Management of complex head and neck basal cell carcinomas using a combined reflectance confocal microscopy/optical coherence tomography: a descriptive study
Introduction Recently, a combined reflectance confocal microscopy (RCM) optical coherence tomography (OCT) has been tested for the diagnosis of basal cell carcinoma (BCC) Evaluating the role of RCM OCT in management of complex BCCs has not been studied. The objective of the study was to investigate the utility of a new combined RCM OCT device in the evaluation and management of complex BCCs in a descriptive study. Methods Prospective study of consecutive cases (July 2018 June 2019) of biopsy proven 'complex' BCC defined as BCC in the head and neck area with multiple high risk criteria such as large size in the mask area, multiple recurrences, and high risk subtype. All cases were evaluated with a combined RCM OCT device that provided simultaneous image viewing on a screen. Lesions were evaluated bedside with RCM OCT according to previously described criteria. Results Ten patients with complex head and neck BCCs had mean age of 73.1 13.0 years. Six (60% patients were males. Mean BCC clinical size was 1.9 1.2 cm (range 0.6 4.0 cm) RCM detected residual BCC in 8 out of 10 cases (80% and OCT detected residual BCC in all 10 cases (100% Six BCCs (60% had a depth estimate of 1000 um under OCT. In five cases, (50% RCM OCT imaging results led to a change/modification in BCC management. Conclusion The use of a combined RCM OCT device may help in the evaluation of complex head and neck BCCs by guiding treatment selection and defining the extent of surgery.
Archives of Dermatological Research