{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:20:34Z","timestamp":1792797634496,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Pigmented lesions of the genital area are of commonly occurrence, with population-based incidence estimated around 10\u201320%. Historically, invasive biopsy or surgical removal were recommended to obtain a definite diagnosis. Line-field confocal optical coherence tomography (LC-OCT) is a novel multimodality imaging tool, able to reproduce a \u201cvirtual biopsy\u201d of skin lesions, offering vertical, horizontal, and three-dimensional (3D) imaging down to the mid-dermis with high-resolution real-time visualization. The aims of the study were (i) to describe the LC-OCT features in a series of benign and malignant pigmented genital lesions (PGLs), (ii) to investigate the impact of LC-OCT on the diagnostic accuracy, (iii) and to estimate the diagnostic concordance between LC-OCT and histopathology. Methods: This was a retrospective, cross-sectional study including histologically confirmed PGL investigated with LC-OCT over 2 years. Descriptive statistics were calculated for continuous and categorical variables. Diagnostic accuracy of LC-OCT and dermoscopy was compared, and the LC-OCT\u2013histopathology diagnostic concordance was estimated. Results: A total of 96 PGLs were analyzed in 23 male and 57 female patients. Pathologic reporting consisted of 56 melanoses, 21 nevi (15 compound nevi and 6 atypical genital nevi), 10 melanomas, and 9 angiokeratomas. LC-OCT obtained higher diagnostic accuracy rather than dermoscopy; diagnostic concordance LC-OCT\/histopathology was 91% (87\/96; 95% CI 83.7\u201395.3). Melanoses were characterized by a continuous undulated junction. Common genital nevi were identified by the presence of regular dense nests, while dischoesive nests were seen in atypical genital nevi. Features of epidermal disarray with pagetoid cells, junctional atypia, and discohesive nests were observed in melanoma. Angiokeratomas showed the presence of dark vascular lacunae. Conclusions: Providing in vivo key clues with a resolution close to classic histopathology, LC-OCT may have a valuable role in the clinical management of PGLs, particularly when lesions involve large areas or are multiple in number.<\/jats:p>","DOI":"10.3390\/diagnostics15233023","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T16:31:52Z","timestamp":1764261112000},"page":"3023","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Line-Field Confocal Optical Coherence Tomography for the Evaluation of Pigmented Skin Lesions of the Genital Area"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9813-2391","authenticated-orcid":false,"given":"Simone","family":"Cappilli","sequence":"first","affiliation":[{"name":"Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9681-1681","authenticated-orcid":false,"given":"Gerardo","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4009-0659","authenticated-orcid":false,"given":"Elisa","family":"Cinotti","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Boussingault","sequence":"additional","affiliation":[{"name":"Department of Dermatology, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"},{"name":"Department of Dermato-Oncology, Institute Jules Bordet, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-4310","authenticated-orcid":false,"given":"Linda","family":"Tognetti","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona Maria","family":"Fragomeni","sequence":"additional","affiliation":[{"name":"UOC Ginecologia Oncologica, Dipartimento per le Scienze della Salute della Donna e del Bambino e di Sanit\u00e0 Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6959-7250","authenticated-orcid":false,"given":"Javiera","family":"P\u00e9rez-Anker","sequence":"additional","affiliation":[{"name":"Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08007 Barcelona, Spain"},{"name":"CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 08034 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4479-9961","authenticated-orcid":false,"given":"Jean-Luc","family":"Perrot","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital of Saint-Etienne, 42270 Saint-Etienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6964-5152","authenticated-orcid":false,"given":"Angela","family":"Santoro","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Woman and Child\u2019s Health and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Pathology Institute, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Garganese","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa di Chirurgia degli Organi Genitali Esterni Femminili, Divisione di Ginecologia Oncologica, Dipartimento per le Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Gemelli Women\u2019s Health Center for Digital and Personalized Medicine, Dipartimento Universitario Scienze della Vita e Sanit\u00e0 Pubblica, Sezione di Ginecologia ed Ostetricia, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Franco","family":"Zannoni","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Woman and Child\u2019s Health and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Pathology Institute, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Suppa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"},{"name":"Department of Dermato-Oncology, Institute Jules Bordet, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"},{"name":"Groupe d\u2019Imagerie Cutan\u00e9e Non Invasive (GICNI) of the Soci\u00e9t\u00e9 Fran\u00e7aise de Dermatologie (SFD), 75008 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketty","family":"Peris","sequence":"additional","affiliation":[{"name":"Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8283-2633","authenticated-orcid":false,"given":"Alessandro","family":"Di Stefani","sequence":"additional","affiliation":[{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Pathology Unit, Department of Woman and Child\u2019s Health and Public Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Pathology Institute, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1111\/j.1600-0560.2008.01041.x","article-title":"Nevi with site-related atypia: A review of melanocytic nevi with atypical histologic features based on anatomic site","volume":"35","author":"Hosler","year":"2008","journal-title":"J. Cutan. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4274\/jus.galenos.2022.2022.0030","article-title":"Genital pigmented lesions","volume":"10","author":"Erfan","year":"2023","journal-title":"J. Urol. Surg."},{"key":"ref_3","first-page":"e550","article-title":"Pigmented genital lesions: A prospective cross-sectional study","volume":"37","author":"Ravni","year":"2023","journal-title":"J. Eur. Acad. 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