Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study

Abstract

Background

Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions.

Objective

To provide an overview of RCM practice in real-life.

Methods

A multicenter, prospective study carried out in 10 university dermatology departments in France.

Results

0verall, 410 patients were enrolled. Half of the patients (48%) were referred by private-practice dermatologists. They were referred for diagnosis (84.9%) or pre-surgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13,6%), and pre-surgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these,50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82). Limitations: This study was performed in the settings of French tertiary referral hospitals. Conclusion: This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients.