Vestnik dermatologii i venerologiiVestnik dermatologii i venerologiiВестник дерматологии и венерологии0042-46092313-6294Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov3710.25208/0042-4609-2014-90-3-85-94CLINICAL PRACTICE GUIDELINESКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИConfocal laser scanning microscopy in vivo for diagnosing melanocytic skin neoplasmsКонфокальная лазерная сканирующая микроскопия in vivo в диагностике меланоцитарных новообразований кожиKubanovaA. A.КубановаА. А.
Russian Federation
ChikinV. V.ЧикинВ. В.
Russian Federation
chikin@mail.ruShtirshneiderYU. YU.ШтиршнайдерЮ. Ю.
Russian Federation
KatuninaO. R.КатунинаО. Р.
Russian Federation
State Research Center of Dermatovenereology and Cosmetology, Ministry of healthcare of the Russian FederationФГБУ «Государственный научный центр дерматовенерологии и косметологии» Минздрава России24062014903859424082017Copyright ©; 2014, Kubanova A.A., Chikin V.V., Shtirshneider Y.Y., Katunina O.R.Copyright ©; 2014, Кубанова А.А., Чикин В.В., Штиршнайдер Ю.Ю., Катунина О.Р.2014Kubanova A.A., Chikin V.V., Shtirshneider Y.Y., Katunina O.R.Кубанова А.А., Чикин В.В., Штиршнайдер Ю.Ю., Катунина О.Р.https://creativecommons.org/licenses/by/4.0https://vestnikdv.ru/jour/article/view/37

The authors discuss the use of confocal laser scanning microscopy in vivo (CLSM) for diagnosing melanocytic skin neoplasms and its value for early diagnostics of melanoma. CLSM is an innovation noninvasive visual examination method for real-time multiple and painless examinations of the patient’s skin without injuring the skin integument. The method ensures early diagnostics of skin melanomas with high sensitivity and specificity, which makes it possible to use CLSM for screening melanocytic skin neoplasms for the sake of the early onset of treatment to save patient life and health.

Рассмотрены возможности конфокальной лазерной сканирующей in vivo микроскопии (КЛСМ) в диагностике меланоцитарных новообразований кожи и ее значение при раннем выявлении меланомы. КЛСМ является инновационным неинвазивным методом визуального исследования кожи, позволяющим обследовать пациента в режиме реального времени, дает возможность проводить безболезненное исследование многократно, не сопровождается нарушением целостности кожных покровов. Метод позволяет с высокой чувствительностью и специфичностью обнаруживать меланому кожи на ранних этапах развития, что дает возможность использовать КЛСМ для скрининга меланоцитарных новообразований кожи и обеспечить раннее начало лечения для сохранения жизни и здоровья пациентов.

конфокальная лазерная сканирующая in vivo микроскопиямеланоцитарные новообразования кожиранняя диагностика меланомы кожиconfocal laser scanning microscopy in vivomelanocytic skin neoplasmsearly diagnostics of skin melanomasLeBoit P.E., Burg G., Weedon D, Sarasain A. (Eds.): World Health Organization Classification of Tumours. Pathology and Genetics of Skin Tumours. IARC Press: Lyon 2006.Tannous Z.S., Mihm M.C. Jr, Sober A.J., Duncan L.M. Congenital melanocytic nevi: Clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol 2005; 52: 197-203.Togawa Y., Nakamura Y., Kamada N. et al. Melanoma in association with acquired melanocytic nevus in Japan: a review of cases in the literature. Int J Dermatol 2010; 49: 1362-1367.Fernandes N.C. The risk of cutaneous melanoma in melanocytic nevi. An Bras Dermatol 2013; 88 (2): 314-315.Chen S.T., Geller A.C., Tsao H. Update on the epidemiology of melanoma. Curr Dermatol Rep 2013; 2 (1): 24-34.Wong J.R., Harris J.K., Rodriguez-Galindo C., Johnson K.J. Incidence of childhood and adolescent melanoma in the United States: 1973- 2009. Pediatrics 2013; 131 (5): 846-854.Leiter U., Garbe C. Epidemiology of melanoma and nonmelanoma skin cancer the role of sunlight. Adv Exp Med Biol 2008; 624: 89-103.Zlokachestvennye novoobrazovaniya v Rossii v 2012 godu (zabolevaemost' i smertnost') / Pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoy. M: FGBU «MNIOI im. P.A. Gertsena» Minzdrava Rossii; 2014, 250 s.Gilyazutdinov I.A., Khasanov R.Sh., Safin I.R., Moiseev N.V. Zlokachestvennye opukholi myagkikh tkaney i melanoma kozhi. M: Prakticheskaya meditsina, 2010; 204Brehmer F., Ulrich M., Haenssle H.A. Strategies for early recognition of cutaneous melanoma - present and future. Dermatol Pract Concept 2012; 2 (3): 29-37.Gordeladze A.S., Novitskaya T.A. Melanotsitarnye opukholi. Chast' 1. Melanotsitarnye opukholi kozhi (rabochie standarty patologoanatomicheskogo issledovaniya) / Pod red. prof. G.B. Koval'skogo // Biblioteka patologoanatoma. Nauch.