In vivo real-time confocal reflectance microscopy: a noninvasive guide for Mohs micrographic surgery facilitated by XXXX , an excellent contrast enhancer.

@entity1 @entity5 @entity1489 @entity40321 @entity15484 @entity1711 @entity1710 @entity1491
BACKGROUND: Mohs micrographic surgery (MMS) is based on microscopically controlled excision of cutaneous @entity5 and offers the highest cure rates with maximum tissue preservation. In vivo confocal microscopy (CM) allows noninvasive optical imaging of thin sections of living skin, in its native state, in real time, with high resolution and contrast. OBJECTIVE: To evaluate the feasibility of the use of in vivo CM as a surgical guide in MMS. METHODS: Five @entity1 with a biopsy-proven @entity1491 ( @entity1491 ) were imaged by in vivo CM on one or two sites from the clinically visible @entity1489 . The first Mohs layer was then excised, and the fresh-frozen sections were correlated with the CM findings. @entity15484 ( @entity40321 ) 20% was applied on the Mohs defect followed by in vivo CM on one site from each lesion. A second Mohs layer was subsequently excised, and fresh-frozen sections were correlated with CM findings. RESULTS: The findings of in vivo CM were confirmed by @entity1710 and @entity1711 -stained frozen sections after excisions of the first and second Mohs layers. @entity40321 was found to provide an excellent contrast between @entity1491 cells and the surrounding tissue, detected readily with both in vivo and ex vivo CM. The @entity5 cells with @entity40321 exhibited intensely bright nuclei with an excellent contrast as compared with the low-contrast dark nuclei without @entity40321 application. CONCLUSION: In vivo CM is a potential surgical guide for MMS, and @entity40321 provides an excellent exogenous agent to enhance @entity5 contrast for CM.
