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Background: Skin disease is a significant contributor to the global disease burden, with dermatologic health disparities adding to this burden. Internists, general practitioners, and other medical professionals often manage skin disease with limited exposure to dermatologic education in medical school. Objective: This study evaluated a brief educational intervention for medical students to improve dermatologic knowledge, diagnostic and communication skills, and comfort in performing dermatology-focused physical exams. A secondary focus of the intervention was to promote awareness of skin disease, detection, and prevention for patients with a variety of skin tones. Methods: Sixty-five first through fourth-year students at Rutgers RWJMS participated in a pre-test–post-test within-subject study. Students described images using open-ended responses followed by multiple-choice identification questions. Students watched a one-hour self-paced module created by a licensed dermatologist and completed a follow-up assessment. Results: At pre-test, descriptions were brief and often inaccurate but significantly improved post-intervention to include descriptors such as primary morphology and demarcation. Accuracy on diagnostic and management questions significantly improved and comfort in advising patients and performing dermatologic exams significantly increased. Conclusions: A low-cost, brief, self-paced module can augment dermatologic education for medical students while increasing exposure to multiple skin tone presentations of lesions. [ABSTRACT FROM AUTHOR]

A line-field confocal optical coherence tomography (LC-OCT) combines confocal microscopy and optical coherence tomography into a single, rapid, easy-to-use device. This meta-analysis was performed to determine the reliability of LC-OCT for diagnosing malignant skin tumors. PubMed, EMBASE, Web of Science databases, and the Cochrane Library were searched for research studies in the English language from inception till December 2023. To assess quality and the risk of bias, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used. The sensitivity and specificity of each study were calculated. The bivariate summary sensitivity and specificity were calculated using the linear mixed model. Five studies with 904 reported per lesion analyses in our study; the specificity and sensitivity ranged from 67% to 97% and 72% to 92%, respectively. The pooled specificity and sensitivity were 91% (95% CI: 76–97%) and 86.9% (95% CI: 81.8–90.8%), respectively. The summary sensitivity and specificity from the bivariate approach are 86.9% (95% CI: 81.8–90.8%) and 91.1% (95% CI: 76.7–97.0%), respectively. The area under the curve is 0.914. LC-OCT shows great sensitivity and specificity in diagnosing malignant skin tumors. However, due to the limited number of studies included in our meta-analysis, it is premature to elucidate the true potential of LC-OCT. [ABSTRACT FROM AUTHOR]

Ex vivo confocal microscope (EVCM) rapidly images freshly excised tissue at a histopathological resolution. EVCM features of keratinocyte skin cancers are well‐established, but those of benign clinical mimickers remain scarce. We describe EVCM features of common benign lesions and compare them with their malignant differentials. EVCM was used to image 14 benign and 3 cancer tissues. We compared EVCM features of benign lesions with corresponding histopathology and with those of keratinocyte cancers. Key features of benign lesions were identified and differentiated from malignant lesions. Elastin and fat appeared prominent in EVCM; while koilocytes and melanin were difficult to identify. Visualization of entire epidermis was challenging due to difficulty of tissue flattening during imaging. Benign lesions can be differentiated from keratinocyte cancers with EVCM. Using EVCM, a rapid, bedside diagnosis and management of skin neoplasms is possible, especially in a remote location without a histopathology lab. [ABSTRACT FROM AUTHOR]

* Context.--Histopathology is the current standard to diagnose skin disease. However, biopsy may not always be feasible, such as in patients with multiple nevi, a patient with a lesion on an aesthetically significant site, or in children. Recently, noninvasive techniques, including reflectance confocal microscopy (RCM), optical coherence tomography, and Raman spectroscopy, have enabled dermatologists to manage skin lesions in real time without the need for biopsy. Objective.--To report the updated diagnostic accuracy of RCM for equivocal skin lesions. Design.--In this study, we retrospectively reviewed our data of clinically suspicious lesions from 2010 to 2017 that were evaluated by RCM. Results.--Our results showed an overall sensitivity of 98.2% and specificity of 99.8%. Conclusions.--In conclusion, RCM is a noninvasive real-time tool with the potential to diagnose skin lesions with high accuracy and without biopsy. doi: 10.5858/arpa.2018-0124-OA), Histopathology is the current standard to diagnose skin disease. However, biopsy may not always be feasible, such as in patients with multiple nevi, a patient with a lesion on an [...]

Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive imaging technique that allows for high-resolution visualization of the skin. It has been used to evaluate various skin lesions, but there is limited research on its use for treatment monitoring. Actinic keratosis (AK) is a precancerous skin lesion that can progress to squamous cell carcinoma. This study aimed to assess the effectiveness of LC-OCT in monitoring AK lesions undergoing cryotherapy treatment. The study found that LC-OCT imaging could identify histopathological changes in AK lesions before and after treatment, including reductions in hyperkeratosis, acanthosis, and keratinocytic atypia. LC-OCT has the potential to be a valuable tool for treatment monitoring, but further research is needed to confirm these findings. [Extracted from the article]

Androgenetic alopecia (AGA) is the most common type of non-scarring alopecia. While global photography is the most commonly employed to track therapeutic efficacy, reflectance confocal microscopy (RCM) is a non-invasive imaging tool that may offer novel insights in tracking treatment progression for AGA. Ten patients with androgenetic alopecia initiating topical combination therapy elected to undergo treatment monitoring of this formulation using global photography and/or reflectance confocal microscopy. All patients had evidence of follicular miniaturization at baseline, and rimmed dermal papillae at both baseline and the end of the study. One patient had follicular miniaturization at baseline but not at the end of the study; however, this patient did not exhibit any changes in their Hamilton Norwood Score. Two patients exhibited inflammatory cells in the epidermis of the frontal scalp and mid-scalp at baseline on RCM that were no longer visible on RCM after 12 weeks of treatment. Of these two patients, one patient had a Hamilton Norwood score that did not improve after treatment, even though inflammatory cells were no longer present post-treatment. RCM offers a novel, non-invasive option for monitoring subclinical treatment progress in patients with AGA that can uncover novel insights in patients' presentation and response to treatment earlier than with global photography. [ABSTRACT FROM AUTHOR]

Background: Vivascope 2500 ex vivo confocal microscopy (EVCM) is an emerging optical imaging device that allows nuclear level resolution of freshly excised tissues. EVCM provides, rapid real‐time pathological examination in many subspecialties of pathology including skin, prostate, breast, liver, etc. In contrast to traditional time‐consuming frozen sectioning and histological analysis. Aims: To evaluate the current state of EVCM utilization. Materials and Methods: This study highlights the advantages, limitations, and prospects of EVCM in skin pathology. Results: Our findings demonstrate that EVCM is a promising adjunctive tool to assess margins in Mohs surgery and to provide rapid, accurate diagnosis of cutaneous tumors, infectious and inflammatory diseases. Conclusion: EVCM is a revolutionary device that can be used as an adjunct to paraffin‐fixed, hematoxylin and eosin‐stained slides and frozen sectioning. Additional refinements are required before EVCM can be used as an alternative to frozen sectioning or traditional tissue processing. [ABSTRACT FROM AUTHOR]