Challenges for New Adopters in Pre-Surgical Margin Assessment by Handheld Reflectance Confocal Microscope of Basal Cell Carcinoma; A Prospective Single-center Study
Richarz, Nina Anika (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Boada, Aram (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Jaka, Ane (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bassas-Vila, Julio (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrándiz, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Carrascosa, José Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Yélamos, Oriol (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	In vivo reflectance confocal microscopy (RCM) is a useful tool for assessing pre-surgical skin tumor margins when performed by a skilled, experienced user. The technique, however, poses significant challenges to novice users, particularly when a handheld RCM (HRCM) device is used. To evaluate the performance of an HRCM device operated by a novice user to delineate basal cell carcinoma (BCC) margins before Mohs micrographic surgery (MMS). Prospective study of 17 consecutive patients with a BCC in a high-risk facial area (the H zone) in whom tumor margins were assessed by HRCM and dermoscopy before MMS. Predicted surgical defect areas (cm 2) were calculated using standardized photographic digital documentation and compared to final defect areas after staged excision. No significant differences were observed between median HRCM-predicted and observed surgical defect areas (2. 95 cm 2 [range: 0. 83-17. 52] versus 2. 52 cm 2 [range 0. 71-14. 42]; P = 0. 586). Dermoscopy, by contrast, produced significantly underestimated values (median area of 1. 34 cm 2 [0. 41-4. 64] versus 2. 52 cm 2 [range 0. 71-14. 42]; P < 0. 001). Confounders leading to poor agreement between predicted and observed areas were previous treatment (N = 5), a purely infiltrative subtype (N = 1), and abundant sebaceous hyperplasia (N = 1). Even in the hands of a novice user, HRCM is more accurate than dermoscopy for delineating lateral BCCs margins in high-risk areas and performs well at predicting final surgical defects.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Basal cell carcinoma ; Margin control ; Micrographic Mohs surgery ; Reflectance confocal microscopy
Published in:	Dermatology Practical & Conceptual, Vol. 12 (october 2022) , ISSN 2160-9381

DOI: 10.5826/dpc.1204a162
PMID: 36534521

7 p, 889.0 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles