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The role of in vivo confocal microscopy in the diagnosis of eyelid margin tumors: 47 cases.

Cinotti E, Perrot JL, Campolmi N, Labeille B, Espinasse M, Grivet D, Thuret G, Gain P, Douchet C, Forest F, Haouas M, Cambazard F., J Am Acad Dermatol. 2014 Nov;71(5):912-918.e2. doi: 10.1016/j.jaad.2014.05.060.

ABSTRACT

BACKGROUND: Handheld in vivo reflectance confocal microscopy (IVCM) is a new imaging method that allows noninvasive diagnosis of cutaneous tumors but to date it has not been used in the study of eyelid tumors.

 

OBJECTIVE: We sought to evaluate the suitability of IVCM for eyelid margin tumors.

 

METHODS: We prospectively evaluated the IVCM features of 47 eyelid margin lesions, clinically suspicious of malignancy; 35 of these were excised whereas the other 12, with no IVCM malignant features, were followed up for at least 1 year. Clinical, IVCM, and histologic diagnoses were compared.

 

RESULTS: IVCM showed sensitivity and specificity of 100% and 69.2%, respectively, for malignancy (basal cell carcinoma, squamous cell carcinoma, and melanoma). The follow-up of the 12 nonexcised lesions did not show any clinical progression.

 

LIMITATIONS: The lesions showing neither clinical nor IVCM features for malignancies were not biopsied in view of the potential functional and aesthetic consequences of eyelid margin surgery.

 

CONCLUSION: Used with a handheld dermatology-specific microscope, IVCM can play a role in the noninvasive diagnosis of eyelid margin lesions. Further studies are needed to better define diagnostic criteria of eyelid tumors and improve the specificity of this technique.

 

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