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If not detected and treated early, skin cancer, especially melanoma, can be devastating for patients and their families. The gold standard for early diagnosis has always been a biopsy. Until recently there have not been ideal options for circumstances when a biopsy is not feasible, such as patients with numerous atypical lesions, patients with lesions at aesthetically important sites, or in small children. In cases such as these, rather than automatically performing a biopsy, non-invasive diagnostic methods and devices can allow us to better manage the lesion than relying on examination by the naked eye. Some of these devices are computer based and provide machine vision, while others allow the pathologist to look into the in vivo cellular details without the need for the removal of the skin or any other surgical procedures. Many of these devices are relatively new and require extensive experience for interpreting the results. NIDIskin.com is here to act as an educational forum dedicated to Non-Invasive Diagnostic Imaging of the Skin. Right now our focus is on Confocal Microscopy, a technology which only in recent years has been applied to studying the skin. In the future, as new diagnostic technologies and methods inevitable emerge, NIDIskin.com will serve as a resource to explore and promote the sharing of knowledge for those methods as well.
Why are we focusing on Confocal Microscopy? Aside from the benefits of it being non-invasive, in some cases Confocal Microscopy can actually be more informative than a biopsy, because in a traditional biopsy the pathologist is not able to view the entire lesion. For example: a large pigmented lesion on the face, which could be a benign lentigo, a pigmented actinic keratosis, or a superficial melanoma. The most effective traditional evaluation would be to excise the entire lesion and perform a histological analysis, but it would be impractical to excise a benign lesion on the face and leave the patient with a scar. Confocal Microscopy can further rule out benign diagnoses before determining the necessity of surgery.
We feel that Confocal Microscopy is an excellent tool for managing pigmented lesions and that patients should benefit from it and any new Non-Invasive Diagnostic Imaging technology. In order for that to happen, we need more trained physicians to use it and to teach others.