In vivo reflectance confocal microscopy is a novel technique which enables the visualization of the skin at quasi-histologic resolution up to the papillary dermis. Since the melanin and small organelles are a strong source of contrast, this technique revealed to be useful in skin cancer diagnosis. Through confocal microscopy it is possible to in vivo visualize the architecture and the cytology of a skin tumor. In melanocytic lesion, it is possible to detect aggregates of melanocytes at the junction and in superficial dermis and to distinguish between a regular benign proliferation and malignant cells in the epidermis and superficial dermis. It is also useful for the diagnosis of epithelial tumors, such as basal cell carcinoma and squamous cell carcinoma, and in the identification of benign epithelial proliferation, like seborrheic keratosis and solar lentigo.
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