{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T18:25:33Z","timestamp":1788027933760,"version":"build-2784847793"},"reference-count":44,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,10,30]],"date-time":"2014-10-30T00:00:00Z","timestamp":1414627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100016239","name":"Dutch Ministry of Economic Affairs, Agriculture and Innovation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100016239","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Gelderland and Overijssel"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early recognition of squamous cell carcinoma (<jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>) is difficult. Non\u2010invasive reflectance confocal microscopic (<jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>) imaging of the skin is a promising diagnostic technique. Although several <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features for <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> have been described, it is not determined whether <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> has the ability to distinguish between <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content> and actinic keratosis (<jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine <jats:italic>in vivo<\/jats:italic> reflectance confocal microscopic features that are specific for making a distinction between <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 24 patients, 30 lesions clinically suspicious for <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content> were selected for <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> imaging. Following the imaging procedure, a 3\u00a0mm skin biopsy was obtained for confirmation of the histopathological diagnosis. Two observers evaluated the <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> images according to a literature based list of <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features. The obtained data were evaluated by an univariate and forward multivariate logistic regression analysis, kappa analysis and independent <jats:italic>T<\/jats:italic>\u2010test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The univariate logistic regression showed statistically significant odds ratios for several <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features, including architectural disarray in the stratum granulosum, architectural disarray in the spinous layer and nest\u2010like structures in the dermis. The forward multivariate logistic regression analysis showed that the combination of these features increased the ability to make the correct diagnosis AK and SCC non\u2010invasively. The interobserver agreement between a starting and an experienced <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> observer ranged from poor to no agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study revealed specific <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features that can distinguish between <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>, stimulating further prospective, large cohort research in this field. This will result in correct, efficient and adequate diagnosis and treatment of clinically difficult to distinguish <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content> lesions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12806","type":"journal-article","created":{"date-parts":[[2014,10,30]],"date-time":"2014-10-30T12:24:58Z","timestamp":1414671898000},"page":"1302-1309","source":"Crossref","is-referenced-by-count":47,"title":["Reflectance confocal microscopy: non\u2010invasive distinction between actinic keratosis and squamous cell carcinoma"],"prefix":"10.1111","volume":"29","author":[{"given":"M.","family":"Peppelman","sequence":"first","affiliation":[{"name":"Department of Dermatology Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.P.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of 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