Evidence map›Paper›PMID 42517502›Full record

Observational studyInternational journal of dermatology2026

Reflectance Confocal Microscopy Integrated With Dermoscopy in a Real-World Tertiary Referral Cohort: Diagnostic Agreement, Management Outcomes, and Number Needed to Excise in 1057 Lesions.

Luca Ambrosio, Claudio Conforti, Giovanni Di Lella, Carmen Cantisani, Francesca Svara, Federico Garbarino, Alessia Paganelli, Camilla Chello, Caterina Longo, Steven Paul Nisticò and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Luca AmbrosioIDI-IRCCS, Dermatological Research Hospital, Rome, Italy.
Claudio ConfortiIDI-IRCCS, Dermatological Research Hospital, Rome, Italy.
Giovanni Di LellaIDI-IRCCS, Dermatological Research Hospital, Rome, Italy.
Carmen CantisaniDermatology Unit, Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.ORCID https://orcid.org/0000-0003-2181-951X
Francesca SvaraDermatology Unit, Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Federico GarbarinoIDI-IRCCS, Dermatological Research Hospital, Rome, Italy.
Alessia PaganelliIDI-IRCCS, Dermatological Research Hospital, Rome, Italy.ORCID https://orcid.org/0000-0002-0916-7769
Camilla ChelloDermatology Unit, Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Caterina LongoDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
Steven Paul NisticòDermatology Unit, Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Giovanni PellacaniDermatology Unit, Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate non-invasive assessment of cutaneous lesions requires integration of diagnostic information with real-world management outcomes. Reflectance confocal microscopy (RCM) is increasingly used as a second-level tool after dermoscopy, but evidence linking diagnostic agreement, histological verification, and management across melanocytic and non-melanocytic lesions remains limited.

methodsThis retrospective observational study included 886 patients with 1057 cutaneous lesions evaluated by combined dermoscopy and RCM at a tertiary referral center between October 2023 and September 2024. Lesions were classified as benign melanocytic, malignant melanocytic, benign non-melanocytic, or malignant non-melanocytic. RCM-dermoscopy agreement was assessed using observed agreement and Cohen's kappa; chi-square testing evaluated diagnostic association. Histology-based performance analyses were restricted to histologically confirmed lesions.

resultsAmong 931 lesions with both classifications available, observed agreement was 37.8%, with fair agreement by Cohen's kappa (κ = 0.211; 95% confidence interval [CI], 0.172-0.251). Diagnostic distributions were significantly associated (χ

conclusionsIn this real-world tertiary referral cohort, RCM integrated with dermoscopy supported lesion stratification and management across diagnostic categories. The significant association but fair agreement between modalities highlights their complementary role. Diagnostic performance estimates should be interpreted within the histology-confirmed subset and in light of verification bias.

Indexed as

DermoscopyMelanomaSkin NeoplasmsAdultAgedAged, 80 and overFemaleHumansMaleMicroscopy, ConfocalMiddle AgedNon-Melanoma Skin NeoplasmsRetrospective StudiesTertiary Care Centersclinical managementcutaneous neoplasmsdermoscopymelanomanumber needed to excisereflectance confocal microscopy

Identifiers

PMID42517502
PMCPMC13646474

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Registered trials

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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.