CONFOCAL LASER SCANNING MICROSCOPY FOR DIAGNOSES OF MELANOCYTIC SKIN NEOPLASMS

Abstract

In cases of complicated differential diagnosis of benign melanocytic neoplasms and skin melanoma, clinical visual examination and superficial dermatoscopy do not always allow to make an accurate diagnosis, which is especially important in cases of suspected skin melanoma. In recent years the method of confocal microscopy (CM) has been used for non-invasive skin examination. In the present study 15 patients with suspected skin melanoma were examined by confocal laser microscopy in cases of complex differential diagnosis (18 melanocytic neoplasms in total). Ten patients were diagnosed with skin melanoma, including two amelanotic melanomas, which were subsequently confirmed by histological examination of the material obtained after surgical excision. The results of the study to determine the effectiveness of differential diagnosis of skin melanoma by laser confocal microscopy showed that differential diagnosis of skin melanoma is possible in the presence of the main criteria of malignancy: cellular atypia at the site of the dermo-epidermal junction (the first main criterion) and abnormality of papillary architecture (the second main criterion). At detection at least one of these criteria, a diagnosis of skin melanoma was made, which in all cases was confirmed by the results of histological examination. Inclusion of CM in the diagnostic algorithm of examination of patients with melanocytic neoplasms, suspicious of melanoma, makes it possible to improve the diagnosis of melanoma at early stages.