▸ In Vivo Reflectance Confocal Microscopy
In vivo reflectance confocal microscopy is an ‘optical biopsy’ which can replace surgical biopsy for diagnosis of some skin lesions. Confocal microscopy is based on laser technology, and allows visualisation of the surface layers of the skin at a microscopic level.
Although not currently subsidised by the medicare schedule of benefits, confocal microscopy is a cost-effective and painless technique.
Confocal microscopy is especially useful to establish the diagnosis of difficult pigmented lesions on the face, and can distinguish subtle early melanoma from benign age-related marks without the need for surgical biopsy.
Confocal microscopy is also an essential adjunctive test to delineate margins of subclinical involvement of poorly demarcated facial lentigomaligna, and is used to guide surgery and detect recurrence.
Confocal microscopy is helpful for diagnosis of atypical melanomas including amelanotic melanoma and mucosal melanoma,
Melanoma Dermatology is one of only two centres in NSW offering in vivo reflectance confocal microscopy. The service is lead by A/Prof Pascale Guitera who is a world expert and pioneer of the technique.
▸ Optical Coherence Tomography
Optical Coherence Tomography(OCT) is an emerging technology similar to ultrasound. It allows cross-sectional images of tissue structure on the microscopy scale in situ and in real time.
OCT is helpful to diagnose superficial basal cell carcinoma (sBCC), differentiate invasive carcinomas and monitor response to topical non-invasive treatments.
OCT is a non-invasive diagnostic test which can be used to confirm the clinical impression of sBCC, and guide non-invasive topical treatment without the need for surgical biopsy.
▸ Specialised Medical Photography