Hibler Brian P, Yélamos Oriol, Cordova Miguel, Sierra Heidy, Rajadhyaksha Milind, Nehal Kishwer S, Rossi Anthony M
Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA, and Dermatology Department, Hospital Clínic, Universitat de Barcelona, Spain.
Cutis. 2017 May;99(5):346-352.
Diagnosis and management of lentigo maligna (LM) and LM melanoma (LMM) is challenging. Novel noninvasive imaging technologies such as reflectance confocal microscopy (RCM) have advanced the ability to better diagnose and monitor challenging lesions. In addition, the new handheld RCM (HRCM) together with the use of videomosaics has allowed an accurate evaluation of large lesions in concave/convex areas of the body (eg, the face). Herein, we review the impact of HRCM in the detection, treatment decision-making, and monitoring of 5 cases of complex facial LM/LMM. In the cases presented, HRCM enabled the detection of subclinical margins, presence of invasion, detection of persistence/recurrence, and monitoring of surgical and nonsurgical therapies. In this preliminary report, our results suggest that HRCM is a versatile ancillary tool in pretreatment decision-making, intraoperative surgical mapping, and posttreatment monitoring of complex facial LM/LMM.
恶性雀斑样痣（LM）和恶性雀斑样痣黑色素瘤（LMM）的诊断与管理具有挑战性。诸如反射式共聚焦显微镜（RCM）等新型非侵入性成像技术提高了对具有挑战性病变进行更好诊断和监测的能力。此外，新型手持式RCM（HRCM）与视频拼接技术的结合，使得对身体凹凸部位（如面部）的大病变进行准确评估成为可能。在此，我们回顾了HRCM对5例复杂面部LM/LMM的检测、治疗决策及监测的影响。在所呈现的病例中，HRCM能够检测亚临床边界、浸润情况、持续性/复发性，以及监测手术和非手术治疗。在这份初步报告中，我们的结果表明，HRCM是复杂面部LM/LMM预处理决策、术中手术定位及治疗后监测的一种多功能辅助工具。
