BACKGROUND
Confocal laser scanning microscopy (CLSM) is a state-of-the-art non-invasive and promising method for diagnostics of dermatological and dermato-oncological diseases allowing real-time visualization of specific pathomorphological symptoms of different dermatological conditions, including melanocytic neoplasms, for their differential diagnosis.
OBJECTIVE
To summarize and analyze work experience on the confocal microscope at the URIDI.
MATERIAL AND METHODS
Dermatoscopy and CLSM were performed on a VivaScope 1500/3000 confocal laser scanning microscope, Lucid-Tech. Inc., Henrietta, NY; MAVIG GmbH Munich, Germany. Statistical processing of the data was performed using Statistica 12.0 software.
RESULTS
Since 2012, 656 patients have been examined at the URIDI using CLSM. Of these, 272 patients with various skin neoplasms were referred to the Institute due to specific dermatoscopy patterns and suspected skin malignancy. Basal cell carcinoma of the skin was suspected in 17% of examined patients, in 11%, the skin melanoma was suspected, and in more than 90% of patients, the diagnosis was confirmed by biopsy. In 107 patients referred for CLSM with suspected primary skin lymphoma, specific signs of this disease were revealed, and a mathematical formula to estimate the probability of the diagnosis based on the aggregate of pathomorphological visualized symptoms was developed. The diagnosis was confirmed by pathomorphological and immunohistochemical studies in 77% of the subjects. We examined 163 patients with chronic dermatoses and visualized pathomorphological patterns typical of rare dermatoses (scleroderma, discoid lupus erythematosus, Devergie disease, chromoblastomycosis).
CONCLUSION
The CLSM study identified the set of specific signs of dermato-oncological diseases and chronic dermatoses, including rare ones. Subsequent pathomorphological confirmation of the diagnosis in the majority of examined patients indicates the high accuracy of the method, and its noninvasive nature and information value allow accelerating the diagnosis in challenging cases.
