Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study
Marion Stefanski1, Aurore Le Guern2, Laetitia Visseaux3
1Department of Oncodermatology, Reims University Hospital, Reims France; Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France.
Background:
Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions.
Objective:
To provide an overview of RCM practice in real-life.
Methods:
A multicenter, prospective study carried out in 10 university dermatology departments in France.
Results:
Overall, 410 patients were enrolled. One-half of the patients (48%) were referred by private practice dermatologists. They were referred for diagnosis (84.9%) or presurgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13.6%), and presurgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these, 50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82).
Limitations:
This study was performed in the settings of French tertiary referral hospitals.
Conclusion:
This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients.
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