Digital pathology using ex vivo confocal laser scanning microscopy

Ex vivo confocal laser scanning microscopy (EVCM) is a novel diagnostic method for bedside use with the possibility to perform rapid dermatopathological examinations on fresh tissue, while directly creating digital pictures. The aim of this article is to provide an overview of current study results in the field of EVCM. Due to the large number of studies in dermatology, the focus is set on the diagnosis of dermatological diseases. Nonmelanocytic cancer (NMSC) is considered the most studied disease in EVCM with high potential for clinical application. In addition, more studies on other dermatological diseases, such as neoplastic, infectious and even rare dermatological diseases, have shown promising results. The potential implementation of artificial intelligence (AI) in EVCM could make bedside diagnostics even more efficient and accelerate the clinical workflow. EVCM offers a user-friendly technology that mimics dermatopathology, thus, establishing its importance as an innovative addition to conventional dermatohistopathology. In addition to technical challenges, the current lack of immunohistochemistry in EVCM remains a limitation.