Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2024;14(1):e2024010 1

Simple Paper Tape as a Navigation Guide for 
Handheld in Vivo Imaging Techniques: Line-field 

Confocal Optical Coherence Tomography (LC-OCT) 
and Reflectance Confocal Microscopy (RCM)

Alvaro Abarzúa-Araya2, Javiera Perez-Anker1

1 Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain

2 Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

Citation: Abarzúa-Araya A, Perez-Anker J. Simple Paper Tape as a Navigation Guide for Handheld in Vivo Imaging Techniques: Line-
field Confocal Optical Coherence Tomography (LC-OCT) and Reflectance Confocal Microscopy (RCM). Dermatol Pract Concept. 
2024;14(1):e2024010. DOI: https://doi.org/10.5826/dpc.1401a10

Accepted: July 6, 2023; Published: January 2024

Copyright: ©2024 Abarzúa-Araya et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing Interests: None.

Authorship: Both the authors have contributed significantly to this publication.

Corresponding Author: Alvaro Abarzúa-Araya, MD, Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, 
Spain, Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.  
E-mail: alvaroabarzuaaraya@gmail.com

Case Presentation

Image acquisition and navigation with a handheld probe 

when using reflectance confocal microscopy (RCM) and 

line-field confocal optical coherence tomography (LC-OCT) 

is not easy. It is operator dependent and requires a high level 

of precision to capture the lesion of interest. It is also nec-

essary to maintain the exact position of the probe over the 

lesion being evaluated for long periods of time. Specifically, 

when evaluating facial lesions, the probe can easily slide 

from the skin, making the in vivo diagnostic procedure chal-

lenging [1].

Moreover, it is sometimes difficult to determine an ac-

curate evaluation of small lesions with handheld probes. To 

overcome this limitation, other authors have proposed the 

use of paper rings; however, they are expensive and not read-

ily available [2].

Teaching Point

To aid in the lesion navigation, a surgical paper tape is per-

forated with a punch scalpel at the center line of the tape 

using the specific size (3 mm – 6 mm) required according 

to the lesion size (Figure 1A). The paper tape is then at-

tached to the skin with the opening centered over the lesion 

of interest (Figure 1B). The paper tape is easily visualized 

under RCM or LC-OCT. This strategy is simple, reproduc-

ible, cost-effective, and easy to use and does not interfere 

with the acquisition of in vivo imaging techniques such as 

LC-OCT or RCM.



2 Image Letter | Dermatol Pract Concept. 2024;14(1):e2024010

References

1. Navarrete-Dechent C, Cordova M, Aleissa S, et al. Use of  paper

tape to guide reflectance confocal microscopy navigation of

large skin lesions. J Am Acad Dermatol. 2020;82(6):e199-e201. 

DOI: 10.1016/j.jaad.2019.07.039. PMID: 31326468. PMCID:

PMC6980414.

2. Marino ML, Rogers T, Sierra Gil H, Rajadhyaksha M,

 Cordova MA, Marghoob AA. Improving lesion localization when 

imaging with handheld reflectance confocal microscope. Skin Res

Technol. 2016;22(4):519-520. DOI: 10.1111/srt.12280. PMID:

26792361.

Figure 1. (A) Paper tape perforated with a 3-mm punch each 1cm in the middle line. (B) line-field confocal optical coherence tomography 

3D view. Note the transition between de normal epidermis and the paper tape fibers.