Discoid lupus erythematosus: Reflectance confocal microscopy features correlate with horizontal histopathological sections

Lacarrubba, Francesco; Verzì, Anna Elisa; Caltabiano, Rosario; Broggi, Giuseppe; Natale, Angelo Di; Micali, Giuseppe

doi:10.1111/srt.12636

Cited by 27 publications

(28 citation statements)

References 7 publications

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“…In our study, we compared horizontal RCM with horizontal histopathology, achieving a remarkable correlation further confirming the diagnostic reliability of RCM. Undoubtedly, histologic vertical sections examination is the gold standard for the diagnosis of MF; however, HHS represents an unequivocal control to match and enforce RCM findings. Comparing RCM and HHS would represent a different perspective that could overcome the limits of conventional vertical histopathology.…”

Section: Reflectance Confocal Microscopy and Horizontal Histopathologmentioning

confidence: 99%

Confocal microscopy features of patch‐stage mycosis fungoides and their correlation with horizontal histopathological sections. A case series

et al. 2018

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Section: Reflectance Confocal Microscopy and Horizontal Histopathologmentioning

confidence: 99%

Confocal microscopy features of patch‐stage mycosis fungoides and their correlation with horizontal histopathological sections. A case series

et al. 2018

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“…A perfect correlation between RCM features and histology was note: the presence of roundish areas filled with highly refractive amorphous material at stratum corneum level, corresponding to dilated follicles in correlation to infundibular hyperkeratosis (follicular plugging). 5,10,18,19 Epidermal layer, is characterized by atypical honeycomb pattern corresponding to structural keratinocyte disarrangement, small polygonal/round bright cells related to the grade of inflammation. At dermo-epidermal junction a mild disarrangement (with variable degree) with presence of several small polygonal/round bright cells and some dendritic cells in the context of a partial or total disappearance of the dermal papillae is detected attributable to vacuolar appearance of the basal layer (interface dermatitis).…”

Section: Discussionmentioning

confidence: 99%

“…Conceivably, such variability among different CLEs subtypes is also observed at examination with non-invasive techniques, such as dermoscopy or reflectance confocal microscopy (RCM). 5…”

Section: Introductionmentioning

confidence: 99%

The combined role of clinical, reflectance confocal microscopy and dermoscopy applied to chronic discoid cutaneous lupus and subacutus lupus erythematosus: A case series and literature review

Mazzilli

Vollono

Diluvio

et al. 2020

Lupus

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Main subtypes of cutaneous lupus erythematosus are represented by acute, subacute cutaneous, intermittent and chronic cutaneous lupus erythematosus. Discoid lupus erythematosus represents the most common phenotype of chronic cutaneous lupus erythematosus. The spectrum of clinical manifestations mirrors that of several and distinct histopathological features. Such variability among different CLE subtypes is also observed at dermoscopy. Dermoscopy is nowadays considered an additional valuable method for skin lesions assessment in general dermatology, following and completing the well-known clinical diagnostic steps, such as medical history and clinical examination. In vivo reflectance confocal microscopy (RCM) is a non-invasive imaging tool able to assess the epidermis and upper dermis producing high resolution (horizontal ∼1.25 μm, vertical ∼5 μm), en face tissue sections used for melanocytic and inflammatory evaluation. In this study, we reported dermoscopic and RCM features about 9 patients affected by subacute and chronic lupus erythematosus retrospectively analyzed.

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“…Discoid lupus erythematosus (DLE) is the most common subtype of cutaneous lupus that usually affects sun‐exposed areas such as the face, upper trunk, and scalp 1 . It is characterized clinically by round demarcated plaques with varying degrees of erythema, telangiectasia, scaling, follicular plugging, dyspigmentation, and, in the absence of prompt diagnosis and treatment, may lead to scarring and skin atrophy 1,2 . Early and active lesions usually display surrounding erythema, while long‐standing disease often presents dyschromic and atrophic areas with adherent thick scales and follicular plugging 3 .…”

Section: Introductionmentioning

confidence: 99%

“…It is a non‐invasive technique for real‐time evaluation of the upper layers of the skin down to the superficial reticular dermis, with resolution at the cellular level, close to conventional histopathology 2,3,7‐11 . RCM has also been used for the evaluation of several inflammatory skin conditions, such as skin DLE, and it showed good correlation with conventional histopathology 1‐3,7‐9,12 . However, RCM is not being widely used in trichology 12 .…”

Section: Introductionmentioning

confidence: 99%

Concordance among in vivo reflectance confocal microscopy, trichoscopy, and histopathology in the evaluation of scalp discoid lupus

Melo

Carvalho

Ardigò

et al. 2020

Skin Research and Technology

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Background: Reflectance confocal microscopy (RCM) has been used for the evaluation of several inflammatory skin conditions, including skin discoid lupus erythematosus (DLE), and has been correlated with conventional histopathology (HP). However, RCM is not being widely used in trichology. Few reports and just preliminary data suggest the use of RCM as a complementary tool in alopecias. Objectives: To correlate the major RCM features of scalp DLE with trichoscopy and HP findings of biopsy specimens obtained from the same lesions. Methods: This is an observational, analytical, and cross-sectional study involving 12 patients with a clinically established diagnosis of scalp DLE. Patients underwent global clinical photograph, trichoscopy, and RCM examination in the same site followed by two 4-mm punch biopsy specimens for HP analysis. Inter-methods agreement among RCM imaging, trichoscopy, and horizontal histopathology sections (HHS) were calculated using Cohen Kappa (k) statistics. Results: Statistical analysis of the agreement between RCM and HP features disclosed an overall agreement similar to skin DLE. Seven of the eleven features evaluated had agreement superior to 75%. We also evaluated RCM features associated with three of their corresponding trichoscopic findings for further investigation of their agreement with HP. Statistical analysis showed an enhancement with agreement of 86% when the non-invasive techniques are used together. Conclusion: Consistent correlation between RCM and HP observed in our study supports the reliability of RCM in the diagnosis of scalp DLE. RCM may be considered a promising tool for scalp DLE microscopic evaluation and presents similar RCM features to DLE in other body sites. By associating clinical, trichoscopic and RCM evaluation, dermatologists will have a non-invasive arsenal for the assessment of hair and scalp disorders, benefiting patients.

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Discoid lupus erythematosus: Reflectance confocal microscopy features correlate with horizontal histopathological sections

Cited by 27 publications

References 7 publications

Confocal microscopy features of patch‐stage mycosis fungoides and their correlation with horizontal histopathological sections. A case series

Confocal microscopy features of patch‐stage mycosis fungoides and their correlation with horizontal histopathological sections. A case series

The combined role of clinical, reflectance confocal microscopy and dermoscopy applied to chronic discoid cutaneous lupus and subacutus lupus erythematosus: A case series and literature review

Concordance among in vivo reflectance confocal microscopy, trichoscopy, and histopathology in the evaluation of scalp discoid lupus

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