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Background: The detection of subclinical margin in lentigo maligna/lentigo maligna melanoma (LM/LMM) can be challenging for the dermatologist. Reflectance confocal microscopy (RCM) enables to observe in vivo atypical melanocytes beyond the clinical margins. The aim of this study is to establish which of these methods (clinical examination and dermoscopy versus "Paper tape - RCM") is more precise to define the lesion margin and to reduce the number of re-intervention and overtreatments in cosmetically sensitive areas.

Methods: Fifty-seven cases of LM/LMM were analyzed during 2016-2022. Pre-surgical mapping procedures in 32 lesions were effectuated with dermatoscopy. Furthermore, pre-surgical mapping procedures in 25 lesions were effectuated with RCM and paper tape.

Results: RCM method's accuracy to detect subclinical margins was 92.0%. In 24 of 25 cases, the lesions were excised completely during the first intervention. In 20 of 32 cases analyzed with dermoscopy, a second surgical intervention was effectuated.

Conclusion: The RCM paper method allows us to delineate subclinical margin more accurately and reduce overtreatment, especially in sensitive areas, such as the face and neck.

Titel:	Surgical margin mapping for lentigo maligna and lentigo maligna melanoma: traditional technique (visual inspection with dermoscopy) versus combined paper tape and reflectance confocal microscopy technique.
Autor/in / Beteiligte Person:	Cabrioli, C ; Maione, V ; Arisi, M ; Perantoni, M ; Guasco Pisani, E ; Venturini, M ; Calzavara-Pinton, P ; Licata, G
Link:	Full Text Finder (Volltext)
Zeitschrift:	International journal of dermatology, Jg. 62 (2023-06-01), Heft 6, S. 805-811
Veröffentlichung:	Oxford : Blackwell Science ; <i>Original Publication</i>: Philadelphia, Lippincott., 2023
Medientyp:	academicJournal
ISSN:	1365-4632 (electronic)
DOI:	10.1111/ijd.16688
Schlagwort:	Humans Margins of Excision Dermoscopy methods Microscopy, Confocal methods Hutchinson's Melanotic Freckle diagnostic imaging Hutchinson's Melanotic Freckle surgery Skin Neoplasms diagnostic imaging Skin Neoplasms surgery
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Int J Dermatol] 2023 Jun; Vol. 62 (6), pp. 805-811. <i>Date of Electronic Publication: </i>2023 Apr 19. MeSH Terms: Hutchinson's Melanotic Freckle* / diagnostic imaging ; Hutchinson's Melanotic Freckle* / surgery ; Skin Neoplasms* / diagnostic imaging ; Skin Neoplasms* / surgery ; Humans ; Margins of Excision ; Dermoscopy / methods ; Microscopy, Confocal / methods References: Osborne JE, Hutchinson PE. A follow-up study to investigate the efficacy of initial treatment of lentigo maligna with surgical excision. Br J Plast Surg. 2002;55(8):611-5. 10.1054/bjps.2002.3967. ; Guitera P, Collgros H, Madronio CM, Goumas C, Mann GJ, Watts CG, et al. The steadily growing problem of lentigo maligna and lentigo maligna melanoma in Australia: population-based data on diagnosis and management. 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Surgical margin mapping for lentigo maligna and lentigo maligna melanoma: traditional technique (visual inspection with dermoscopy) versus combined paper tape and reflectance confocal microscopy technique.