The confocal story

Dermatologic diagnosis is primarily based on interpretation of morphological information by visual inspection, confirmed by histopathological diagnosis if necessary. The challenge is to establish a correct diagnosis and to identify all malignant lesions while minimizing unnecessary surgical procedures. In this context, several non-invasive imaging modalities have emerged in recent years that are aimed at increasing accuracy of in vivo diagnosis. Of those, reflectance confocal microscopy has shown the most promising results. In vivo reflectance confocal microscopy produces horizontal images of the skin at a cellular resolution from the surface to the upper dermis. It enables to visualize tissue in its physiological state avoiding retraction bias due to fixation, staining and sectioning procedures that are a prerequisite to conventional light histopathology. Moreover, RCM enables observation of changes over time