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Biopsy outperforms reflectance confocal microscopy in diagnosing and subtyping basal cell carcinoma: results and experiences from a randomized controlled multicentre trial*
| Content Provider | Oxford Academic |
|---|---|
| Author | Woliner–van der Weg, W. Peppelman, M. Elshot, Y.S. Visch, M.B. Crijns, M.B. Alkemade, H.A.C. Bronkhorst, E.M. Adang, E. Amir, A. Gerritsen, M.J.P. van Erp, P.E.J. Lubeek, S.F.K. |
| Copyright Year | 2021 |
| Abstract | Background: Reflectance confocal microscopy (RCM) is a noninvasive method for skin assessment, allowing entire lesion evaluation up to the papillary dermis. RCM is a potentially attractive alternative to punch biopsy (PB) in basal cell carcinoma (BCC).ObjectivesTo determine the diagnostic accuracy of RCM vs. PB in diagnosing and subtyping BCC, and to study patient satisfaction and preferences.MethodsPatients with a clinically suspected primary BCC were randomized between RCM and biopsy. Conventional surgical excision or follow‐up were used as reference. Sensitivity and specificity for BCC diagnosis and subtyping were calculated for both methods. BCC subtype was stratified based on clinical relevance: aggressive (infiltrative/micronodular) vs. nonaggressive (superficial/nodular) histopathological subtype and superficial vs. nonsuperficial BCC. Data on patient satisfaction and preferences were collected using a questionnaire and a contingent valuation method.ResultsSensitivity for BCC diagnosis was high and similar for both methods (RCM 99·0% vs. biopsy 99·0%; P = 1·0). Specificity for BCC diagnosis was lower for RCM (59·1% vs. 100·0%; P < 0·001). Sensitivity for aggressive BCC subtypes was lower for RCM (33·3% vs. 77·3%; P = 0·003). Sensitivity for nonsuperficial BCC was not significantly different (RCM 88·9% vs. biopsy 91·0%; P = 0·724). Patient satisfaction and preferences were good and highly comparable for both methods.ConclusionsBiopsy outperforms RCM in diagnosing and subtyping clinically suspected primary BCC. This outcome does not support routine clinical implementation of RCM, as a replacement for PBs in this patient group. |
| Related Links | https://academic.oup.com/bjd/article-pdf/184/4/663/47157939/bjd0663.pdf |
| Ending Page | 671 |
| Starting Page | 663 |
| File Format | |
| ISSN | 00070963 |
| e-ISSN | 13652133 |
| DOI | 10.1111/bjd.19381 |
| Journal | British Journal of Dermatology |
| Issue Number | 4 |
| Volume Number | 184 |
| Language | English |
| Publisher | Oxford Academic |
| Publisher Date | 2021-04-01 |
| Access Restriction | Open |
| Subject Keyword | Clinical Medicine Dermatology Medicine and Health |
| Content Type | Text |
| Resource Type | Article |
| Subject | Dermatology |
