Clin Exp Dermatol. 2026 Oct 14:llag447. doi: 10.1093/ced/llag447. Online ahead of print.
ABSTRACT
BACKGROUND: Due to the limited laser penetration depth, reflectance confocal microscopy (RCM) application in the study of thick cutaneous lesions has been limited so far.
OBJECTIVES: To describe clinical, histopathological, dermoscopic and RCM features of cutaneous melanomas with Breslow thickness ≥0.8 mm, to identify possible differences among different histological subtypes, and describe new RCM features of these tumours, with a focus on their potential impact on prognosis.
METHODS: We conducted a retrospective, single-centre, study. We assessed the presence of a new RCM feature named "tumour-vascular interface" (TVI) defined as the presence of vessels adjacent to melanocytic structures. The included cases were classified according to melanoma histotype and the presence of TVI.
RESULTS: A total of 197 melanomas were included and comprehensive description of their clinicopathological, dermoscopic and RCM features was provided. Most cases were superficial spreading melanomas (72.6%) and nodular melanomas (16.2%). The mean Breslow thickness was 2.3 mm (SD ±2.4; range 0.8-25). TVI was identified in 83 cases (42.1%). TVI+ cases were more frequently amelanotic/hypomelanotic (p = 0.011) and ulcerated (p= 0.093) and exhibited a higher mitotic rate (p=0.002). No significant differences in mortality rate or disease progression were observed between TVI+ and TVI- melanomas though TVI+ cases showed a trend toward higher nodal relapse rates (p=0.068).
CONCLUSIONS: This study provides an in-depth analysis of clinicopathological, dermoscopic and RCM features of invasive cutaneous melanomas, suggesting a potential new application of RCM in the study of melanoma vascularization and its possible correlation with clinical behaviour.
PMID:42874065 | DOI:10.1093/ced/llag447