New peri-op approach accurately IDs melanoma in nail matrix

(HealthDay) -- Intraoperative reflectance confocal microscopy (RCM) can be used to diagnose melanonychia striata in the nail matrix, according to a study published online June 7 in the British Journal of Dermatology.

Sébastien Debarbieux, M.D., of the Centre Hospitalier Lyon Sud in Pierre Bénite, France, and colleagues assessed the feasibility of intraoperative diagnosis of melanonychia striata in a series of nine patients who underwent a matricial biopsy for an acquired melanonychia (one benign lentigo, eight melanomas). RCM examination was performed in vivo and/or ex vivo.

The researchers found that confocal and histopathological features correlated well. Confocal features were used for unequivocal intraoperative diagnosis of seven of the melanoma cases, and RCM correctly classified the lentigo as benign. RCM did not provide a definite classification for the last lesion, which corresponded histopathologically to an early melanoma.

"Intraoperative RCM examination of the nail matrix is an efficient diagnostic approach of melanonychia striata that permits an extemporaneous diagnosis of malignancy and therefore a one-step surgical treatment of in situ or minimally invasive melanoma, reducing dramatically the duration of postoperative disability," the authors write.