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Updated: Jul 12, 2026
Combining Reflectance Confocal Microscopy with Optical Coherence Tomography for Noninvasive Diagnosis of Skin Cancers via Image Acquisition
Published on: August 18, 2022
Earlier detection of melanoma using in vivo reflectance confocal microscopy-a retrospective analysis
Lea Pöschmann1, Pauline Waibel1, Frank Friedrich Gellrich1,2
1Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Introduction:
The incidence of melanoma has increased in recent decades. Non-invasive imaging devices, such as in vivo reflectance confocal laser microscopy (RCM), aid in the earlier detection of melanoma and decrease the number of patients that need treatment. RCM can visualise the skin to a depth of 200 μm at the cellular level.
Methods:
We conducted a retrospective analysis of melanocytic lesions, including invasive melanoma, in situ melanoma, and nevi, treated at the University Hospital Dresden. The control group (CG) included lesions examined solely through dermoscopy from 01 January 2016 to 31 December 2019, and the intervention group (IG) included lesions examined using both dermoscopy and, when necessary, RCM from 01 January 2020 to 31 December 2023. All melanoma diagnoses were confirmed histologically, while nevi were included based on clinical and histological diagnoses.
Results:
A total of 5,925 male and female patients (3,062 male and 2,863 female individuals0) with 6,651 melanocytic lesions were enrolled in the study, including 2,381 melanomas, 863 melanomas in situ, and 3,407 nevi. The lesions were found on the head and neck (1414), the trunk (1579), the upper extremities (925), and the lower extremities (892; for 54%, data were not collected). In the IG, significantly more invasive melanomas (43% vs. 30%, p < 0.001) and in situ melanomas (16% vs. 11%, p < 0.001) were diagnosed, while fewer nevi were diagnosed (42% vs. 60%, p < 0.001). Additionally, more melanomas were diagnosed at an early stage in the IG: IA (48% vs. 41%), p < 0.001. In the IG, fewer sentinel lymph node biopsies were performed (35% vs. 42%, p = 0.002), and there were significantly fewer positive results (21% vs. 27%, p < 0.001). Melanomas in the IG were less frequently ulcerated (15% vs. 21%, p < 0.001) and had a lower tumour thickness (1.81 vs. 1.97 mm, p < 0.001).
Conclusion:
Using confocal microscopy in routine care could lead to earlier detection of melanoma, including significantly more in situ and early invasive cases. Melanomas had fewer ulcerations, lower tumour thickness, and SLNBs were less frequently performed, as well as less frequently positive.
