Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study

Background: Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions. Objective: To provide an overview of RCM practice in real-life. Methods: A multicenter, prospective study carried out in 10 university dermatology departments in France. Results: Overall, 410 patients were enrolled. One-half of the patients (48%) were referred by private practice dermatologists. They were referred for diagnosis (84.9%) or presurgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13.6%), and presurgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these, 50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82). Limitations: This study was performed in the settings of French tertiary referral hospitals. Conclusion: This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients. ( J Am Acad Dermatol 2024;91:516.)