BACKGROUND: Kaposi's sarcoma (KS) is an unusual, clinically polymorphic, vascular neoplasm with genetic, infectious, environmental and immunological pathogenesis. Reflectance confocal microscopy (RCM) made in vivo noninvasive imaging of the skin possible and has been used for the evaluation of several skin diseases offering important microscopic information.

OBJECTIVE: The purpose of our study is to describe the RCM features of KS and correlate them with histopathology evaluating the effective prediction attitude and repeatability of RCM. 

METHODS: Twelve KS lesions underwent RCM followed by histological examination. Data obtained were statistically correlated. 

RESULTS: Analysis of the incidence of 11 selected microscopic criteria (by RCM and optical histology: inflammatory cells in the epidermis and in the dermis, single or in aggregates; spindle cells; stroma; anastomosing, newborn, increased number and dilated vessels; extravasated erythrocytes; deposits of hemosiderin) was performed disclosing a good correlation and high sensitivity of RCM. 

CONCLUSION: In our study RCM seems to provide high accuracy to predict histological findings, demonstrating its possible role in the management of patients affected by KS.