Confocal Microscopy - Digital Imaging

Alexander Witkowski analyzing a confocal microscopy image

Reflectance confocal microscopy (RCM) is a non-invasive, painless virtual biopsy of a chosen skin lesion (mole) that enables trained dermatologists to visualize structures at the cellular level. A confocal expert can differentiate between moles that should be biopsied, detecting skin cancers at their earliest stages, and reducing invasive biopsies of concerning moles by up to 50%. 

Series of images, known as confocal mosaics, provide the ability to observe cellular structures in the skin, including the nuclei of melanocytes. RCM has shown considerable applicability in detecting and differentiating skin cancers by reducing biopsy rates. It is also a promising new tool for the evaluation and in vivo monitoring of psoriasis, lupus erythematosus, contact dermatitis, acne, characterization and evaluation of pigment distribution and response to therapy in melasma, and other skin diseases.

This new technology is being utilized for the first time in the Northwest and made possible through the new Skin Cancer Imaging Center at the OHSU Department of Dermatology. We believe this new technology could become a standard of care in dermatology and look towards future research to provide evidence-based recommendations for dermatology practices everywhere.

Skin Cancer Imaging Center

The Skin Cancer Imaging Center is a specialty service offered at OHSU Dermatology. The clinic's co-directors, Dr. Alexander Witkowski, M.D., Ph.D. and Joanna Ludzik, M.D., Ph.D., completed medical training and residency in Europe, as well as earning their Ph.D.s in Modena (Italy), focused on implementing virtual biopsies with reflectance confocal microscopy and its application to diagnosing melanoma subtypes at the patient bedside. The duo implemented this technology into private practice in their native Poland, before joining OHSU. They are excited to bring this technology to OHSU and to dermatology practice in the United States.