Reflectance confocal microscopy to facilitate knifeless skin cancer management

Management of nonmelanoma skin cancer (NMSC) in elderly patients carries a risk for morbidity; these patients frequently struggle to care for their biopsy sites and experience biopsy- and surgery-related complications. To minimize this treatment-related morbidity, we designed a knifeless treatment approach that employs reflectance confocal microscopy (RCM) in lieu of skin biopsy to establish the diagnosis of NMSC, then uses either intralesional or topical chemotherapy or immunotherapy (as appropriate, depending on depth of invasion) to cure the NMSC. By using this approach, the patient is spared surgery-related difficulties.