Dermatology Department, Miami Cancer Institute, Miami, FL, United States; Department of Human Pathology, Oswaldo Cruz Foundation, Salvador, BA, Brazil.
Medical School, Florida Atlantic University College of Medicine, BocaRaton, FL, United States.
An Bras Dermatol. 2022 Nov-Dec;97(6):697-703. doi: 10.1016/j.abd.2021.10.010. Epub 2022 Sep 21.
Since its first introduction into medical practice, reflectance confocal microscopy (RCM) has been a valuable non-invasive diagnostic tool for the assessment of benign and malignant neoplasms of the skin. It has also been used as an adjunct for diagnosing equivocal cutaneous neoplasms that lack characteristic clinical or dermoscopic features. The use of RCM has led to a decreased number of biopsies of benign lesions. Multiple published studies show a strong correlation between RCM and histopathology thereby creating a bridge between clinical aspects, dermoscopy, and histopathology. Dermatopathologists may potentially play an important role in the interpretation of confocal images, by their ability to correlate histopathologic findings. RCM has also been shown to be an important adjunct to delineating tumoral margins during surgery, as well as for monitoring the non-surgical treatment of skin cancers. Advanced technology with smaller probes, such as the VivaScope 3000, has allowed access to lesions in previously inaccessible anatomic locations. This review explains the technical principles of RCM and describes the most common RCM features of normal skin with their corresponding histological correlation.
自从反射共聚焦显微镜（RCM）首次引入医学实践以来，它一直是评估皮肤良恶性肿瘤的一种有价值的非侵入性诊断工具。它也被用作诊断缺乏特征性临床或皮肤镜特征的可疑皮肤肿瘤的辅助手段。RCM 的使用导致良性病变活检数量减少。多项已发表的研究表明 RCM 与组织病理学之间具有很强的相关性，从而在临床方面、皮肤镜和组织病理学之间架起了桥梁。通过关联组织病理学发现，皮肤科病理学家在解释共聚焦图像方面可能发挥重要作用。RCM 还被证明是在手术中描绘肿瘤边界以及监测皮肤癌非手术治疗的重要辅助手段。具有更小探头的先进技术，如 VivaScope 3000，允许进入以前无法到达的解剖部位的病变。本文综述了 RCM 的技术原理，并描述了正常皮肤的最常见 RCM 特征及其相应的组织学相关性。
