (3.5%) were judged as negative on confocal examination, even if 6 of them were diagnosed as melanomas by clinical and/or dermoscopic evaluation. After histopathological revision, these cases were grouped into 5 categories: (1) amelanotic melanoma (n = 1), (2) hyperkeratotic melanomas (n = 2), (3) lentiginous melanomas (n = 2), (4) melanoma with small pagetoid cells (n = 1), (5) spitzoid melanoma (n = 1). Conclusion: Confocal and dermoscopic examination, along with patient-related information and clinical history, can lead to an optimal patient management.
Inglese
Coco, V., Farnetani, F., Cesinaro, A. M., Ciardo, S., Argenziano, G., Peris, K., Pellacani, G., Longo, C., False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal, <<DERMATOLOGY>>, 2016; 232 (2): 189-197. [doi:10.1159/000443637] [http://hdl.handle.net/10807/92531]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/92531
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