Reflectance confocal microscopy terminology for non-melanocytic skin lesions: A Delphi consensus of experts
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Date
2025
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier Inc.
Abstract
Background
There is lack of uniformity in reflectance confocal microscopy (RCM) terminology.
Objective
To establish expert consensus on a standardized set of RCM terms that describe non-melanocytic lesions (NML).
Methods
We invited RCM experts to participate in a Delphi-consensus study. Fifty-nine RCM descriptors were extracted from a previous systematic review on RCM terminology for describing NML. Of these, 35 items were presented as 4 groups of synonymous terms and 24 items as single, non-synonymous terms. For the first round, an agreement threshold was set at >70%. Participants could also propose new terms. Terms with ≤70% agreement and newly proposed terms were carried over to the next round. For subsequent rounds, agreement threshold was set at >50%.
Results
The study was conducted between June 2021 and May 2023. Forty-two of 44 (95%) invited experts participated. Three iterative Delphi rounds were completed, resulting in a consensus list of 36 terms, including 32 synonymous- and 4 non-synonymous- terms for describing NML.
Limitations
Only experts were included. We did not evaluate definitions of terms in the study.
Conclusions
We propose a simplified list of RCM terms, vetted by RCM experts, for describing and diagnosing NML. Uniform terminology could benefit clinical practice, research, and education.
Description
Keywords
Reflectance confocal microscopy, Basal cell carcinoma, Squamous cell carcinoma, Actinic keratosis, Bowen’s disease, Solar lentigo, Seborrheic keratosis, Non-invasive, Delphi