Reflectance Confocal Microscopy for Skin Cancer Margins: How it Works

Since its first application to human skin imaging in 1995, confocal microscopy has continued to improve as both a noninvasive, in vivo imaging technique for intact skin and an efficient and cost-effective ex vivo imaging approach for excised skin. The purpose of this article is to present the principles behind confocal microscopy imaging of skin, provide a frame of reference regarding where the technology currently stands in its development towards widespread clinical practice, and elucidate how confocal microscopy can be used for preoperative and intraoperative delineation of skin cancer margins.