WCD 2019 | New frontiers for melanoma early diagnosis: less removals and more economic saving. Outcomes from the use of Confocal Laser Microscopy were presented by an Italian research team

A research conducted by the University of Modena and Reggio Emilia has shown a higher level of diagnostic accuracy from RCM (96%) compared to Dermoscopy (90%)

The study has estimated a €200,000 saving per one million people each year, together with a removal reduction of more than 50% and a better diagnostic accuracy of melanoma compared to Dermoscopy.

These are the most relevant elements based on the research ran by the University of Modena and Reggio Emilia; results will be presented for the first time during the 24th Congress of Dermatology in Milan that will end on Saturday 15 June. According to this study, Confocal Laser Microscopy (96%) has a higher level of diagnostic accuracy than Dermoscopy (90%) has.

Data being published has highlighted the diagnostic performance for ambiguous lesions for the diagnosis of melanoma.

Sensitivity (ability to diagnose melanoma) RCM=96% vs Dermoscopy=90%; specificity (a benign nevus even if suspected as melanoma) RCM=56% vs Dermoscopy=38%.

Giovanni Pellacani, Head of the Dermatology department at UNIMORE and President of WCD2019, said: “96 out of 100 is a very high percentage in medicine as it indicates the precision which we identify a tumour with”; he added: “New technology is so fast in gathering data and it is possible to assess a lesion at histologic level within one minute or two”.

This project, which has been funded by the Ministry of Health, has examined 3000 cases (data are available for 2000 cases). The study has seen the participation of UNIMORE, IRCSS of Reggio Emilia and IRST of Mendola.

The research included two groups:

• Group 1: Dermoscopy only.
• Group 2: Confocal Laser Microscopy.

Group 1: 3 benign nevi removed in order to find a melanoma.

Group 2: 1.4 benign nevi removed to find a melanoma.

With Confocal Laser Microscopy there is a 64% reduction of benign nevi removals.

Professor Pellacani has said: “It is the first time that such a precise and committed study is conducted. In this way we can remove less nevi and more melanoma. This will represent for our National Health System an annual saving of €200,000 per one million people”.

General scenario

The diagnosis of Cutaneous Melanoma has increased its accuracy over the last years thanks to the use of non-invasive methods such as videodermatoscopy. It is possible to diagnose those nevi which seem to be benign but are instead melanoma. Such diagnosis happens in a very early stage, before the tumour can cause any problem.

Non-invasive diagnostics for cutaneous lesions of the skin has evolved over the last years thanks to accurate diagnostic methods which “scan” the nevus, allowing its correct diagnosis. Amongst the most innovative methods, Confocal Laser Microscopy has a resolutive capacity similar to the histologic one; it allows a precise diagnosis of melanoma and possible benignities, avoiding unnecessary surgical abscissions.

Using these tools, it would be enough to undertake an accurate visit of nevi all over the body. With such screening, one can avoid a melanoma to be diagnosed when it is too late.