Search

Background: Over the last few decades, Reflectance Confocal Microscopy (RCM) has been tested as a diagnostic technique and recently, demonstrates effectiveness to monitor the therapeutic response in melanoma and non-melanoma skin cancer, but it has not been used for follow-up in Cutaneous Lymphoma. This innovative technology allows an in vivo dynamic evaluation of multiple lesions and helps to identify areas of active disease. Moreover, the non-invasive nature of this technique allows repetitive sampling without biopsy collection, causing no further morbidity to patients. Its main advantage is the possibility of risk-free longitudinal monitoring. Objective: Our aim was to evaluate the role of RCM in the follow-up of patients with Mycosis Fungoides (MF). Additionally, to correlate RCM features with clinical and histopathological features before and after treatment. Method: Patients were assessed with RCM on the same site that diagnostic biopsies were performed and re-assessed 6 months after treatment. RCM descriptors were defined by a systematic review. Histopathological correlation and clinical correlation were assessed. Results: A total of 30 patients were assessed by RCM and biopsies were taken in 38 lesions. After 20 to 30 weeks under treatment, 19 lesions were re-assessed by RCM and 12 were re-biopsied. RCM demonstrated good correlation with clinical and histopathological assessments with 4 RCM parameters (epidermotropic lymphocytes, Pautier’s microabscess, interface dermatitis and junctional lymphocytes) achieving an AUC 0.955 (SD: 0.053, p: 0.003). Conclusion: RCM is an excellent tool to assess the response of skin lesion in patients with MF, with excellent correlation with clinic and histological assessment. Keywords: Follow up, Score, Cutaneous T-cell lymphoma, Skin cancer, Reflectance Confocal Microscopy, Mycosis Fungoides

Squamous cell carcinoma (SCC) is the second-most common malignant cutaneous cancer, with 60% occurring in the head and neck region. Metastases are uncommon and imply a more conservative prognosis. This report describes a case of parotid-invasive, facial squamous cell carcinoma, highlighting the importance of its prognostic and therapeutic management. The patient is an 81-year-old female, exhibiting extensive tumoral lesions in the pre-auricular region, affecting the parotid parenchyma and implying the metastatic involvement of the intra-parotid lymph node. Parotid involvement caused by SCC in specificity tumors is discussed herein. Parotid invasion is currently recognized as an isolated variable. It affects survival rates and determines certain changes in case management, such as the broadening of resection areas and adjuvant radiotherapy.