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Current Dermatology Reports
Published in: Current Dermatology Reports 3/2017

01-09-2017 | Skin Cancer (D Siegel and O Markowitz, Section Editors)

Reflectance Confocal Microscopy for Margin Assessment and Management of Lentigo Maligna

Authors: Tyler D. Menge, Brian P. Hibler, Miguel Cordova, Anthony M. Rossi

Published in: Current Dermatology Reports | Issue 3/2017

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Abstract

Purpose of Review

Lentigo maligna (LM) is a form of melanoma in situ and represents a diagnostic and therapeutic challenge due to its poorly defined, irregular borders; propensity for subclinical extension; and location on the background of severely sun-damaged skin. Reflectance confocal microscopy (RCM) is a non-invasive optical imaging tool that allows clinicians to detect LM and assess margin status in vivo.

Recent Findings

RCM is very accurate for diagnosing LM and guiding biopsies, with sensitivities ranging from 93 to 100% and specificities 71–82%. It has also been used pre-operatively to map lesions, intra-operatively for real-time evaluation of surgical margins, and post treatment to monitor for recurrence.

Summary

The advent of newer technologies, including RCM, has advanced our ability to better diagnose and manage LM. RCM offers clinicians the ability to guide biopsies, accurately detect subclinical disease, and readily map LM margins. Future research is aimed at using RCM to allow clinicians to better spare healthy tissue and to reduce disease recurrence without subjecting patients to the lost time, cost, and potential morbidity associated with multiple surgeries.
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Metadata
Title
Reflectance Confocal Microscopy for Margin Assessment and Management of Lentigo Maligna
Authors
Tyler D. Menge
Brian P. Hibler
Miguel Cordova
Anthony M. Rossi
Publication date
01-09-2017
Publisher
Springer US
Published in
Current Dermatology Reports / Issue 3/2017
Electronic ISSN: 2162-4933
DOI
https://doi.org/10.1007/s13671-017-0194-5

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