This atlas provides a detailed overview of the novel technique of ex vivo confocal microscopy for rapid imaging of excised tissues in dermatological practice. It features an extensive collection of ex vivo images acquired from normal skin structures and from a variety of neoplastic lesions (benign and malignant) and inflammatory lesions. Each chapter contains several image types of a particular disorder, including gray-scale, digital purple-pink images (DHE) and hematoxylin and eosin (H&E) correlations to assist the acquisition of diagnostic skills. Guidance on how to use techniques for tissue preparation, staining, handling and image acquisition are also provided enabling the reader to develop confidence in integrating this technique into their day-to-day practices. Furthermore, this atlas also provides an update on the ongoing latest advances in the field.
Cutaneous Atlas of Ex Vivo Confocal Microscopy covers how to apply these techniques into dermatological practice, especially in Mohs surgery for the evaluation of keratinocytic neoplasm and in dermatopathology for rapid evaluation of varied skin lesions. It is therefore a valuable resource for trainee, residents, practicing dermatologists and dermatopathologists who are seeking a resource to assist in developing their knowledge and skills of utilizing these methodologies.
Author(s): Manu Jain (editor), Anthony Rossi (editor), Kishwer Nehal (editor), Mercedes Sendín-Martín (editor)
Publisher: Springer
Year: 2022
Language: English
Pages: 192
Foreword
Preface
Contents
Contributors
Basics of Ex Vivo Confocal Microscopy
1 Roles and Applications of Ex Vivo Confocal Microscopy
1.1 Introduction
1.2 Applications of Ex Vivo Confocal Microscopy in Dermatology (Table 1.1)
1.3 Applications of Ex Vivo Confocal Microscopy in Non-Dermatologic Field (Table 1.2)
References
2 Principles of Ex Vivo Confocal Microscopy
2.1 Historical Perspective of Reflectance Mode Confocal Microscopy
2.2 Ex Vivo Confocal Microscopy in Practice
2.3 The Reflectance Contrast Mechanism
2.4 Geometric Optics
2.5 Confocal Image Formation
References
3 Hands-On Guide for Ex Vivo Confocal Imaging
3.1 Introduction
3.2 Material required for imaging (Fig. 3.1)
3.3 Tissue Type, Source, and Preparation(Fig. 3.2)
3.4 Tissue Staining (Fig. 3.3)
3.5 Tissue Mounting and Flattening (Fig. 3.4)
3.6 Image Acquisition (Figs. 3.5, 3.6, 3.7, 3.8, 3.9)
3.7 Cleaning the Equipment
3.8 Modes of Imaging (Fig. 3.8)
3.9 Options For Image Acquistion (Fig. 3.9)
3.10 Challenges Encountered During Ex Vivo Confocal Imaging (Figs. 3.10 and 3.11)
References
Normal Skin
4 Normal Skin on Ex Vivo Confocal Microscopy: Patterns and Histopathologic Correlation
Abstract
4.1 Epidermis
4.2 Dermoepidermal Junction
4.3 Dermis
4.4 Hypodermis
4.5 Muscle, Vessels, and Nerves
4.6 Adnexal Structures
4.7 Regional Variations of Skin
References
Benign Skin Tumours
5 Features of Benign Epidermal Nonmelanocytic Lesions on Ex Vivo Confocal Microscopy and Histopathologic Correlation
5.1 Introduction
5.2 Solar Lentigo
5.3 Seborrheic Keratosis
5.4 Verruca Vulgaris
5.5 Molluscum Contagiosum
References
6 Features of Benign Nonmelanocytic Dermal and Subcutaneous Lesions on Ex Vivo Confocal Microscopy and Histopathologic Correlation
6.1 Introduction
6.2 Dermatofibroma
6.3 Lipoma
6.4 Epidermal Inclusion Cyst
6.5 Fibroepithelial Polyp
6.6 Neurofibroma
References
Malignant Keratinocyte Neoplasms
7 Morphological Features of Basal Cell Carcinoma on Ex Vivo Confocal Imaging and Histopathologic Correlation
Abstract
References
8 Squamous Cell Carcinoma Features on Ex Vivo Confocal Imaging and Histopathologic Correlation
8.1 Introduction
8.2 Actinic Keratosis
8.3 In Situ Squamous Cell Carcinoma
8.4 Infiltrating Squamous Cell Carcinoma
References
Melanocytic Lesions
9 Acquired Nevi: Junctional, Compound, and Dermal
9.1 Basics of Acquired Nevi
9.1.1 Basics of Acquired Nevi
References
10 Dysplastic Nevi
10.1 Basics of Dysplastic Nevi
10.1.1 Basics of Dysplastic Nevi
References
11 Melanoma
11.1 Basics of Melanoma
References
Inflammatory Lesions
12 Features of Lichen Planus and Psoriasis on Ex Vivo Confocal Imaging and Histopathologic Correlation
Abstract
12.1 Introduction
12.2 Psoriasis
12.3 Lichen Planus
References
13 Eczema: Features on FCM, Digital H&E, and Corresponding Conventional H&E
Abstract
13.1 Introduction
References
14 Fluorescence Confocal Microscope for Identification of Discoid Lupus Erythematosus Histologic Features
Abstract
14.1 Introduction
References
15 Immunofluorescence with Confocal Microscopy: Pemphigoid, Pemphigus, Cutaneous Vasculitis, Lichen Planus, and Cutaneous Lupus Erythematosus
15.1 Introduction
15.2 Bullous Pemphigoid
15.3 Pemphigus Vulgaris
15.4 Cutaneous Vasculitis
15.5 Lichen Planus
15.6 Cutneous Lupus Erythematosus
References
Future of Ex Vivo Confocal Microscopy
16 Advances in Technology, Staining Protocol, and Flattening Devices in Ex Vivo Confocal Microscopy
16.1 Introduction
16.2 Reflectance Confocal Microscopy in Ex Vivo Confocal Microscopy
16.3 Fluorescence Confocal Microscopy for Ex Vivo Confocal Microscopy
16.4 Fusion Mode: Simultaneous Fluorescence + Reflectance
16.5 Fusion Mode with Strip Mosaicking and Digital H&E
16.6 New Staining Protocols
16.7 Artificial Intelligence Color and Image Interpretation
References
17 Epidermal Reconstruction During Ex Vivo Confocal Microscopy for Detection of Superficial Basal Cell Carcinoma with 3D-Mosaicking and Intensity Projection
17.1 Epidermal Flattening
References
Index
