Evidence map›Paper›PMID 41908627›Full record

ReviewJPRAS open2026

Reflectance confocal microscopy in the management of lentigo maligna and lentigo maligna melanoma: a systematic review.

Olivier Mathieu, Douglas Henderson, Emilien Ezine, Kevin Serror, Barouyr Baroudjian, Maxime Battistella, Céleste Lebbé, Marc Chaouat, David Boccara

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Olivier MathieuDepartment of Plastic and Reconstructive Surgery, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Douglas HendersonDepartment of Otolaryngology-Head Neck Surgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Emilien EzineDepartment of Pathology, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Kevin SerrorDepartment of Plastic and Reconstructive Surgery, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Barouyr BaroudjianDepartment of Pathology, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Maxime BattistellaDepartment of Pathology, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Céleste LebbéDepartment of Dermato-Oncology, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
Marc ChaouatDepartment of Plastic and Reconstructive Surgery, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
David BoccaraDepartment of Plastic and Reconstructive Surgery, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are difficult to manage because of their subclinical extension and ill-defined margins, especially on chronically sun-damaged facial skin. Reflectance confocal microscopy (RCM), a non-invasive imaging technique with near-histological resolution, has emerged as a valuable adjunct for diagnosis, presurgical margin mapping, and postoperative surveillance. Objective: To systematically review current evidence on the role of RCM in LM and LMM management. Methods: A systematic review was performed in accordance with PRISMA 2020 guidelines. PubMed, Embase, and Scopus were searched up to July 2025. Eligible studies assessed RCM for diagnostic accuracy, presurgical mapping, surgical outcomes, or follow-up. Findings were synthesized qualitatively. Results: Twenty-nine studies were included. Across diverse study designs, RCM demonstrated higher diagnostic accuracy than dermoscopy for LM, with reported sensitivities ranging from 85 % to 100 % and specificities from 71 % to 97 %. In comparative studies and meta-analyses, RCM showed superior specificity compared with dermoscopy and improved discrimination between LM and early invasive LMM. Presurgical RCM margin mapping was associated with higher first-stage clearance rates (up to 63.6 % vs. 34.7 % with standard assessment), fewer surgical stages (mean 1.1-1.2 vs. 1.7-1.9), narrower excision margins, and lower local recurrence rates (approximately 2-5 % vs. up to 13 % in non-RCM series). RCM was also effective for monitoring non-surgical therapies and detecting early recurrences within surgical scars. Major barriers to widespread adoption include cost, limited availability, training requirements, and the absence of standardized protocols. Conclusions: RCM strengthens the management of LM and LMM by improving diagnostic confidence, enabling precise margin mapping, and supporting long-term surveillance. Broader adoption will depend on standardization of mapping techniques, integration into clinical workflows, and validation of artificial intelligence-assisted interpretation.

Indexed as

Lentigo malignaLentigo maligna melanomaMargin mappingMelanoma in situNon-invasive imagingReflectance confocal microscopy

Identifiers

PMID41908627
PMCPMC13019939

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.