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and bright nucleated cells in the upper dermis” as rcm features indicating melanomas. the authors noted “regular dermoepidermal architecture, and absence of pagetoid infiltration and atypical cells” as features favoring benign lesions.[20] segura et al. described a two step method for the diagnosis of melanoma. in the first step, melanocytic lesions were differentiated from non melanocytic lesions. in the second step, melanoma was distinguished from melanocytic nevi.[21]
a systematic review found a sensitivity of 93% and specificity of 76% for the diagnosis of melanoma using rcm.[22] pellacani et al., in a randomized clinical trial on suspect lesions concluded that “adjunctive use of rcm reduced unnecessary excisions and assured the removal of aggressive melanomas at baseline in a real life. all lesions, where a diagnosis of melanoma was delayed, were thinner than 0.5 mm.”[23]