Reflectance confocal microscopy for cutaneous infections and infestations

Abstract

Reflectance confocal microscopy (RCM) is a high-resolution emerging imaging technique that allows non-invasive diagnosis of several cutaneous disorders. A systematic review of the literature on the use of RCM for the study of infections and infestations has been performed to evaluate the current use of this technique and its possible future applications in this field. RCM is particularly suitable for the identification of Sarcoptes scabies, Demodex folliculorum, Ixodes, Dermatophytes and Candida species in the clinical practice and for the follow-up after treatment. The cytopathic effect of herpes simplex virus, varicella zoster virus and molluscipoxvirus is also detectable by this imaging technique even in a pre-vesicular stage. In addition, thanks to its non-invasiveness, RCM allows pathophysiological studies.

A Case Report of Real-Time in vivo Demonstration of Sarcoptes scabiei

“…RCM has also been utilized for infestations such as scabies or pediculosis (4-13). As previously stated, crusted scabies is a relatively challenging entity, for which RCM may prove to be particularly helpful in the diagnosis (2,4,8,9,12). Similar to our report, some authors have provided real-time video recordings of S. scabiei moving within the skin (7,8,10).…”

“…However, the advent of a hand-held device has partially circumvented these problems. More importantly, at present, RCM is only available in some clinics due to the prohibitively high initial cost of setup (2,7,8,11,12).…”

Handheld reflectance confocal microscopy, dermatoscopy and histopathological correlation of common inflammatory balanitis

“…It is mainly used in the diagnosis of skin tumors, but it has also been reported as a useful tool for the assessment of some inflammatory diseases with a precise correlation with conventional histopathology . Genital skin ideally suits well for RCM examination because of its thin or absent cornified layer, surprisingly, few studies are available . In our study, patients were examined using the handheld RCM device which provides an easier and more rapid access to the genital areas than the wide‐probe device.…”

Advances in the use of Reflectance Confocal Microscopy in Melanoma

“…RCM cannot be used for acral lesions, due to thick stratum corneum. In contrast, RCM is well-suited detailed examination of mucosal lesions [50,52,57] and complex pigmented areas of the face [15]. …”