TY - JOUR
T1 - False-Negative Cases on Confocal Microscopy Examination
T2 - A Retrospective Evaluation and Critical Reappraisal
AU - Coco, Valeria
AU - Farnetani, Francesca
AU - Cesinaro, Anna Maria
AU - Ciardo, Silvana
AU - Argenziano, Giuseppe
AU - Peris, Ketty
AU - Pellacani, Giovanni
AU - Longo, Caterina
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background: Confocal microscopy is a second-level examination for dermoscopically equivocal melanocytic lesions. However, the number of false-negative cases on confocal microscopy and the scenarios in which confocal microscopy may fail have not been fully elucidated. Objective: To calculate the percentage of false-negative melanomas upon reflectance confocal microscopy examination in a large series of cases. Methods: A retrospective analysis on 201 melanomas, evaluated for dermoscopic/confocal criteria of melanoma, was carried out. Results: Twenty-three melanomas out of 201 cases (11.4%) revealed a low 7-point checklist score. On confocal examination, 22 out of 23 lesions have been diagnosed correctly as melanomas. Only 1 lesion did not display melanoma features, neither upon dermoscopy nor upon confocal microscopy examination. Seven lesions out of 201 cases (3.5%) were judged as negative on confocal examination, even if 6 of them were diagnosed as melanomas by clinical and/or dermoscopic evaluation. After histopathological revision, these cases were grouped into 5 categories: (1) amelanotic melanoma (n = 1), (2) hyperkeratotic melanomas (n = 2), (3) lentiginous melanomas (n = 2), (4) melanoma with small pagetoid cells (n = 1), (5) spitzoid melanoma (n = 1). Conclusion: Confocal and dermoscopic examination, along with patient-related information and clinical history, can lead to an optimal patient management.
AB - Background: Confocal microscopy is a second-level examination for dermoscopically equivocal melanocytic lesions. However, the number of false-negative cases on confocal microscopy and the scenarios in which confocal microscopy may fail have not been fully elucidated. Objective: To calculate the percentage of false-negative melanomas upon reflectance confocal microscopy examination in a large series of cases. Methods: A retrospective analysis on 201 melanomas, evaluated for dermoscopic/confocal criteria of melanoma, was carried out. Results: Twenty-three melanomas out of 201 cases (11.4%) revealed a low 7-point checklist score. On confocal examination, 22 out of 23 lesions have been diagnosed correctly as melanomas. Only 1 lesion did not display melanoma features, neither upon dermoscopy nor upon confocal microscopy examination. Seven lesions out of 201 cases (3.5%) were judged as negative on confocal examination, even if 6 of them were diagnosed as melanomas by clinical and/or dermoscopic evaluation. After histopathological revision, these cases were grouped into 5 categories: (1) amelanotic melanoma (n = 1), (2) hyperkeratotic melanomas (n = 2), (3) lentiginous melanomas (n = 2), (4) melanoma with small pagetoid cells (n = 1), (5) spitzoid melanoma (n = 1). Conclusion: Confocal and dermoscopic examination, along with patient-related information and clinical history, can lead to an optimal patient management.
KW - Confocal microscopy
KW - Dermoscopy
KW - Histopathology#
KW - Melanoma
KW - Nevi
KW - Skin cancer
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U2 - 10.1159/000443637
DO - 10.1159/000443637
M3 - Article
AN - SCOPUS:84957900202
SP - 189
EP - 197
JO - Dermatology
JF - Dermatology
SN - 1018-8665
ER -