Ex vivo confocal laser scanning microscopy: A diagnostic technique for easy real‐time evaluation of benign and malignant skin tumours

Abstract

Ex vivo confocal laser scanning microscopy (ex vivo CLSM) is a novel diagnostic tool for a quick bedside evaluation of freshly excised tissue, comparable to histology. We aimed to assess the sensitivity and specificity of ex vivo CLSM in detecting malignant features, to validate its reliability in identifying various skin tumours based on a combination of confocal features and to evaluate the digital staining mode (DS). One‐hundred twenty freshly excised skin samples from 91 patients were evaluated. Each lesion was screened for the presence of 23 predefined confocal criteria with ex vivo CLSM, followed by a histopathological examination. The diagnostic agreement between ex vivo CLSM and histology was 89.2%. The diagnostic accuracy of ex vivo CLSM in detecting malignancy reached a sensitivity of 98% and a specificity of 76%. Ex vivo CLSM enabled a rapid identification of the most common skin tumours, the tumour dignity and cytological features. The DS demonstrated a close resemblance to conventional histopathology.

Ex vivo confocal microscopy features of common benign lesions that mimic non‐melanoma skin cancers: Towards clinical integration

“…There is literature available that describes the EVCM features of IDN, NF, fibroma, condyloma, VV, and MC, but it is limited [12, 15, 16]. In our lesions, we observed similar features: basal cell hyperpigmentation in fibroma, intense pink Henderson Paterson bodies in MC, interlacing dark purple fibrous structures in NF, and presence of koilocytes in VV and condyloma, maturation of dark purple nevocytes in depth in IDN.…”

“…In our lesions, we observed similar features: basal cell hyperpigmentation in fibroma, intense pink Henderson Paterson bodies in MC, interlacing dark purple fibrous structures in NF, and presence of koilocytes in VV and condyloma, maturation of dark purple nevocytes in depth in IDN. We have detected well‐established features of SCC and BCCs in our lesions [9, 10, 12–14, 17, 18]. Additionally, we observed clusters of dark purple inflammatory cells surrounding the tumors, which serves as an excellent clue for detecting tumor remnants [9, 10, 12, 18].…”

“…Also, features to distinguish melanoma from nevi with EVCM are well-established [11]. However, a detailed description of non-melanocytic benign tumors and their distinction from the NMSCs are scarce in the literature [12][13][14]. Here, we describe the EVCM features of these benign lesions and differentiate them from basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).…”

Nonporous versus Mesoporous Bioinspired Polydopamine Nanoparticles for Skin Drug Delivery

“…LSCM was a novel tool to detect the pathway of drug penetration through the skin by visual observation. It had already been used in several dermatological fields, including benign and malignant skin tumors, inflammatory and infectious diseases, and healthy skin . On account of the similar lipophilicity to the RA, as well as the high fluorescence quantum yield, long-wavelength emission, and outstanding photostability, NR was well known as an environmentally sensitive lipophilic dye for labeling and sensing biomolecules .…”

“…It had already been used in several dermatological fields, including benign and malignant skin tumors, inflammatory and infectious diseases, and healthy skin. 48 On account of the similar lipophilicity to the RA, as well as the high fluorescence quantum yield, long-wavelength emission, and outstanding photostability, NR was well known as an environmentally sensitive lipophilic dye for labeling and sensing biomolecules. 49 The skin tissues treated with pure NR, PDA-NR, and mPDA-NR were optical scanning, and LCSM was used to directly evaluate the drug penetration properties of the nanoparticles.…”