Article first published online: 03 Aug 2017
Routine punch biopsies are considered to be standard care for diagnosing and subtyping basal cell carcinoma ( BCC ) when clinically suspected.
We assessed the efficacy of a one‐stop‐shop concept using in vivo reflectance confocal microscopy ( RCM ) imaging as a diagnostic tool vs. standard care for surgical treatment in patients with clinically suspected BCC .
In this open‐label, parallel‐group, noninferiority, randomized controlled multicentre trial we enrolled patients with clinically suspected BCC at two tertiary referral centres in Amsterdam, the Netherlands. Patients were randomly assigned to the RCM one‐stop‐shop (diagnosing and subtyping using RCM followed by direct surgical excision) or standard care (planned excision based on the histological diagnosis and subtype of a punch biopsy). The primary outcome was the proportion of patients with tumour‐free margins after surgical excision of BCC .
Of the 95 patients included, 73 (77%) had a BCC histologically confirmed using a surgical excision specimen. All patients (40 of 40, 100%) in the one‐stop‐shop group had tumour‐free margins. In the standard‐care group tumour‐free margins were found in all but two patients (31 of 33, 94%). The difference in the proportion of patients with tumour‐free margins after BCC excision between the one‐stop‐shop group and the standard‐care group was −0·06 (90% confidence interval −0·17−0·01), establishing noninferiority.
The proposed new treatment strategy seems suitable in facilitating early diagnosis and direct treatment for patients with BCC , depending on factors such as availability of RCM , size and site of the lesion, patient preference and whether direct surgical excision is feasible.
08 Dec 2019
An unusual case of mycosis fungoides with cerebral involvement, which achieved a durable complete remission after autologous stem-cell transplantation and interferon alfa-2a maintenance therapy. https://t.co/LCZbpZwDkc #CTCL #interferon https://t.co/UA8uMiBvI5
07 Dec 2019
31M born in Cape Verde presented w/ 3/52 hx of 7cm bosselated & exulcerated plaque w/ rapid growth & bleeding, assoc. w/ wt loss, fatigue & occasional cough. PCR detected Bartonella spp DNA and also tested +ve for HIV. What's your diagnosis? https://t.co/vC2R8lz0zc #medderm #BJD https://t.co/d8f75TZbhn
06 Dec 2019
RT The British Association of Dermatologists @HealthySkin4All: New @BrJDermatol research investigated the genetic basis of fibrosis in recessive dystrophic epidermolysis bullosa. This finding could lead to possible future treatment. https://t.co/WmYsCGncdW @CharityDEBRA @Wiley_Health https://t.co/wRgfgUk3jT