Reflectance confocal microscopy terminology for nonmelanocytic skin lesions: A Delphi consensus of experts.

Navarrete-Dechent C, Longo C, Liopyris K, Ardigo M, Ahlgrimm-Siess V, Bahadoran P, Carrera C, Tavoloni Braga JC, Chen CJ, Correa L, de Carvahlo N, Durkin J, Farnetani F, Grant-Kels JM, Gill M, Gonzalez S, Hartmann D, Hoffman-Wellenhof R, Huho A, Ludzik J, Malvehy J, Marghoob AA, Moscarella E, Oliviero M, Puig S, Rabinovitz H, Rao B, Rezze GG, Rossi AM, Rubinstein G, Ruini C, Sattler E, Soyer HP, Schwartz R, Thng S, Ulrich M, Witkowski A, Dusza SW, Guitera P, Pellacani G, Scope A, Jain M. J Am Acad Dermatol, (May 12 2025), doi:10.1016/j.jaad.2025.05.1362.

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 (NMLs).

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, nonsynonymous 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 nonsynonymous 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.