7 Jabotinsky st. Moshe Aviv tower, 19th floor. Ramat-Gan
7 Jabotinsky st. Moshe Aviv tower, 19th floor. Ramat-Gan
Reflectance confocal microscopy (RCM) is a non-invasive imaging technology that allows the doctor to look at living skin at near-microscopic resolution, with no cutting and no tissue sample.
The device directs low-power laser light at the skin and records the light reflected from different structures. This produces horizontal, black-and-white images of the upper layers of the skin, from the epidermis down to the papillary dermis, in which the physician can identify cells and structures that are not visible with standard dermoscopy.
The imaging allows a suspicious lesion to be examined in detail without harming the skin, and is often referred to as a “virtual biopsy“. It does not replace histological examination, but it adds valuable information for deciding whether a lesion needs a biopsy or can be followed with monitoring.
Dr. Reiter trained in the use of reflectance confocal microscopy during his two-year fellowship in dermatologic oncology at Memorial Sloan Kettering Cancer Center in New York, where he worked with non-invasive imaging technologies for the early diagnosis of skin cancer. He continues to work in this field through research and scientific publications.
The patient lies down comfortably, and the doctor places a small ring with a drop of fluid on the skin over the examined lesion; the imaging head attaches to this ring. The examination is not painful and involves no radiation exposure.
During the examination, series of images are captured at different depths. The system also combines dermoscopy and a body map, so each lesion is documented in its exact location and saved for comparison in the future.
The doctor analyzes the images in real time and explains the findings and the recommended next steps to the patient.
The examination is particularly useful in the following situations:
It is important to know that the technology reaches a limited depth of the skin and is therefore not suitable for every lesion. In some cases, a biopsy will still be recommended after imaging to confirm the diagnosis.
The imaging can be complemented by an LC-OCT examination, which also displays the skin in vertical cross-sections and at a greater depth.
Reflectance confocal microscopy is a complementary tool to dermoscopy that helps refine the diagnosis and, in appropriate cases, reduce the need for biopsies. The decision about whether the examination is suitable is made by the doctor, based on the findings of the clinical and dermoscopic examination.
If you notice a suspicious spot on your skin, especially one that is unusual, new or has recently changed, see a dermatologist who specializes in dermoscopy promptly.
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