In vivo reflectance confocal microscopy of basal cell carcinoma with cystic degeneration

Basal cell carcinoma (BCC) is the most common skin cancer, may display various clinical aspects, frequently has subclinical extension, and through local invasion may induce important tissue damage. Reflectance confocal microscopy (RCM) is a modern technique that allows a non-invasive investigation of skin structure with a nearly histological resolution, and may achieve an optimal in vivo evaluation of skin tumors in combination with dermoscopy. We report a case of nodular BCC with areas of cystic degeneration in which in vivo RCM and dermoscopy evaluation enabled an accurate diagnosis and a detailed preoperative evaluation of tumor margins allowing the optimization of surgical treatment, with best aesthetic and functional results.