Adjunctive use of reflective confocal microscopy nearly halves the number of unnecessary excisions and effectively identifies aggressive melanoma at baseline, a randomised trial shows.

Compared with standard care alone, the non-invasive imaging technique has superior accuracy and detects lesions thinner than 0.5mm, the researchers say.

“The findings of our study clearly demonstrated that the use of confocal microscopy is strongly needed in referral centres dealing with melanoma diagnosis,” said first author and dermato-oncology specialist Dr Giovanni Pellacani, from Sapienza University in Rome, Italy.

In their multi-site clinical trial, Dr Pellacani and colleagues assigned some 3200 patients (mean age 49) to standard care with clinical and dermoscopy evaluation with or without adjunctive reflective confocal microscopy (RCM).