WEDNESDAY, Oct. 16, 2024 -- Remote cutaneous confocal microscopy (CCM) has good diagnostic accuracy and can reduce the number of unnecessary biopsies, according to a study published online Oct. 8 in the Journal of the American Academy of Dermatology.

Genevieve Ho, M.D., from University of Sydney, and colleagues examined the diagnostic accuracy and safety of a "store and forward" approach for remote-CCM in a prospective study involving lesions selected for biopsy for skin malignancy across five Australian tertiary dermatology centers. CCM, clinical, and dermoscopy images were acquired before biopsy and accessed for interpretation by CCM readers. Diagnosis with CCM was compared to results from histopathology.

The researchers found that melanoma was the most common malignancy of the 201 lesions included (47.2 percent). Overall, 90 percent of the 89 lesions potentially "saved" from biopsy (44.8 percent) were truly benign lesions and 10.1 percent were missed malignant lesions of melanoma in situ and squamous cell carcinoma (seven and two patients, respectively). No invasive melanomas were missed. For detection of malignancy, sensitivity and specificity of remote-CCM were 89 and 64 percent, respectively.

"This study provides reliable estimates of diagnostic accuracy for remote CCM, particularly in high-risk settings. Remote-CCM can reduce the number of unnecessary biopsies by up to 40 percent whilst safely identifying and managing invasive melanomas," the authors write.

Several authors disclosed ties to the pharmaceutical and dermatology industries.