WEDNESDAY, Feb. 7, 2024 -- Adjunctive, handheld reflectance confocal microscopy (RCM) improves diagnostic accuracy of lesions clinically suspicious for basal cell carcinoma (BCC), according to a study published online Jan. 29 in the Journal of the American Academy of Dermatology.

Caterina Longo, M.D., Ph.D., from the University of Modena and Reggio Emilia in Italy, and colleagues examined the additional benefit of handheld RCM in terms of diagnostic accuracy for skin cancer in a prospective study conducted in three skin cancer reference centers in Italy. A total of 1,005 lesions with clinical-dermoscopic suspicion of BCC were included.

The researchers found that of the lesions, 474 were histopathologically confirmed and 531 were diagnosed by clinical-dermoscopic-RCM correlation, confirmed with two years of follow-up. Seven hundred forty of the lesions were confirmed BCCs. For dermoscopy alone, the sensitivity and specificity were 93.2 and 51.7 percent, respectively, with a positive predictive value (PPV) and negative predictive value (NPV) of 84.4 and 73.3, respectively. Higher rates were seen with adjunctive RCM, with sensitivity and specificity of 97.8 and 86.8 percent, respectively, and PPV and NPV of 95.4 and 93.5, respectively.

"The results of our prospective, multicenter study, carried out on 1,005 lesions suspicious of BCC at clinical examination, provides real-life diagnostic accuracy of dermoscopy for BCC, as a standalone tool and with adjunctive handheld-RCM assessment," the authors write.