The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review

Background: Actinic keratosis (AK) is a precancerous skin lesion that can progress to squamous cell carcinoma (SCC). Early diagnosis and effective treatment are crucial, but current treatment evaluation methods lack consistency. Reflectance confocal microscopy (RCM) has emerged as a promising non-in...

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Main Authors: Jinrui Zhang, Haolong Ran, Yongyao Zhao, Xiyu Liang, Zhiqian Gu, Yanning Xue
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Photodiagnosis and Photodynamic Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S157210002500064X
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author Jinrui Zhang
Haolong Ran
Yongyao Zhao
Xiyu Liang
Zhiqian Gu
Yanning Xue
author_facet Jinrui Zhang
Haolong Ran
Yongyao Zhao
Xiyu Liang
Zhiqian Gu
Yanning Xue
author_sort Jinrui Zhang
collection DOAJ
description Background: Actinic keratosis (AK) is a precancerous skin lesion that can progress to squamous cell carcinoma (SCC). Early diagnosis and effective treatment are crucial, but current treatment evaluation methods lack consistency. Reflectance confocal microscopy (RCM) has emerged as a promising non-invasive tool for monitoring treatment outcomes in AK, but the absence of standardized evaluation protocols limits its clinical applicability. Objective: This study aims to establish standardized RCM imaging features for evaluating treatment responses in AK, thereby enhancing the consistency and clinical utility of RCM in treatment monitoring. Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Studies that evaluated the treatment of AK using RCM were included. A comprehensive literature search was performed across MEDLINE, Embase, and the Cochrane Library up to October 2024. Data on study design, treatment modalities, RCM imaging features, and scoring systems were extracted. A meta-analysis was not performed due to heterogeneity in study designs and outcome measures. Conclusion: This review identifies key RCM imaging features of AK, including keratinocyte atypia and architectural disarray, and highlights the lack of a standardized scoring system for evaluating treatment outcomes. The findings underscore the need for a universally accepted protocol to improve the consistency and reliability of RCM in clinical practice. Standardization of RCM evaluation will enhance its utility in both clinical monitoring and future research on AK treatment.
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spelling doaj-art-474e250f9aba4f2aa1944cd6d38c1e122025-08-20T03:05:14ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002025-06-015310453910.1016/j.pdpdt.2025.104539The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic reviewJinrui Zhang0Haolong Ran1Yongyao Zhao2Xiyu Liang3Zhiqian Gu4Yanning Xue5Department of Dermatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Dermatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Dermatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Dermatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Dermatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaCorresponding author: No. 155 Hanzhong Road, Qinhuai District, Nanjing, China.; Department of Dermatology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaBackground: Actinic keratosis (AK) is a precancerous skin lesion that can progress to squamous cell carcinoma (SCC). Early diagnosis and effective treatment are crucial, but current treatment evaluation methods lack consistency. Reflectance confocal microscopy (RCM) has emerged as a promising non-invasive tool for monitoring treatment outcomes in AK, but the absence of standardized evaluation protocols limits its clinical applicability. Objective: This study aims to establish standardized RCM imaging features for evaluating treatment responses in AK, thereby enhancing the consistency and clinical utility of RCM in treatment monitoring. Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Studies that evaluated the treatment of AK using RCM were included. A comprehensive literature search was performed across MEDLINE, Embase, and the Cochrane Library up to October 2024. Data on study design, treatment modalities, RCM imaging features, and scoring systems were extracted. A meta-analysis was not performed due to heterogeneity in study designs and outcome measures. Conclusion: This review identifies key RCM imaging features of AK, including keratinocyte atypia and architectural disarray, and highlights the lack of a standardized scoring system for evaluating treatment outcomes. The findings underscore the need for a universally accepted protocol to improve the consistency and reliability of RCM in clinical practice. Standardization of RCM evaluation will enhance its utility in both clinical monitoring and future research on AK treatment.http://www.sciencedirect.com/science/article/pii/S157210002500064XReflectance confocal microscopyActinic keratosisTreatment monitoring
spellingShingle Jinrui Zhang
Haolong Ran
Yongyao Zhao
Xiyu Liang
Zhiqian Gu
Yanning Xue
The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review
Photodiagnosis and Photodynamic Therapy
Reflectance confocal microscopy
Actinic keratosis
Treatment monitoring
title The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review
title_full The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review
title_fullStr The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review
title_full_unstemmed The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review
title_short The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review
title_sort clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis a systematic review
topic Reflectance confocal microscopy
Actinic keratosis
Treatment monitoring
url http://www.sciencedirect.com/science/article/pii/S157210002500064X
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