Reflectance confocal microscopy (RCM) enables in vivo imaging of human skin at a quasi
histologic resolution. The black-and-white RCM images show horizontal sections of the
skin, at a maximum depth of 350
m. To date, the RCM features of a significant number of
skin conditions have been described. The main focus of the research community investigating
RCM, however, lies on describing and diagnosing melanocytic skin lesions. Taking
into account all RCM studies dealing with diagnostic accuracy in melanocytic skin lesions,
sensitivity and specificity of approximately 90% and 86% could be found. Improvement of
diagnostic accuracy, improved assessment of dermoscopic-histologic correlation, in vivo
biopsy side selection, surgical margin assessment, and response control of conservative
therapies in skin diseases are some of the major advantages of this novel imaging method.
Additionally, RCM holds inherent potential for teledermatologic application and automated
image analyzing. This article describes morphologic features of diverse skin lesions and
features of “normal skin,” summarizes diagnostic advances of RCM, compares studies
dealing with diagnostic applicability, and discusses further research goals of this exciting
new imaging technique.
Semin Cutan Med Surg 28:172-179 © 2009 Elsevier Inc. All rights reserved.

Reflectance confocal microscopy (RCM) enables in vivo imaging of human skin at a quasi
histologic resolution. The black-and-white RCM images show horizontal sections of the
skin, at a maximum depth of 350
m. To date, the RCM features of a significant number of
skin conditions have been described. The main focus of the research community investigating
RCM, however, lies on describing and diagnosing melanocytic skin lesions. Taking
into account all RCM studies dealing with diagnostic accuracy in melanocytic skin lesions,
sensitivity and specificity of approximately 90% and 86% could be found. Improvement of
diagnostic accuracy, improved assessment of dermoscopic-histologic correlation, in vivo
biopsy side selection, surgical margin assessment, and response control of conservative
therapies in skin diseases are some of the major advantages of this novel imaging method.
Additionally, RCM holds inherent potential for teledermatologic application and automated
image analyzing. This article describes morphologic features of diverse skin lesions and
features of “normal skin,” summarizes diagnostic advances of RCM, compares studies
dealing with diagnostic applicability, and discusses further research goals of this exciting
new imaging technique.
Semin Cutan Med Surg 28:172-179 © 2009 Elsevier Inc. All rights reserved.