-praktich. zhurnal. SPb.: GUZ «GPAB», 2009. Vyp. 111. - 48 s.Friedman R.J., Gutkowicz-Krusin D., Farber M.J. et al. The diagnostic performance of expert dermoscopists vs a computer-vision system on small-diameter melanomas. Arch Dermatol 2008; 144: 476-482.Cinar P., Zell J.A., Taylor T.H. et al. Pediatric and AYA invasive cutaneous melanoma: population-based study comparing adult melanoma cases. J Clin Oncol (ASCO Meeting Abstracts) 2008; 26: 9071.Avril M.F., Cascinelli N., Cristofolini M. et al. Clinical diagnosis of Melanoma:-W.H.O. Melanoma Programme Publications: russkaya versiya / Pod red. L.V. Demidova, 1994, 28 s.Gel'fond M.L. Differentsial'naya diagnostika opukholey kozhi v praktike dermatologov i kos-metologov. [Practical Oncology 2012; 13 (2): 69-79Dubenskiy V.V., Red'ko R.V., Garmonov A.A. Novoobrazovaniya kozhi v praktike dermatovenerologa / Pod red. V.V.Dubenskogo. Tver': OOO «Triada», 2002; 148 sRager E.L., Bridgeford E.P., Ollila D.W. Cutaneous melanoma: update on prevention, screening, diagnosis, and treatment. Am Fam Phys 2005; 72 (2): 269-276.Anisimov V.V., Gel'fond M.L., Barchuk A.S. Znachenie khirurgicheskogo i lazernogo udaleniya dobrokachestvennykh novoobrazovaniy kozhi v ambulatornoy praktike. Ambulatornaya khirurgiya 2001; 1: 24-29.Mellett D.R. Khirurgiya po Mokhsu // Sekrety dermatologii / Pod red. D.E.Fittspatrika, D.L.Elinga: per. s angl. M.-SPb: «Binom» - «Nevskiy Dialekt», 1999; 397-400.Friedman R., Rigel D., Kopf A. Early detection of malignant melanoma: role of physician examination and self-examination of the skin. CA Cancer J Clin 1985; 35: 130-151.Rigel D.S., Russak J., Friedman R. The evolution of melanoma diagnosis: 25 years beyond the ABCDs. CA Cancer J Clin 2010; 60: 301-316.Semiletova Yu.V., Anisimov V.V., Vagner R.I. Lechenie bol'nykh pervichnoy melanomoy kozhi. Sovremennoe sostoyanie problemy.Demidov L.V., Sokolov D.V., Bulycheva I.V. et al. The progress in the diagnosis of cutaneous melanoma. Journal of N.N. Blokhin Russian Cancer Research Center RAMS 2007; 18 (1): 36-41.Prikaz Minzdrava Rossii ot 20.12.2012 N 1143n "Ob utverzhdenii standarta pervichnoy mediko-sanitarnoy pomoshchi pri zlokachestvennykh novoobrazovaniyakh kozhi (melanoma, rak) I-IV stadii (obsledovanie v tselyakh ustanovleniya diagnoza zabolevaniya i podgotovki k protivoopukholevomu lecheniyu)" (Zaregistrirovano v Minyuste Rossii 05.03.2013 № 27454).Menzies S.W., Ingvar C., Crotty K. et al. Frequency and morphologic characteristics of invasive melanomas lacking specific surface microscopic features. Arch Dermatol 1996; 132: 1178-1182.Argenziano G., Fabbrocini G., Carli P. et al. Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions. Comparison of the ABCD rule of dermatoscopy and a new sevenpoint checklist based on pattern analysis. Arch. Dermatol 1998; 134: 1563-1570.Gerger A., Koller S., Kern T. et al. Diagnostic applicability of in vivo confocal laser scanning microscopy in melanocytic skin tumors. J Invest Dermatol 2005; 124: 493-498.Gropper C.A., Stiller M.J., Shupak J.L. et al. Diagnostic high-resolution ultrasound in dermatology. Int J Dermatol 1993; 32: 234-250.Harland C.C., Bamber J.C., Gusterson B.A. et al. High frequency, high resolution B-scan ultrasound in the assessment of skin tumours. Br J Dermatol 1993; 128: 525-532.Wassef C., Rao B.K. Uses of non-invasive imaging in the diagnosis of skin cancer: an overview of the currently available modalities. Int J Dermatol 2013; 52: 1481-1489.Kardynal A., Olszewska M. Modern non-invasive diagnostic techniques in the detection of early cutaneous melanoma. J Dermatol Case Rep 2014; 1: 1-8.Ferris L.K., Harris R.J. New diagnostic aides for melanoma. Dermatol Clin 2012; 30 (3): 535-545.Abramovits W., Stevenson L.C. Changing paradigms in dermatology: new ways to examine the skin using noninvasive imaging methods. Clin Dermatol 2003; 21: 353-358.Rajadhyaksha M., Gonzalez S., Zavislan J. et al. In vivo confocal scanning laser microscopy of human skin II: advances in instrumentation and comparison to histology. J Invest Dermatol 1999; 113: 293-303.Gonzalez S. Confocal reflectance microscopy in dermatology: promise and reality of non-invasive diagnosis and monitoring. Actas Dermosifiliogr 2009; 100 (Suppl. 