Reflectance confocal microscopy of vulvar epithelial neoplasia: a pilot study

Fouques, Clélia; Dorez, M.; Duff, F. Le; Cardot‐Leccia, Nathalie; Chevallier, A; Lacour, J; Bahadoran, Philippe; Bongain, A

doi:10.1111/bjd.15573

Cited by 3 publications

(7 citation statements)

References 9 publications

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“…These features were also observed in LS, with the distinct presence of sclerotic, collagenous areas and pronounced, hyalinised vessels in the dermis of LS vulvar skin. In line with previous findings, our control group included healthy vulvar skin that showed a normal honeycomb pattern of the epidermis and a distinct dermal‐epidermal junction (DEJ) 17,20 …”

Section: Discussionmentioning

confidence: 61%

“…In line with previous findings, our control group included healthy vulvar skin that showed a normal honeycomb pattern of the epidermis and a distinct dermalepidermal junction (DEJ). 17,20 This study adds to the sparse available data of the application of RCM in vHSIL, LS and healthy vulvar skin. Fouques et al were the first and only to report on RCM features of 10 patients with lesions suspicious for vHSIL.…”

Section: Discussionmentioning

confidence: 97%

“…Fouques et al were the first and only to report on RCM features of 10 patients with lesions suspicious for vHSIL. 20 They described features of vHSIL including an atypical honeycomb pattern, parakeratosis and keratinocyte atypia. This concurs with our findings, although lymphocytic influx, a common (71%) feature in our analysis, was not described.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Despite these applications, RCM imaging of the vulvar area has only been described in a few pilot studies to date. [16][17][18][19][20][21] Therefore, the primary objective was to explore the technical feasibility and patient acceptability of RCM imaging on the vulva.…”

Section: Introductionmentioning

confidence: 99%

“…This technique has been applied for diagnosis of melanoma and basal cell carcinoma (BCC) and may reduce unnecessary biopsies of benign lesions 14,15 . Despite these applications, RCM imaging of the vulvar area has only been described in a few pilot studies to date 16–21 …”

Section: Introductionmentioning

confidence: 99%

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Reflectance confocal microscopy as a non‐invasive imaging tool in vulvar high‐grade squamous intraepithelial lesions and lichen sclerosus: A descriptive morphological study in patients and healthy volunteers

Huisman

Pagan

Ulrich³

et al. 2023

Experimental Dermatology

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Incorrect and delayed diagnosis of vulvar high‐grade squamous intraepithelial neoplasia (vHSIL) and lichen sclerosus (LS) increases malignant progression risks and negatively impacts prognosis and quality of life. There is a need to improve diagnosis and monitoring. Reflectance confocal microscopy is a non‐invasive imaging tool that visualizes skin structures at cellular resolution. The objectives were to explore feasibility and patient acceptability of vulvar RCM imaging and to identify RCM characteristics that are discriminative for vulvar HSIL and LS. This was a prospective, cross‐sectional, observational clinical trial in patients with vHSIL and LS compared to healthy volunteers. RCM images and vulvar tissue samples were obtained. Five (5) patients with vHSIL, 10 patients with LS and 10 healthy volunteers were enrolled. In total, 100 image series of vulvar skin were obtained, including lesional and nonlesional sites. The RCM technique was considered acceptable for application by patients and healthy controls. Healthy vulvar skin was characterized by a homogenous, normal honeycomb patterned epidermis and a clear epidermal‐dermal junctions. Vulvar HSIL and LS displayed an atypical honeycomb pattern of the epidermis and lymphocytic influx with presence of melanophages. Distinct features specifically observed in LS included the presence of hyalinised vessels and sclerotic areas in the dermis. RCM is a non‐invasive imaging technique that is feasible and clinically acceptable to apply on vulvar skin, both in patients with premalignant lesions and healthy controls. Recognition and validation of disease‐specific characteristics could make reflectance confocal microscopy a clinical tool to non‐invasively aid identification of vulvar premalignancies.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reflectance confocal microscopy as a non‐invasive imaging tool in vulvar high‐grade squamous intraepithelial lesions and lichen sclerosus: A descriptive morphological study in patients and healthy volunteers

Huisman

Pagan

Ulrich³

et al. 2023

Experimental Dermatology

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Reflectance confocal microscopy as a complementary diagnostic tool for vulvar lichen sclerosus and vulvar vitiligo in juvenile Chinese girls

Wang,

Chen,

Qin

et al. 2024

Experimental Dermatology

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Pigmented nonmelanoma skin cancers of the genital area: a diagnostic and therapeutic challenge – monocentric experience and review of the literature

Licata,

Tancredi,

Giorgio

et al. 2024

Int J Dermatology

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Nonmelanoma skin cancers (NMSC), comprising basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are typically encountered on photo‐exposed skin. Nevertheless, several cases of NMSC have been described in covered areas such as the genital region; furthermore, some of these lesions may express a variable degree of pigmentation. Due to the existence of mucosal melanoma, an accurate diagnosis is paramount. In this narrative review, we focused our attention on management and – in particular‐ diagnosis of pigmented NMSC (pNMSC) located in the genital region, emphasizing the features assessed by dermoscopy and reflectance confocal microscopy. As an implementation, we included data on pNMSC from the Dermatology Unit of the University of Campania Vanvitelli. BCC in the genital region represents only 1% of all BCC cases. It has been supposed that the mutation of patched 1 may lead to the development of BCC even without concomitant UV exposure. Pigmented variants on genitals have seldom been described. More prominent dermoscopic features seem to be blue‐gray ovoid nests and arborizing vessels associated with whitish structureless areas. SCC and Bowen's disease (BD) – a variant of in situ SCC – may be encountered in the genital area and are sometimes associated with human papillomavirus (HPV) infection. Pigmented SCC is very rare, and most of the literature is focused on pigmented BD (pBD), which is mainly characterized by gray‐brown dots in a linear fashion and glomerular vessels without evident scales. In conclusion, pNMSC is rarely encountered on genitals; evaluation with dermoscopy or other ancillary devices like RCM is important both to exclude benign lesions like seborrheic keratosis and lentigo and to rule out melanoma.

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Reflectance confocal microscopy of vulvar epithelial neoplasia: a pilot study

Cited by 3 publications

References 9 publications

Reflectance confocal microscopy as a non‐invasive imaging tool in vulvar high‐grade squamous intraepithelial lesions and lichen sclerosus: A descriptive morphological study in patients and healthy volunteers

Reflectance confocal microscopy as a non‐invasive imaging tool in vulvar high‐grade squamous intraepithelial lesions and lichen sclerosus: A descriptive morphological study in patients and healthy volunteers

Reflectance confocal microscopy as a complementary diagnostic tool for vulvar lichen sclerosus and vulvar vitiligo in juvenile Chinese girls

Pigmented nonmelanoma skin cancers of the genital area: a diagnostic and therapeutic challenge – monocentric experience and review of the literature

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