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Comparative Study
. 2013 Dec;69(6):e295-300.
doi: 10.1016/j.jaad.2013.07.022. Epub 2013 Sep 13.

In vivo confocal microscopy in clinical practice: comparison of bedside diagnostic accuracy of a trained physician and distant diagnosis of an expert reader

Babar K Rao  1 , Rosa Mateus, Cindy Wassef, Giovanni Pellacani
Affiliations
Comparative Study

In vivo confocal microscopy in clinical practice: comparison of bedside diagnostic accuracy of a trained physician and distant diagnosis of an expert reader

Babar K Rao et al. J Am Acad Dermatol. 2013 Dec.

Abstract

Background: Reflectance confocal microscopy (RCM) is an imaging tool that allows the visualization of cellular details without biopsy. To our knowledge, RCM sensitivity and specificity has not been studied in a telemedicine setting.

Objective: We sought to assess RCM diagnostic accuracy in a support teleconsultation setting.

Methods: Between June 2010 and September 2011, 340 lesions were imaged using a confocal scanning microscope. The images were evaluated by 2 readers, one on site, and the other at a distance.

Results: A total of 334 cases were included. For each reader the sensitivity was greater than 90% and specificity for each reader was greater than 60%. Both readers had a combined sensitivity of 98.6% and 44% specificity.

Limitations: RCM may be limited in the correct classification of epithelial tumors.

Conclusions: RCM is a tool in the clinical diagnosis of skin lesions, providing a high diagnostic accuracy in teleconsultation use.

Keywords: AK; BCC; MM; RCM; SCC; SK; actinic keratosis; basal cell carcinoma; cutaneous lesions; malignant melanoma; noninvasive imaging; reflectance confocal microscopy; seborrheic keratosis; squamous cell carcinoma; teledermatology.

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