2): 59-69.Longo C., Zalaudek I., Argenziano G., Pellacani G. New directions in dermatopatology: in vivo confocal microscopy in clinical practice. Dermatol Clin 2012; 30 (4): 799-814.Corcuff P., Bertrand C., Leveque J.L. Morphometry of human epidermis in vivo by real-time confocal microscopy. Arch Dermatol Res 1993; 285: 475-481.Ulrich M., Lange-Asschenfeldt S. In vivo confocal microscopy in dermatology: from research to clinical application. J Biomed Opt 2013; 18 (6): 061212.Tavoloni Bragaa J.C., Caob T., Olivierob M.C. et al. In vivo confocal microscopy: a promising diagnostic method for cutaneous oncology. J Clin Exp Dermatol Res 2012; S3: 002.Rajadhyaksha M., Grossman M., Esterowitz D. et al. In vivo confocal scanning laser microscopy of human skin: melanin provides strong contrast. J Invest Dermatol 1995; 104: 946-952.Gonzalez S., Swindells K., Rajadhyaksha M., Torres A. Changing paradigms in dermatology: confocal microscopy in clinical and surgical dermatology. Clin Derm 2003; 21: 359-369. 94 к № 3, 2014Branzan A.L., Landthaler M., Szeimies R.-M. In vivo confocal scanning laser microscopy in dermatology. Lasers Med Sci 2007; 22: 73-82.Rudnicka L., Olszewska M., Rakowska A. In vivo reflectance confocal microscopy: usefulness for diagnosing hair diseases. J Dermatol Case Report 2008; 4: 55-59.Rajadhyaksha M., Anderson R.R.,Webb R.H. Video-rate confocal scanning laser microscope for imaging human tissues in vivo. Appl Opt 1999; 38: 1-12.Huzaira M., Rius F., Rajadhyaksha M. et al. Topographic variations in normal skin, as viewed by in vivo reflectance confocal microscopy. J Invest Dermatol 2001; 116: 846-852.Busam K.J., Charles C., Lee G., Halpern A.C. Morphologic features of melanocytes, pigmented keratinocytes and melanophages by in vivo confocal scanning laser microscopy. Mod Pathol 2001; 14 (9): 862-868.Sauermann K., Clemann S., Jaspers S. et al. Age related changes of human skin investigated with histometric measurements by confocal laser scanning microscopy in vivo. Skin Res Technol 2002; 8: 52-56.Sauermann K., Jaspers S., Koop U., Wenck H. Topically applied vitamin C increases the density of dermal papillae in aged human skin. BMC Dermatol 2004; 4 (1): 13.Yamashita T., Kuwahara T., Gonzalez S., Takahashi M. Non-invasive visualization of melanin and melanocytes by reflectance-mode confocal microscopy. J Invest Dermatol 2005; 124: 235-240.Reflectance confocal microscopy of cutaneous tumors. Ed. by S. Gonzalez, M. Gill, A.C. Halpern, Informa Healhcare, 2008, 275 P.Pellacani G., Cesinaro A.M., Seidenari S. Reflectance-mode confocal microscopy of pigmented skin lesions-improvement in melanoma diagnostic specificity. J Am Acad Dermatol 2005; 53: 979-985.Langley R.G., Rajadhyaksha M., Dwyer P.J. et al. Confocal scanning laser microscopy of benign and malignant melanocytic skin lesions in vivo. J Am Acad Dermatol 2001; 45: 365-376.Stevenson A.D., Mickan S., Mallett S., Ayya M. Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions. Dermatol Pract Concept 2013; 3 (4): 19-27.Busam K.J., Hester K., Charles C. et al. Detection of clinically amelanotic malignant melanoma and assessment of its margins by in vivo confocal scanning laser microscopy. Arch Dermatol 2001; 137: 923-929.Pellacani G., Longo C., Malvehy J. et al. In vivo confocal microscopic and histopathologic correlations of dermoscopic features in 202 melanocytic lesions. Arch Dermatol 2008; 144 (12): 1597-1608.Pellacani G., Longo C., Ferrara G. et al. Spitz nevi: in vivo confocal microscopic features, dermatoscopic aspects, histopathologic correlates and diagnostic significance. J Am Acad Dermatol 2009; 60: 236-247.Gangley R., Walsh N., Sutherland A.E. et al. The diagnostic accuracy of in vivo confocal scanning laser microscopy compared to dermascopy of benign and malignant melanocytic lesions: a prospective study. Dermatology 2007; 215: 365-372.Shtirschneider Y.Y., Michenko A.V., Katunina O.R., Zubarev A.R. Up-to-date non-invasive visualization technologies in dermatology. Vestn Dermatol Venerol 2011; 6: 41-53.Curchin C.E., Wurm E.M., Lambie D.L. et al. First experiences using reflectance confocal microscopy on equivocal skin lesions in Queensland. Australas J Dermatol 2011; 52: 89-97.