Combo of Dermoscopy, Handheld RCM Has High Sensitivity, Specificity for Basal Cell Carcinoma

WEDNESDAY, Aug. 26, 2026 (HealthDay News) -- The combination of dermoscopy and handheld reflectance confocal microscopy (HH-RCM) has high sensitivity and specificity for overall basal cell carcinoma (BCC) and can reduce unnecessary diagnostic biopsies, according to a study published online July 28 in the Journal of the European Academy of Dermatology and Venereology.Yannick S. Elshot, M.D., Ph.D., from The Netherlands Cancer Institute in Amsterdam, and colleagues examined the diagnostic accuracy of combined dermoscopy and HH-RCM for diagnosing and subtyping primary head and neck BCC in a prospective, single-center, paired diagnostic comparison study.Data were included for 340 consecutive lesions suspected of being BCC by the naked eye. The researchers found that in 33 percent of cases, biopsy subtypes were inconsistent with excisional specimens. Combined dermoscopy-HH-RCM had overall BCC diagnostic sensitivity and specificity of 97.5 and 85.2 percent, respectively. Sensitivity improved to 98.8 percent and specificity to 94.1 percent in cases where diagnostic confidence was high. For BCC subtyping, the sensitivity and specificity were 95.5 and 44.8 percent, respectively, for detecting nonsuperficial BCC and 58.8 and 79.6 percent, respectively, for detecting infiltrative BCC. Excision of ≤0.7 percent (two) of benign lesions would have resulted from hypothetically applying international Mohs micrographic surgery criteria to the subset of the cohort with high diagnostic confidence (281 patients)."HH-RCM reduces unnecessary biopsies with higher confidence than dermoscopy alone," the authors write. "Although HH-RCM has increased diagnostic accuracy compared to dermoscopy, it cannot completely replace diagnostic punch biopsies when management relies solely on BCC subtyping."Abstract/Full Text.Sign up for our weekly HealthDay newsletter

Combo of Dermoscopy, Handheld RCM Has High Sensitivity, Specificity for Basal Cell Carcinoma

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