Has this promising novel technology for non-invasive early diagnostics of cutaneous melanoma the capability to detect a developing melanoma before it could be seen or suspected by dermatoscopy?
Nevi as the precursor lesion of malignant melanoma is still under discussion, but giant congenital nevus is considered to be responsible for the development of melanoma. However, we have recently uncovered that melanoma-initiating cells reside in the dermis, especially in the secretory portion of sweat glands of volar skin. Given that acral melanoma is diagnosed with parallel ridge pattern (as described in the picture) in the dermoscopic findings, early diagnosis of the malignant melanoma patients should be performed with FISH analysis of biopsy skin to detect the amplification of oncogenic cyclinD1.
http://archderm.jamanetwork.com/article.aspx?articleid=400888
Conference Paper Pathological Significance of Sweat Glands as Melanocytic Ste...
Confocal is suitable for manytypes of nevi and melanomas but is not appropriate here for 2 reasons: its field of view is narrow at most 8x8mm especially compared to the surface of a giant congenital nevi, and its depth is 200 to 300 microns while it is suspected that giant congenital nevi degenerate in their depth part.
no because confocal has a maximum field of view of 8x8mm and a maximal depth of 200-300 microns while GCN are very large and seem to degenerate in their deep part
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