Systematic review and proposal of an in vivo reflectance confocal microscopy assessment tool for cutaneous lymphoma

Bruna Melhoranse Gouveia, Jillian Wells, Jennifer Kim, Germana Consuegra, Caterina Longo, Pablo Fernandez-Penas

Research output: Contribution to journalReview articlepeer-review


Background: Reflectance confocal microscopy (RCM) is a non-invasive imaging technique that provides dynamic information and allows in vivo monitoring, with excellent histologic correlation. In the last decade, the use of RCM for cutaneous T-cell lymphomas (CTCL) has been reported. CTCL may require multiple biopsies for diagnosis due to its equivocal clinical presentation. RCM was described as a possible tool to help determine the best site for skin biopsy. This study aims to systematically review all RCM features reported in literature for CTCL. Method: A systematic literature search concerning CTCL evaluated by RCM was performed in eight electronic databases until May 2019 following PRISMA-DTA quality assessment. Results: Eighteen RCM features were described in patients with CTCL. The most frequent were: interface dermatitis (89%), epidermal lymphocytes (82%), epidermal architectural disarray (81%), and vesicle-like structure (Pautrier microabscess) (51%). Conclusion: In order to establish comparable parameters among the studies identified, we proposed descriptors for CTCL features and a grading system to quantify them. This will facilitate to define the role of RCM in the diagnosis and monitoring of CTCL patients.

Original languageEnglish
JournalJournal of Cutaneous Pathology
Publication statusE-pub ahead of print - Oct 16 2019


  • CTCL
  • cutaneous lymphoma
  • mycosis fungoides
  • RCM score
  • reflectance confocal microscopy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology


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