Ričardas Rotomskis


Malignant melanoma is one of the most aggressive cancers. Its incidence worldwide has been increasing at a greater rate than that of any other cancer. Unlike other developed European countries, malignant melanoma is usually diagnosed at stages II-III in Lithuania. Early melanoma detection plays a critical role for patient’s prognosis and survival rates, as metastatic melanoma has poor prognosis and its treatment is ineffective in most cases. Accurate diagnosis in early stages, determination of the level of dysplasia of melanocytic skin lesions and objective evaluation of the dysplasia progression possibilities is essential to improve early diagnosis and prophylaxis of melanoma. The attempts have been made to apply confocal skin imaging system for diagnosis of melanocytic cutaneous lesions, as it enables to make optical skin biopsy – the visualization of superficial skin layers at cellular-level resolution. The aim of this study is to provide early data received, when the same skin melanocytic lesions and the level of their atypia/dysplasia were evaluated with dermoscope, siascope, confocal skin imaging system and compared with the golden diagnostic standard – histological evaluation data.
Total of 34 atypical melanocytic skin lesions were selected using clinical, dermoscopy and siascopy criteria. The level of atypia/dysplasia was measured with reflectance confocal microscopy. Histologycal evaluation was done in all cases. Accurate clinical diagnosis with confocal skin imaging system was performed in 11 out of 11 melanoma cases, 7 out of 8 cases of high grade atypia, 1 out of 4 cases of medium grade atypia, 2 out of 6 cases of light atypia and 4 out of 5 benign lesions (without atypia).
The preliminary results allow to conclude that confocal skin imaging system may be used for accurate diagnosis of melanocytic skin lesions and early stages of melanoma.
The study to confirm this is still being carried on.

Keyword(s): optical biopsy, reflectance confocal microscopy, dysplasia in nevi, melanoma.
DOI: 10.5200/220
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