An article published in JAMA Dermatology stated that the use of adjunctive reflectance confocal microscopy (RCM) for assessing questionable skin lesions reduced the number of needless skin excisions by 43%.Between January 2017 and December 2019, 3165 patients with suspect lesions were included in the study and randomly assigned 1:1 to standard therapeutic care, which included clinical and dermoscopy evaluation with or without adjunctive RCM, a novel non-invasive technology that provides in vivo imaging of the skin with high diagnostic accuracy.

When compared to standard therapeutic care alone, adjunctive RCM had a greater positive predictive value (18.9 vs. 33.3, respectively), a lower benign-to-malignant ratio (3.7:1.0 vs. 1.8:1.0), and a 43.4 per cent reduction in the number of patients who needed to be excised (5.3 vs. 3.0). Furthermore, all 15 lesions with a delayed melanoma diagnosis were less than 0.5 mm in thickness. Eight of them were found to have melanoma in situ.

But the researchers stated that the study did not apply to general dermatology across the world, as reflectance confocal microscopy was not yet widely available. (Medscape Medical News, June 01, 2022)