Application and comparison of invasive and non-invasive methodologies in the study of diseases of the cutaneous annexes

The purpose of the study is to evaluate the diagnostic accuracy of non-invasive instrumental methodologies—in particular OCT (optical coherence tomography) and confocal microscopy—in diseases of the cutaneous annexes and compare them to invasive methodologies (biopsy and surgical removal).

Scope of Research / Research project / Updated Objectives of Research:

The application of dermoscopy to the study of diseases of the cutaneous annexes goes back to 2002, when it was applied for the first time to nails in an attempt to distinguish between benign lesions and malignant pigmentations without carrying out a biopsy. The technique, subsequently applied to the scalp in order to study the skin, vessels, and hair, can provide a non-invasive diagnosis (avoiding biopsy). Today, dermoscopy is largely utilized for the study of diseases of the cutaneous annexes (trichoscopy or onicoscopy); diagnostic schemes and criteria for various pathologies have been developed. Although histological diagnosis remains the gold standard for diagnostic certainty, new non-invasive techniques such as OCT (Optical Coherence Tomography) and confocal microscopy are increasingly of great interest among experts.


Compared to a histologic exam, these techniques are: 1. less invasive, allowing the visualization of structures in vivo not altered by trauma; 2. quick to execute; and 3. repeatable over time. In the last few years, several studies evaluating the specificity and diagnostic sensibility of OCT (in nail pathologies) and confocal microscopy (in pathologies of the cutaneous annexes) have demonstrated that these methodologies improve diagnostic accuracy and avoid unnecessary surgical excisions. Furthermore, because it is possible to make a detailed observation of the cutaneous strata, these instruments can be used for in vivo evaluation of treatment response and disease progression. However, more in-depth studies are necessary to determine specific diagnostic patterns—above all, in the field of diseases of the annexes.

director of research group


Cosimo Misciali

Adjunct professor

Michela Valeria Rita Starace

Junior assistant professor (fixed-term)


Francesca Bruni