Marina Agozzino

Pilot study on reflectance confocal microscopy imaging of lichen planus: a real‐time, non‐invasive aid for clinical diagnosis

Background  Lichen planus (LP) represents a relatively common skin inflammatory entity included in the major group of interface dermatitis. In recent years, reflectance confocal microscopy has demonstrated to be a valuable tool for the ‘in vivo’ characterization of various skin diseases with cellular level resolution. No data are currently available that uses reflectance confocal microscopy to study LP.

Natural evolution of Spitz nevi.

Background: The natural evolution of melanocytic nevi is a complex, multifactorial process that can be studied by monitoring nevi on a long-term basis. Methods: To assess the evolution pathway of Spitz nevi, lesions with clinical and dermoscopic features suggestive of Spitz nevi were monitored and baseline and follow-up images compared. Results: Sixty-four patients (mean age 10.4 years) with lesions suggestive of Spitz nevi were included. Lesions were monitored for a mean follow-up period of 25 months. Upon side-by-side evaluation of baseline and follow-up images, 51 (79.7%) lesions showed an involution pattern and 13 (20.3%) lesions showed a growing or stable pattern. No significant differences were found between growing and involving lesions in terms of patient age and sex and the location and palpability of lesions. The great majority of growing lesions were pigmented or partially pigmented (92.3%), whereas 47.1% of lesions in involution were amelanotic (p = 0.005). Conclusion: In this series of lesions clinically and dermoscopically diagnosed as Spitz nevi, spontaneous involution seems to be the most common biologic behavior.

Psoriasis plaque test with confocal microscopy: evaluation of different microscopic response pathways in NSAID and steroid treated lesions.

Pathophysiology of psoriasis is complex and characterized by microscopic, specific changes. In vivo reflectance confocal microscopy (RCM) provides tissue and cell morphology information in non‐invasive way, generating quasi‐histologic resolution. Concerning plaque psoriasis, confocal criteria have been described disclosing high agreement between RCM and conventional histology.

In Vivo Characterization of Healthy Oral Mucosa by Reflectance Confocal Microscopy: A Translational Research for Optical Biopsy

Abstract Purpose: To characterize in vivo microscopic features of healthy oral mucosa by noninvasive, real-time reflectance confocal microscopy (RCM). Material and Methods: One hundred healthy mucosal sites (38 lips, 24 cheeks, 10 gingivae, and 28 tongues) from 50 randomly selected volunteers were imaged by a commercially available in vivo RCM (Vivascope3000, Lucid, Rochester, NY). Morphological results were described and correlated with conventional histology. Results: Specific microscopic parameters (cellular morphology, anatomical structures features, architectural patterns) were identified by RCM for each mucosal site. Conclusions: RCM features reproducibility in different mucosal sites and subjects, which suggests that RCM can be an adjunct tool for clinical management in stomatology.

Reflectance Confocal Microscopy for the Evaluation of Solitary Red Nodules

The correct assessment of a solitary red nodule in clinical practice is of crucial importance, amelanotic melanoma being the most important differential diagnosis. Dermoscopy is nowadays a pivotal tool in the management of skin tumors, however it has some limitations in the evaluation of nonpigmented lesions, in which the diagnosis is merely based on the evaluation of the vascular pattern. Recently, reflectance confocal microscopy has been introduced as a new, noninvasive technique for the diagnosis of skin lesions. Confocal microscopy provides skin imaging in vivo at cellular level resolution, close to conventional histology. We present a series of clinical scenarios of red nodules, including melanoma metastasis, pyogenic granuloma, eccrine poroma, Spitz nevus and dermatofibroma. Reflectance confocal microscopy examination added important information to the clinical diagnosis and subsequent management in all cases except for dermatofibroma. We discuss the advantages and limitations of this technique in this particular field of application.

In vivo reflectance confocal microscopy for varicella prompt diagnosis and treatment in a severely immunosuppressed patient

In vivo reflectance confocal microscopy for varicella prompt diagnosis and treatment in a severely immunosuppressed patient Leonardo Spagnol Abraham, Mariana Carvalho Costa, Marina Agozzino, Beatrice Amorosi, Carlo Cota and Marco Ardigo IRCCS San Gallicano Dermatological Institute, Rome, Italy, Department of Dermatology, Instituto de Dermatologia Prof. Rubem David Azulay, Rio de Janeiro, Brazil and Department of Pathology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

Reflectance confocal microscopy for plaque psoriasis therapeutic follow-up during an anti-TNF-α monoclonal antibody: an observational multicenter study

Psoriasis is a chronic recurrent inflammatory skin disease that affects 2–3% of the world population. Biologics are relatively new systemic treatments that block molecular steps important in the pathogenesis of psoriasis. In vivo Reflectance confocal microscopy (RCM) is a non‐invasive, imaging technique already reported to be useful in the evaluation of the follow‐up of PP under treatment with topical actives and phototherapy. No reports on systemic treatments have been proposed in literature so far.

Interest of reflectance confocal microscopy for inflammatory oral mucosal diseases

V. Sanz-Motilva,* A. Martorell-Calatayud, B. Llombart, C. Requena, C. Serra-Guill en, E. Nagore, C. Guill en, V. Traves, O. Sanmart ın Department of Dermatology, Instituto Valenciano de Oncolog ıa, Valencia, Spain, Department of Dermatology, Hospital de Manises, Valencia, Spain, Department of Pathology, Instituto Valenciano de Oncolog ıa, Valencia, Spain *Correspondence: V. Sanz-Motilva. E-mail: vsanzmotilva@hotmail.com

Reflectance Confocal Microscopy Algorithms for Inflammatory and Hair Diseases

Reflectance confocal microscopy (RCM) allows real-time, noninvasive microscopic view of the skin at nearly histologic resolution serially over time. RCM increases the sensibility and sensitivity of the diagnosis of skin tumours. RCM evaluates descriptive features of psoriasis, lupus erythematosus, contact dermatitis, and others. Three groups of optical histology have been described: psoriasiform, spongiotic, and interface dermatitis. In a multicenter study, RCM patterns of spongiotic, hyperkeratotic, and interface dermatitis have been analyzed and an algorithmic method of analysis for fast application in the clinical setting based on a multivariate analysis has been proposed. A tree decision diagram has been also established.

Dermoscopic and confocal microscopy patterns of vulvar mucosal melanotic macules.

CONFOCAL REFLECTANCE MICROSCOPY Confocal reflectance microscopic examination was performed with the handled Vivascope 3000 (Caliber Imaging and Diagnostics, Inc, Rochester, NY). A regular honeycomb pattern was detected in the superficial layers. At the level of the epithelialechorion junction, cord-like structures were visible, and these were composed of tubular structures rimmed by monomorphic roundish cells that corresponded to the parallel pattern seen during the dermoscopic evaluation (Fig 2, A [maroon square] and B). In the area of the dermoscopic ring-like pattern, dermal papillae appeared rimmed by bright, monomorphic, roundish cells, corresponding to hyperpigmented keratinocytes (Fig 2, A [blue square] and C ). A few plump, bright cells corresponding tomelanophages were seenwithin the dermal papillae (Fig 2, C ).