Role of noninvasive imaging in the management of skin cancer

The use of noninvasive imaging technologies has recently changed the clinical approach to diagnosis and management of skin cancers, becoming an essential tool in daily dermatological practice. The present research focused on new applications of noninvasive imaging techniques, namely: a) evaluation of clinical and dermoscopic criteria of nevus-associated melanoma (NAM); b) assessment of the accuracy of dermoscopy, compared to clinical examination, in the detection of borders of basal cell carcinoma (BCC) and description of the most common dermoscopic findings in the clinically healthy tissue surrounding BCC, in case of not-matching clinically and dermoscopically detected margins; c) evaluation of the diagnostic accuracy of electrical impedance spectroscopy in the diagnosis of actinic keratosis (AK) and subclinical lesions in comparison to the naked eye examination and dermoscopy. Concerning NAM, different clinical and dermoscopic features of melanomas associated with congenital or non-congenital nevi and their correlation with specific patients’ characteristics were discovered. As regards BCC, dermoscopic findings in the area between clinically and dermoscopically detected margins were described, which are useful to better define the actual tumor margins and achieve a really radical excision. Finally, the possible usefulness of electrical impedance spectroscopy in the management of AKs was evaluated, obtaining preliminary data of good sensitivity but low specificity, likely open to improvement in the future. These results confirm the pivotal role of noninvasive imaging in both diagnostic and therapeutic phase of dermato-oncology, and suggest possible additions and/or changes to currently employed criteria.