Line?field confocal optical coherence tomography for the in vivo real?time diagnosis of different stages of keratinocyte skin cancer: a preliminary study

Background The treatment of keratinocyte cancers (KC) strictly depends on their differentiation and invasiveness. Non-invasive diagnostic techniques can support the diagnosis in real-time, avoiding unnecessary biopsies. This study aimed to preliminarily define main imaging criteria histological correlations actinic keratosis (AK), Bowen’s disease (BD) squamous cell carcinoma (SCC) using novel device line-field confocal optical coherence tomography (LC-OCT). Methods Dermoscopy LC-OCT images 73 histopathologically confirmed lesions (46 AKs, 11 BD 16 SCCs) were included study. Exemplary (10 5 additionally investigated with reflectance microscopy. Results Most common findings KC descriptive statistics hyperkeratosis/parakeratosis, disruption stratum corneum, broadened epidermis, basal suprabasal atypia, dilated vessels/neoangiogenesis elastosis/collagen alterations. In univariate multinomial logistic regression, a preserved DEJ was less SCC compared AK BD, displayed marked atypia involving all epidermal layers (bowenoid pattern), while showed ulceration, increased thickness, keratin plugs, acantholysis, not visible/interrupted bright particles. confidence by 24.7 % dermoscopy alone. Conclusions Our describes for first time specific features different stages histopathological correlates, focusing morphology architecture epidermis DEJ. may open new scenarios bedside diagnosis, planning follow-up KC.