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  • Title: Reflectance confocal microscopy for the diagnosis of vulvar melanoma and melanosis: preliminary results.
    Author: Cinotti E, Perrot JL, Labeille B, Adegbidi H, Cambazard F.
    Journal: Dermatol Surg; 2012 Dec; 38(12):1962-7. PubMed ID: 23127153.
    Abstract:
    BACKGROUND: In the early stages, vulvar melanoma can mimic vulvar melanosis and therefore the diagnosis is often late and carries a poor prognosis. In vivo reflectance-mode confocal microscopy (RCM) is an emerging technique that allows noninvasive high-resolution imaging of the skin and mucosa, but it has not been employed in the study of genital pigmentation. OBJECTIVE: To analyze the characteristics of vulvar melanosis and vulvar melanoma using RCM to define the confocal aspects that allow a correct differential diagnosis. METHODS AND MATERIALS: Features of eight melanoses and two melanomas of the vulva were analyzed using RCM. RCM diagnosis was then compared with clinical and histologic diagnosis. RESULTS: Two major characteristics are associated with vulvar melanosis: papillae rimmed by bright monomorphous cells and possible presence of a few dendritic bright cells in the basal layer of the epithelium. Two major features of vulvar melanoma have been identified: atypical cells in the epithelium and loss of normal architecture of chorion papillae. CONCLUSIONS: Reflectance Confocal Microscopy can play a role in noninvasive differentiation between vulvar melanoma and vulvar melanosis, but further broader studies are needed to validate our observations.
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