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Stefanski M, Le Guern A, Visseaux L, Ehret M, Colomb M, Jeudy G, Le Duff F, Vourc'h M, Baroudjian B, Perea-Villacorta R, Bernigaud C, Mallet S, Norberciak L, Debarbieux S, Perrot JL, Grange F, Modiano P, Monnier J, Bahadoran P. Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study. J Am Acad Dermatol 2024; 91:51-56. [PMID: 38387851 DOI: 10.1016/j.jaad.2024.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/03/2023] [Accepted: 01/10/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions. OBJECTIVE To provide an overview of RCM practice in real-life. METHODS A multicenter, prospective study carried out in 10 university dermatology departments in France. RESULTS Overall, 410 patients were enrolled. One-half of the patients (48%) were referred by private practice dermatologists. They were referred for diagnosis (84.9%) or presurgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13.6%), and presurgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these, 50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82). LIMITATIONS This study was performed in the settings of French tertiary referral hospitals. CONCLUSION This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients.
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Affiliation(s)
- Marion Stefanski
- Department of Oncodermatology, Reims University Hospital, Reims France; Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | - Aurore Le Guern
- Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | | | - Marine Ehret
- Department of Dermatology, Emile Muller Hospital, Mulhouse, France
| | - Michel Colomb
- Department of Oncodermatology, Reims University Hospital, Reims France
| | - Géraldine Jeudy
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | - Florence Le Duff
- Department of Dermatology, Nice University Hospital, Nice, France
| | - Morgane Vourc'h
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | | | - Rosa Perea-Villacorta
- Department of Dermatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Stéphanie Mallet
- Department of Dermatology and Skin Cancers, La Timone Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Laurène Norberciak
- Delegation of Clinical Research and Innovation, Biostatistics, Saint Philibert Hospital, Catholic University of Lille, Lille, France
| | | | - Jean-Luc Perrot
- Department of Dermatology, Saint Etienne University Hospital et Laboratoire Hubert Curien UMR CNRS 5516, Saint Etienne, France
| | - Florent Grange
- Department of Dermatology, Valence Hospital, Valence, France
| | - Philippe Modiano
- Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | - Jilliana Monnier
- Department of Dermatology and Skin Cancers, La Timone Hospital, AP-HM, Aix-Marseille University, Marseille, France
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Owida HA. Developments and Clinical Applications of Noninvasive Optical Technologies for Skin Cancer Diagnosis. J Skin Cancer 2022; 2022:9218847. [PMID: 36437851 PMCID: PMC9699785 DOI: 10.1155/2022/9218847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/29/2022] [Accepted: 11/09/2022] [Indexed: 04/03/2024] Open
Abstract
Skin cancer has shown a sharp increase in prevalence over the past few decades and currently accounts for one-third of all cancers diagnosed. The most lethal form of skin cancer is melanoma, which develops in 4% of individuals. The rising prevalence and increased number of fatalities of skin cancer put a significant burden on healthcare resources and the economy. However, early detection and treatment greatly improve survival rates for patients with skin cancer. Since the rising rates of both the incidence and mortality have been particularly noticeable with melanoma, significant resources have been allocated to research aimed at earlier diagnosis and a deeper knowledge of the disease. Dermoscopy, reflectance confocal microscopy, optical coherence tomography, multiphoton-excited fluorescence imaging, and dermatofluorescence are only a few of the optical modalities reviewed here that have been employed to enhance noninvasive diagnosis of skin cancer in recent years. This review article discusses the methodology behind newly emerging noninvasive optical diagnostic technologies, their clinical applications, and advantages and disadvantages of these techniques, as well as the potential for their further advancement in the future.
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Affiliation(s)
- Hamza Abu Owida
- Medical Engineering Department, Faculty of Engineering, Al Ahliyya Amman University, Amman 19328, Jordan
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Meng X, Chen J, Zhang Z, Li K, Li J, Yu Z, Zhang Y. Non-invasive optical methods for melanoma diagnosis. Photodiagnosis Photodyn Ther 2021; 34:102266. [PMID: 33785441 DOI: 10.1016/j.pdpdt.2021.102266] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/09/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
Cutaneous melanoma is one of the most common malignancies with increased incidence in the past few decades, making it a significant public health problem. The early diagnosis of melanoma is a major factor in improving patient's survival. The traditional pathway to melanoma diagnosis starts with a visual diagnosis, followed by subsequent biopsy and histopathologic evaluation. Recently, multiple innovative optical technology-based methods, including dermoscopy, reflectance confocal microscopy, optical coherence tomography, multiphoton excited fluorescence imaging and stepwise two-photon excited fluorescence (dermatofluoroscopy), have been developed to increase the diagnostic accuracy for the non-invasive melanoma diagnosis. Some of them have already been applied to real-life clinical settings, others require more research and development. These technologies show promise in facilitating the diagnosis of melanoma since they are non-invasive, sensitive, objective and easy to apply. Diagnostic accuracy, detection time, portability and the cost-effectiveness of the device are all aspects that need to be improved. This article reviews the method of these emerging optical non-invasive diagnostic technologies, their clinical application, their benefits and limitations, as well as their possible future development.
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Affiliation(s)
- Xinxian Meng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jun Chen
- Department of Dermatology and Dermatologic Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zheng Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ke Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jie Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhixi Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yixin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China; Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.
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