IN VIVO CONFOCAL MICROSCOPY IN DERMATOLOGY
2001; Elsevier BV; Volume: 19; Issue: 2 Linguagem: Inglês
10.1016/s0733-8635(05)70274-6
ISSN1558-0520
AutoresBryan A. Selkin, Milind Rajadhyaksha, Salvador González, Richard Langley,
Tópico(s)Photoacoustic and Ultrasonic Imaging
ResumoRecent advances in technology and instrumentation have added to the tools available to dermatologists for clinical screening and diagnosis. The gold standard for diagnosis in dermatology is histopathologic examination of tissue. Physician diagnostic accuracy, however, is less than perfect, resulting in the possibility of unnecessary biopsies of benign lesions, false negatives caused by sampling error, and the potential of undiagnosed malignancies if a biopsy is not performed.15 Although cutaneous biopsies are associated with a relatively low morbidity, there is always the risk for infection, bleeding, and scarring. Biopsies also destroy the site of interest, and dynamic changes over time cannot be observed. Histologic processing is timeconsuming and can produce tissue artifact. The search to overcome the drawbacks of the traditional skin biopsy and to provide high-resolution images has led to the development of noninvasive techniques such as dermoscopy13, 20 and in vivo confocal microscopy.23 Confocal microscopy is based on either white light tandem scanning or laser scanning methods.2, 4, 19, 23 With confocal microscopy, the skin lesion is imaged in vivo, in real time, and the confocal images are displayed on a video monitor.23 The images may be recorded on videotape, and subsequently sequences of confocal images can be taken from the videotape and enhanced. The detection of back-scattered light and variations in tissue refractive index allow for high resolution of cellular detail and contrast when examining thin tissue specimens with confocal microscopy, thus making staining unnecessary.5, 23 Instead of examining an isolated sample, it is possible to perform real-time imaging of three-dimensional morphology and dynamic events.21
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