In vivo reflectance confocal microscopy of erythematosquamous skin diseases.
BACKGROUND
In vivo reflectance confocal microscopy (RCM) represents a promising imaging tool that allows a non-invasive examination of skin morphology in real time at nearly histological resolution, showing microanatomical structures and individual cells.


OBJECTIVE
The aim of our study was to evaluate the diagnostic accuracy of confocal examination of erythematosquamous skin diseases, to define typical RCM-features and assess them for their presence or absence, diagnostic performance and reliability.


METHODS
Three independent observers received standardized instructions about diagnostic RCM-features of erythematosquamous skin diseases. A total of 1700 RCM images obtained from 75 patients with psoriasis, contact dermatitis, mycosis fungoides, chronic discoid lupus erythematosus (CDLE) or subacute cutaneous lupus erythematosus (SCLE) and from 10 'healthy adults' without any skin disease were evaluated by each observer.


RESULTS
Overall, sensitivity and specificity values as observed by three observers were, respectively, 89.13% and 95.41% for psoriasis; 83.33% and 92.31% for contact dermatitis; 62.96% and 94.53% for SCLE/CDLE; and 63.33% and 92.89% for mycosis fungoides.


CONCLUSIONS
Reflectance confocal microscopy examination appears to be a promising method for non-invasive assessment of erythematosquamous skin diseases. This study provides a set of well-described morphological criteria with obvious diagnostic impact, which should be used in further investigations.
Koller
Silvia
S
Department of Dermatology, Medical University of Graz, Graz, Austria. silvia.koller@meduni-graz.at
Gerger
Armin
A
Ahlgrimm-Siess
Verena
V
Weger
Wolfgang
W
Smolle
Josef
J
Hofmann-Wellenhof
Rainer
R