title: Reflectance confocal microscopy features of acral lentiginous melanoma: a comparative study with acral nevi.
abstract: BACKGROUND
  Acral lentiginous melanoma (ALM) can be difficult to differentiate from acral nevus. Reflectance confocal microscopy (RCM) is widely used for the diagnosis of melanocytic tumours, but the RCM features of ALM and acral nevus have not been described yet.
  
  
  OBJECTIVE
  To determine the RCM features of ALM and acral nevus, and their correlation with clinical and histological characteristics.
  
  
  METHODS
  Retrospective study of 17 cases of ALM and 26 acral nevi.
  
  
  RESULTS
  Pagetoid cells were present in all ALMs with a visible epidermis and in three nevi. A proliferation of atypical melanocytes at the dermal-epidermal junction (DEJ) and/or in the dermis was visible in nine ALMs but not in nevi. The histopathological examination of initial skin biopsies was unable to diagnose ALM in four cases, differing from RCM that could identify malignant tumour cells by exploring the whole lesions.
  
  
  CONCLUSIONS
  Reflectance confocal microscopy can help in the differentiation of ALM and acral nevus, and to guide the biopsy.
authors.affiliation: Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France.
authors.forename: E
authors.initials: E
authors.lastname: Cinotti
authors.affiliation: Dermatology Department, Hospices Civils of Lyon, Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Debarbieux
authors.affiliation: Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Perrot
authors.affiliation: Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France.
authors.forename: B
authors.initials: B
authors.lastname: Labeille
authors.affiliation: Pathology Department, LPCE, CHU of Nice, Nice, France.
authors.forename: E
authors.initials: E
authors.lastname: Long-Mira
authors.affiliation: Pathology Department, CHU of Saint-Etienne, Saint-Etienne, France.
authors.forename: C
authors.initials: C
authors.lastname: Habougit
authors.affiliation: Pathology Department, CHU of Saint-Etienne, Saint-Etienne, France.
authors.forename: C
authors.initials: C
authors.lastname: Douchet
authors.affiliation: Pathology Department, Hospices Civils of Lyon, Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Depaepe
authors.affiliation: Pathology Department, LPCE, CHU of Nice, Nice, France.
authors.forename: H
authors.initials: H
authors.lastname: Hammami-Ghorbel
authors.affiliation: Pathology Department, LPCE, CHU of Nice, Nice, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Lacour
authors.affiliation: Dermatology Department, Hospices Civils of Lyon, Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.affiliation: Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France.
authors.forename: F
authors.initials: F
authors.lastname: Cambazard
authors.affiliation: Pathology Department, LPCE, CHU of Nice, Nice, France.|Centre de Recherche Clinique, INSERM U 1065 Equipe 1 CHU of Nice, Nice, France.
authors.forename: P
authors.initials: P
authors.lastname: Bahadoran
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D018613:Microscopy, Confocal / Q000379:methods*; D009506:Nevus / Q000175:diagnosis* / Q000473:pathology