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Determination of optical coherence tomography patterns of pigmented skin lesions and comparison with dermoscopy and histopathology in conventional sections


Cutaneous melanoma is a cancer that affects young people and it has an aggressive behavior when diagnosed late. Treatment is primarily surgical, and radiation therapy and chemotherapy is not effective in advanced stage. The early diagnosis allows the increasing in cure rates and survival of patients with this disease. As the pigmented skin lesions are often not diagnosed by their clinical characteristics, even for a experienced professional, additional criteria are needed for the clinical diagnosis with greater accuracy, justifying the emergence of dermoscopy. Using the dermoscopic exam it is possible to achieve an increase in the clinical accuracy of approximately 10% to 20% depending on the experience of the examiner. However, the existence of limitations in the dermatoscopic examination in the diagnosis of pigmented skin lesions, led to the development of other diagnostic methods such as optical coherence tomography (OCT - Optical Coherence Tomography) as a method that seeks to accomplish the clinical diagnosis of lesions considered a challenge. The OCT, still experimental, is a diagnostic imaging technique that provides images of the emerging morphology of biological tissues in vivo and in real time with micro resolution. It consists of an optical system that allows us to obtain images in two and / or three dimensions, perpendicular to the skin surface, similar to the histology and without harming the patient. Today, although a very small number of publications, most studies performed a comparison between optical coherence tomography and histopatology. Comparison between optical coherence tomography of the skin, conventional histopathology (gold standard) and dermoscopy, as proposed in this study may bring new knowledge in relation to pigmented skin lesions leading to correct diagnosis of lesions that are extremely dubious in dermoscopy and may also contribute to the determination of diagnostic standards of the method currently being studied. (AU)

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