title: Reflectance confocal microscopy of mucosal pigmented macules: a review of 56 cases including 10 macular melanomas.
abstract: BACKGROUND
  Although most mucosal pigmented macules are benign, it can be clinically challenging to rule out an early melanoma. Reflectance confocal microscopy (RCM) is a noninvasive imaging technique useful in discriminating between benign and malignant skin lesions.
  
  
  OBJECTIVE
  To describe the confocal aspects of benign and malignant mucosal pigmented macules with histopathological correlations.
  
  
  METHODS
  We retrospectively reviewed the confocal images of 56 labial or genital pigmented macules including 10 macular melanomas. According to the retrospective nature of the study, we evaluated the recorded images chosen by the physicians that performed the RCM examination for each case.
  
  
  RESULTS
  In benign macules, the most frequently observed pattern was a ringed pattern characterized by round or polycyclic papillae, with a hyper-reflective basal layer; another pattern was characterized by sparse bright dendritic cells in the basal layer, the basal epithelial cells being otherwise less reflective. Roundish cells, a high density of dendritic cells with atypias and intraepithelial bright cells were clues to the presence of malignancy.
  
  
  CONCLUSIONS
  Reflectance confocal microscopy seems to be a valuable tool to noninvasively differentiate benign from malignant mucosal pigmented macules and target biopsies in cases of equivocal features.
authors.affiliation: Department of Dermatology, Centre Hospitalier Lyon Sud, Pierre Bénite, France.
authors.forename: S
authors.initials: S
authors.lastname: Debarbieux
authors.forename: J L
authors.initials: JL
authors.lastname: Perrot
authors.forename: N
authors.initials: N
authors.lastname: Erfan
authors.forename: S
authors.initials: S
authors.lastname: Ronger-Savlé
authors.forename: B
authors.initials: B
authors.lastname: Labeille
authors.forename: E
authors.initials: E
authors.lastname: Cinotti
authors.forename: L
authors.initials: L
authors.lastname: Depaepe
authors.forename: N
authors.initials: N
authors.lastname: Cardot-Leccia
authors.forename: J P
authors.initials: JP
authors.lastname: Lacour
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.forename: P
authors.initials: P
authors.lastname: Bahadoran
mesh_terms: D005260:Female; D006801:Humans; D008048:Lip Neoplasms / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008548:Melanosis / Q000473:pathology; D018613:Microscopy, Confocal; D009092:Mucous Membrane / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014846:Vulvar Neoplasms / Q000473:pathology