Caruncular naevi investigated by in vivo confocal microscopy: reporting the first 5 cases

Abstract

AbstractPurpose During body screening of melanocytic lesions, naevi of the eyelids, conjunctiva and caruncula, although accessible to the dermatologist, are often missed out. These tumors have similar characteristics and prognosis as oral or genital ones. We report the first cases of caruncular naevi observed by in vivo confocal microscopy (IVCM).Methods Five patients, 4 men and 1 woman, who presented with a caruncular melanocytic lesion, were examined by IVCM, using the handheld dermatological IVCM Vivascope 3000 (Lucid Inc, NY, MAVIG GmbH, Germany) equipped with 830nm class IB laser.Results Mean age was 39 years old (25‐71). The tumors which were 2.2mm width on average (0.5 ‐ 3.0 mm) were present since 4 years on average (1‐10). Two patients had family history of skin melanoma. IVCM showed hyperreflective round cells that were either isolated or grouped within the lamina propria. No abnormal cells were observed. Despite the benign IVCM aspect, a surgical excision biopsy was performed on 4 patients, for definitive histopathology or esthetic reasons. All 4 were compound naevus on histopathology. The remaining patient had no progression at 6 months follow upConclusion The caruncular site is inaccessible to both dermatoscopic imaging and standard dedicated ophthalmological IVCM. The Vivascope 3000 overpass this site limitation thanks to the small head of the camera and its handy and portable dimensions. In all cases, the IVCM imaging correlated with histopathology. This is the first reported series of caruncular melanocytic lesions explored in IVCM. Grant: GIRCI Rhone Alpes Auvergne 2012