Melanoma Diagnosis by Confocal Microscopy: Promise and Pitfalls Klaus J. Busam, Ashfaq A. Marghoob, Allan Halpern  Journal of Investigative Dermatology  Volume 125, Issue 3, Pages vii-ix (September 2005) DOI: 10.1111/j.0022-202X.2005.23865.x Copyright © 2005 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 1 Melanoma that was not recognized clinically or on confocal images. (A) Confocal image of a facial lesion thought to be clinically “negative” for melanoma shows a preserved honeycomb pattern of epidermal keratinocytes. (B) The corresponding histology reveals in situ melanoma. Journal of Investigative Dermatology 2005 125, vii-ixDOI: (10.1111/j.0022-202X.2005.23865.x) Copyright © 2005 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 2 Langerhans cells may simulate melanocytes on confocal images. (A) Confocal image of a bright dendritic cells within the spinous cell layer of the epidermis. (B) Conventional histology reveals a compound melanocytic nevus. (C) No pagetoid melanocytosis is seen on an immunostain for Melan-A. (D) Numerous Langerhans cells (dendritic cells immunopositive for CD1a) are present. Journal of Investigative Dermatology 2005 125, vii-ixDOI: (10.1111/j.0022-202X.2005.23865.x) Copyright © 2005 The Society for Investigative Dermatology, Inc Terms and Conditions