Preliminary evaluation of benign vascular lesions using in vivo reflectance confocal microscopy.
BACKGROUND
Reflectance confocal microscopy (RCM) is a novel noninvasive imaging technique for in vivo evaluation of cutaneous lesions at near-histologic resolution. The applicability of RCM for various neoplastic and inflammatory skin diseases has been shown, but a descriptive evaluation of different vascular lesions has not yet been performed.


OBJECTIVE
To define specific RCM criteria for congenital and acquired vascular lesions and to determine whether these criteria may assist in their differential diagnosis.


METHODS
Seven patients with a clinical diagnosis of vascular lesion, including spider angioma, venous lake, cherry angioma, pyogenic granuloma, port wine stain, angiokeratoma, and lymphangioma, participated in this study. Skin sites were systematically analyzed using RCM, and biopsy was obtained for clinically indeterminate lesions.


RESULTS
For each entity, characteristic RCM criteria could be identified and selected parameters correlated well to established histopathologic findings. The most relevant criteria included the diameter of the vessels and degree of vascular tortuosity or dilation. Additional findings such as flow velocity, inflammation, and disruption of the epidermal architecture could be documented.


CONCLUSIONS
The findings of this preliminary evaluation indicate that RCM may aid in the noninvasive characterization of inflammatory, proliferative, and ectatic vascular malformations in vivo.
Astner
Susanne
S
Department of Dermatology, Venerology and Allergology, Charité University Medicine, Berlin, Germany. susanne.astner@charite.de
González
Salvador
S
Cuevas
Jesus
J
Röwert-Huber
Joachim
J
Sterry
Wolfram
W
Stockfleth
Eggert
E
Ulrich
Martina
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D017789:Granuloma, Pyogenic / Q000473:pathology*; D006801:Humans; D008202:Lymphangioma / Q000473:pathology*; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D009383:Neoplasms, Vascular Tissue / Q000473:pathology*; D010865:Pilot Projects; D019339:Port-Wine Stain / Q000473:pathology*; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult