Abstract Background: Currently, there is no uniform and official terminology in Portuguese for reflectance confocal microscopy analysis, despite the increasing number of Brazilian dermatologists using this new tool. Objective: To present the terminology in Brazilian Portuguese for the description of reflectance confocal microscopy and establish the first Brazilian consensus on terms related to normal skin and cutaneous tumors. Methods: 10 Brazilian specialists from different institutions and states of Brazil were selected to evaluate the best corresponding terms in Portuguese for normal skin, melanocytic and non-melanocytic tumors. The terms used were translated from international consensuses in the English language. The modified Delphi method was used to create the consensus in 3 steps. Results: The terms considered the most appropriate in the Portuguese language to describe the findings of normal skin, melanocytic and non-melanocytic lesions in the reflectance confocal microscopy analysis were presented. Study limitations: The limitations of the present study include the number of participants and limited regional representation (only two of the five Brazilian regions were represented). Conclusion: This Brazilian consensus represents an opportunity for dermatologists and physicians specializing in cutaneous oncology to become familiar with reflectance confocal microscopy, propagating the technique in clinical and research environments to stimulate national and international publications on this subject.

Abstract: Surgical excision of basal cell carcinoma with minimum margins requires serial assessment of layers by frozen histopathology in the case of Mohs micrographic surgery. Evaluation of presurgical tumor margins by in vivo reflectance confocal microscopy is a potential alternative. We selected 12 basal cell carcinoma lesions that were analyzed by confocal microscopy to define margins. The lesions were excised by Mohs surgery. Six tumors showed negative margins in the first phase of Mohs micrographic surgery. We concluded that reflectance confocal microscopy can be useful in the preoperative definition of basal cell carcinoma margins.

O nevo atípico (displásico) é considerado um fator importante associado com o risco aumentado de desenvolvimento do melanoma cutâneo. Acredita-se que nevos atípicos sejam lesões precursoras do melanoma cutâneo. Podem estar presentes em pacientes com múltiplos nevos melanocíticos (síndrome do nevo atípico) ou isolados e em poucas quantidades em um contexto não familial. Aparecem, geralmente, na puberdade e prevalecem em indivíduos jovens. Têm predileção por áreas expostas ao sol, especialmente, o tronco. O grande desafio em relação ao nevo atípico reside na controvérsia em se definir sua nomenclatura, diagnóstico clínico, critérios dermatoscópicos, diagnóstico histopatológico e aspectos moleculares. Esta revisão tem por objetivo trazer o conhecimento, facilitar o entendimento e responder às questões duvidosas concernentes ao nevo atípico.

Atypical nevum (dysplastic) is considered an important factor associated with increased risk of developing cutaneous melanoma. It is believed that atypical nevi are precursor lesions of cutaneous melanoma. They may be present in patients with multiple melanocytic nevi (atypical nevus syndrome) or isolated and in small numbers in a non-familial context. The disease usually begins at puberty and predominates in young people. It has a predilection for sun-exposed areas, especially the trunk. The major challenge in relation to atypical nevi lies in the controversy of defining its nomenclature, clinical diagnosis, dermoscopic criteria, histopathological diagnosis and molecular aspects. This review aims at bringing knowledge, facilitating comprehension and clarifying doubts about atypical nevus.

A incidência do melanoma cutâneo tem aumentado mundialmente e, por tratar-se de neoplasia bastante agressiva e de difícil tratamento em estádios mais avançados, o diagnóstico precoce é fundamental para a cura do paciente. A dermatoscopia surgiu como exame auxiliar in vivo, que tem papel fundamental na realização do diagnóstico precoce e amplifica a acurácia diagnóstica do melanoma. Para a realização do método, é necessário utilizar o dermatoscópio, aparato que permite aumentar a lesão, no mínimo, 10 vezes. A imagem obtida é interpretada utilizando-se o método diagnóstico da preferência do examinador. O método de Análise de Padrões é atualmente o mais utilizado e o que possui maior acurácia para o diagnóstico do melanoma cutâneo, tendo-se demonstrado confiável para o ensino de residentes em dermatologia. Baseia-se em padrões globais e específicos que permitem diferenciar as lesões melanocíticas das não melanocíticas (também importantes no diagnóstico diferencial com o melanoma cutâneo), assim como identificar lesões melanocíticas consideradas benignas, suspeitas ou malignas.

The incidence of cutaneous melanoma is increasing worldwide. Since it has an aggressive behavior and difficult to treat in more advanced stages, early diagnosis is essential for cure. Dermoscopy is an auxiliary diagnostic method that allows an increase in the diagnostic accuracy for cutaneous melanoma using a hand-held microscope with a 10-fold magnification - a dermatoscope. The pattern analysis method is considered a reliable procedure to teach dermatology residents. It is based on global and specific patterns that enable classifying melanocytic and non-melanocytic lesions (which are important in the differential diagnosis of cutaneous melanoma). Among melanocytic lesions, dermoscopy is useful in recognize benign, suspect or malignant lesions.