研究目的
To demonstrate the use of reflectance confocal microscopy (RCM) for margin mapping and monitoring of an amelanotic melanoma in situ, enabling targeted therapeutic intervention and noninvasive assessment of treatment response.
研究成果
RCM effectively mapped the margins and monitored the treatment response of an amelanotic melanoma in situ, allowing for targeted therapy with imiquimod and noninvasive assessment. This case highlights the benefits of RCM in managing subtle melanomas with poor clinical demarcation, reducing the need for repeated interventions. Future research should include larger trials to quantify the impact of RCM in such cases.
研究不足
The study is limited to a single case, which may not be generalizable. The use of RCM requires specialized equipment and expertise, and its accuracy in margin mapping for amelanotic melanomas needs further validation through larger studies. Potential areas for optimization include standardizing RCM protocols and conducting randomized controlled trials.
1：Experimental Design and Method Selection:
A case study approach was used, employing reflectance confocal microscopy (RCM) for noninvasive imaging to map margins and monitor treatment response in a patient with amelanotic melanoma in situ. The method involved using a hand-held RCM device for real-time visualization.
2：Sample Selection and Data Sources:
The sample was a single patient, a 69-year-old female with a history of melanomas, presenting with an amelanotic melanoma in situ on the ear. Data were obtained from clinical examinations, biopsies, and RCM imaging.
3：List of Experimental Equipment and Materials:
VivaScope 3000 RCM device (Lucid Inc.), topical imiquimod medication, biopsy tools for histopathological analysis.
4：Experimental Procedures and Operational Workflow:
Initial clinical and dermoscopic examination was performed, followed by biopsies for diagnosis. RCM was used to map the margins of the lesion, identifying subclinical extension. The patient was treated with topical imiquimod applied once daily for 5 days per week for 4 weeks, then reduced to 3 days per week for 10 weeks. Follow-up RCM imaging and biopsies were conducted at 6 and 12 months post-treatment to assess response.
5：Data Analysis Methods:
RCM images were analyzed for features such as atypical melanocytes, inflammatory cells, and epidermal disarrangement. Histopathological analysis of biopsies confirmed diagnosis and treatment efficacy. Descriptive analysis was used to interpret the imaging and clinical outcomes.
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