Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

SHR Neuro Krebs Kardio Lipid

Borsari, S; Pampena, R; Lallas, A; Kyrgidis, A; Moscarella, E; Benati, E; Raucci, M; Pellacani, G; Zalaudek, I; Argenziano, G; Longo, C.
Clinical Indications for Use of Reflectance Confocal Microscopy for Skin Cancer Diagnosis.
JAMA Dermatol. 2016; 152(10):1093-1098
Web of Science PubMed FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Zalaudek Iris
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Abstract:
Reflectance confocal microscopy (RCM) improves diagnostic accuracy in skin cancer detection when combined with dermoscopy; however, little evidence has been gathered regarding its real impact on routine clinical workflow, and, to our knowledge, no studies have defined the terms for its optimal application. To identify lesions on which RCM performs better in terms of diagnostic accuracy and consequently to outline the best indications for use of RCM. Prospectively acquired and evaluated RCM images from consecutive patients with at least 1 clinically and/or dermoscopically equivocal skin lesion referred to RCM imaging, from January 2012 to October 2014, carried out in a tertiary referral academic center. A total of 1279 equivocal skin lesions were sent for RCM imaging. Spearman correlation, univariate, and multivariate regression models were performed to find features significantly correlated with RCM outcome. In a total of 1279 lesions in 1147 patients, RCM sensitivity and specificity were 95.3% and 83.9%, respectively. The number of lesions needed to excise to rule out a melanoma was 2.4. After univariate and multivariate regression analysis, head and neck resulted as the most appropriate body location for confocal examination; RCM showed a high diagnostic accuracy for lesions located on sun-damaged skin (adjusted odds ratio [aOR], 2.13; 95% CI, 1.37-3.30; P=.001) and typified by dermoscopic regression (aOR, 2.13; 95% CI, 1.31-3.47; P=.002) or basal-cell carcinoma specific criteria (aOR, 9.35; 95% CI, 1.28-68.58; P=.03). Lesions located on the head and neck, damaged by chronic sun-exposure, and dermoscopically typified by regression represent best indications for the use of RCM.
Find related publications in this database (using NLM MeSH Indexing)
Carcinoma, Basal Cell - diagnosis
Carcinoma, Basal Cell - surgery
Carcinoma, Squamous Cell - diagnosis
Carcinoma, Squamous Cell - surgery
Dermoscopy - methods
Diagnosis, Differential -
Hospitals, University -
Humans -
Melanoma - diagnosis
Melanoma - surgery
Microscopy, Confocal - methods
Predictive Value of Tests -
Prospective Studies -
Sensitivity and Specificity -
Skin Neoplasms - diagnosis
Skin Neoplasms - surgery

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