Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study.

BACKGROUND: Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions.

OBJECTIVE: To provide an overview of RCM practice in real-life.

METHODS: A multicenter, prospective study carried out in 10 university dermatology departments in France.

RESULTS: 0verall, 410 patients were enrolled. Half of the patients (48%) were referred by private-practice dermatologists. They were referred for diagnosis (84.9%) or pre-surgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13,6%), and pre-surgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these,50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82).

LIMITATIONS: This study was performed in the settings of French tertiary referral hospitals.

CONCLUSION: This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients.