Improving the overall diagnosis of eyelid margin tumours with in vivo reflectance confocal microscopy

Abstract

PurposeThe clinical diagnosis of eyelid margin tumours is often challenging and surgical excision in this area may have both functional and aesthetic consequences. Aim: to assess the role of handheld in vivo reflectance confocal microscopy (IVCM) in the diagnosis of eyelid margin tumours.MethodsWe prospectively evaluated and characterized 130 eyelid margin lesions using a handheld dermatology IVCM (Vivascope 3000, Mavig/Lcid, NY). Patients were referred to our multidisciplinary consultation from may 2013 to april 2015. All lesions were first clinically characterized as benign or malignant and then evaluated under IVCM by 3 skilled Dermatologists. Surgical excision was decided for 79 of them, based on both clinical and IVCM features. The 51 remaining lesions with no signs of malignancy were under followed up for at least 6 months. Clinical, IVCM, and histopathology diagnoses were compared.ResultsConsidering the 79 excised lesions: IVCM showed a sensitivity (Se) of 90% and a specificity (Sp) of 57% for malignant tumours (basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma) as compared to the histopathology. Clinical evaluation had Se of 81% and Sp of 50%. IVCM showed Se and Sp of respectively 89% and 62% for BCC; 60% and 100% for SCC; 100% and 45% for melanoma. None of the non‐excised lesions had clinical progression at 6 months and all these lesions were considered as benign.ConclusionsIVCM is an important tool in the management of eyelid margin tumours by improving the global sensitivity and specificity of the clinical diagnosis GRANT: AP jeune chercheur GIRCI RAA.