title: Assessment of changes in lentigo maligna during radiotherapy by in-vivo reflectance confocal microscopy: a pilot study.
abstract: BACKGROUND
  Radiotherapy is an effective treatment for therapy of lentigo maligna (LM).
  
  
  OBJECTIVE
  To investigate the usefulness of in-vivo reflectance confocal microscopy (RCM) in radiotherapy of LM and document the changes within the lesions during treatment.
  
  
  METHODS
  A total of six lesions in six patients were investigated by RCM before, during and after radiotherapy. For diagnostic assessment three observers with experience in RCM diagnosis, blinded as to the stage of treatment, assessed the RCM images of each lesion and documented the findings by consensus.
  
  
  RESULTS
  Epidermal disarray worsened in three patients during radiotherapy and superficial necrosis was observed in four patients. Large pagetoid round/dendritic cells decreased or even vanished during or after radiotherapy. Dilated vessels and apoptotic cells were seen in all patients during radiotherapy as well as an increase of inflammatory cells in the epidermis and dermis in most of the patients. Dendritic cells with small dendrites were observed during radiotherapy in all patients with an increase in number in three patients. Melanophages appeared in five patients at least once during the examination period. All RCM images were assessed correctly by the three observers.
  
  
  CONCLUSIONS
  Reflectance confocal microscopy is a useful method to visualize changes during and after radiotherapy and might also be used for early detection of potential treatment failures. In addition, it might be helpful in planning radiotherapy.
authors.affiliation: Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Richtig
authors.forename: E
authors.initials: E
authors.lastname: Arzberger
authors.forename: R
authors.initials: R
authors.lastname: Hofmann-Wellenhof
authors.forename: R
authors.initials: R
authors.lastname: Fink-Puches
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D046169:Dermoscopy / Q000379:methods; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D008875:Middle Aged; D010865:Pilot Projects; D012878:Skin Neoplasms / Q000473:pathology / Q000532:radiotherapy*