Utility of line-field confocal optical coherence tomography in the pediatric population

BACKGROUND: In the last decades diagnosis of dermatological diseases has achieved a significant progress with the aid of imaging technolo-gies. In pediatric population dermatologic procedural investigations require special considerations, skill sets, and knowledge. Avoiding unnec-essary invasive procedures in children is highly recommended to reduce psychological disturbance and cosmetical scars. Line-field confocal optical coherence tomography (LC-OCT) is an innovative, high-resolution, non-invasive imaging technique, that is proving to be valuable in the diagnosis of different skin conditions. In this study, we aimed to analyze the most common indications for LC-OCT in pediatric age group, discussing its potential role in clinical setting.METHODS: A retrospective review of the medical charts of patients <18 years of age, who were performed clinical, dermoscopy and LC-OCT for equivocal skin lesions, was conducted. Diagnostic confidence level was calculated for clinical/dermoscopic diagnosis alone and for com-bined clinical/dermoscopy and LC-OCT findings, based on a three-point scale ranging from 0% to 100%.RESULTS: Seventy-four skin lesions in 73 patients [(39 (53.4%) females and 34 (46.6%) males, mean age 13.2 (range 5-18 years) years] were investigated with LC-OCT. Diagnosis was established with histopathology in 23/74 (31.1%) cases, while 51/74 (68.9%) skin lesions were moni-tored over time or treated with topical/physical therapy. High diagnostic confidence increased by 21.6% after LC-OCT assessment, meanwhile reducing low and average score. CONCLUSIONS: LC-OCT may add practical clues for the identification of common skin conditions in pediatric population, improving diag-nostic confidence and consequent tailored approach.