Dermoscopic and Reflectance Confocal Microscopy Findings in Extra-genital HPV16-associated Pigmented Squamous Cell Carcinoma in situ

Reflectance Confocal Microscopy for Diagnosis of Mammary Paget’s Disease

“…This study confirms previous reports showing that RCM can be used to provide in vivo images of poorly reflective PCs, appearing both as dark holes or target structures (8)(9)(10). The dark halo found in target structures probably relates to clefts between PCs and the surrounding epidermis due to mucin secretion by the former.…”

“…Pagetoid spread of cells 1.5-2 times larger than adjacent keratinocytes is a suggestive feature of MPD in RCM. Therefore, larger size of cells may help to differentiate MPD from other skin tumours with confocal Pagetoid spread, including melanoma, Bowen's disease, Spitz naevus, mycosis fungoides and Bowenoid papulosis (9,10). A higher density of nests was found in deeper layers of the epidermis, dermal-epidermal junction (DEJ) and upper dermis.…”

The role of reflectance confocal microscopy in a case of Bowen’s disease difficult to diagnose

“…Rarely, there may be challenging cases hard to diagnose even with dermoscopic aid [ 1 – 3 ]. In such lesions, reflectance confocal microscopy (RCM) may play an important role as an additional in vivo diagnostic technique [ 4 ].…”

“…The RCM features of pigmented BD are scarcely in the literature [ 4 – 7 ]. Herein, we report on a case of pigmented BD with atypical clinical and dermoscopic features that mimics a melanoma and describe its RCM features.…”

“…The diagnosis of pigmented SCC on RCM rely on the presence of the scale crust, markedly atypical honeycomb or disarranged pattern, round nucleated cells (dyskeratotic keratinocytes) at the spino-granular layer, a ringed pattern composed of small close-set edged papillae at the DEJ, and the presence of tightly coiled vessels in the dermal papillae [ 4 – 6 ]. The diagnosis may sometimes be challenging because of the presence of numerous bright, large, round or dendritic cells infiltrating the epidermis, which may be interpreted as atypical cells seen in melanoma.…”