皮肤共聚焦显微镜 (CCCM) 有助于在细胞水平上对皮肤进行体内可视化。使用跨多个站点的远程 CCM 解释（Remote-CCM）的“存储和转发”方法尚未经过测试，可能会增加无创诊断的机会。为了测试 Remote-CCM 的诊断准确性和安全性。我们前瞻性地招募了澳大利亚五个三级皮肤病中心选择对皮肤恶性肿瘤进行活检的病变。 CCM、临床和皮肤镜图像是在活检前获取的，并通过基于云的平台访问，以供 CCM 读者解读。将 CCM 诊断与组织病理学结果进行比较。在纳入的 201 个病变中，黑色素瘤是最常见的恶性肿瘤（34/72，47.2%）。在可能从活检中“保存”的 89 个病变 (44.8%) 中，80 个 (90%) 是真正的良性病变，9 个 (10.1%) 是 MIS (n=7) 和 SCC (n=2) 漏诊的恶性病变。没有遗漏侵袭性黑色素瘤。远程 CCM 检测恶性肿瘤的敏感性为 89% (95%CI 79-95%)，特异性为 64% (95%CI 55-73%)。该研究从高危人群中招募，并排除了未发现恶性肿瘤的病变。活检。远程 CCM 具有与床边 CCM 相当的准确性，并安全地减少不必要的活检。潜在的 SCC 不适合远程 CCM。建议对交界性黑色素细胞病变进行随访。版权所有 © 2024。由 Elsevier Inc. 出版。

Cutaneous confocal microscopy (CCCM) facilitates in vivo visualisation of skin at a cellular level. Use of a "store and forward" approach for remote CCM interpretation (Remote-CCM) across multiple sites has not been tested and may increase access to non-invasive diagnosis.To test the diagnostic accuracy and safety of Remote-CCM.We prospectively recruited lesions selected for biopsy for skin malignancy across five Australian tertiary dermatology centres. CCM, clinical and dermoscopy images were acquired pre-biopsy and accessed by a cloud-based platform for interpretation by CCM readers. CCM diagnosis was compared to histopathology results.Amongst the 201 lesions included, melanoma was the most common malignancy (34/72, 47.2%). Of the 89 lesions (44.8%) potentially 'saved' from biopsy, 80 (90%) were truly benign lesions and 9 (10.1%) were missed malignant lesions of MIS (n=7) and SCC (n=2). No invasive melanomas were missed. Sensitivity of remote-CCM for detection of malignancy was 89% (95%CI 79-95%) and specificity was 64% (95%CI 55-73%).The study recruited from high-risk populations and excluded lesions that were not biopsied.Remote-CCM has comparable accuracy to bedside-CCM and safely reduces unnecessary biopsies. Potential SCCs are not appropriate for remote-CCM. Follow-up of borderline melanocytic lesions is recommended.Copyright © 2024. Published by Elsevier Inc.