Reflectance Confocal Microscopy (RCM) marks a paradigm shift in biomedical imaging, offering a sophisticated, non-invasive technique to acquire high-resolution images of the skin and superficial tissues. Its development [1] represents a milestone in medical imaging, transitioning from early exploratory stages to becoming a cornerstone in clinical dermatology. RCM's capability for in vivo imaging, capturing live tissue images without the need for biopsies or tissue excision, has made it an indispensable tool in modern medical diagnostics. The inception of RCM can be traced back to its early conceptualization, where the need for less invasive, more accurate diagnostic methods in dermatology was recognized. Over the years, the technology has undergone significant advancements, evolving in its design and functionality. This evolution has been marked by improvements in laser source quality, detector sensitivity, and image processing algorithms, resulting in enhanced image clarity and depth of tissue analysis. RCM's operation relies on a focused laser light to illuminate the target tissue. The tissue interaction with this light, primarily through backscattering and reflection, forms the basis of image creation.

This paper studies a new Bayesian algorithm for the joint reconstruction and classification of reflectance confocal microscopy (RCM) images, with application to the identification of human skin lentigo. The proposed Bayesian approach takes advantage of the distribution of the multiplicative speckle noise affecting the true reflectivity of these images and of appropriate priors for the unknown model parameters. A Markov chain Monte Carlo (MCMC) algorithm is proposed to jointly estimate the model parameters and the image of true reflectivity while classifying images according to the distribution of their reflectivity. Precisely, a Metropolis-within-Gibbs sampler is investigated to sample the posterior distribution of the Bayesian model associated with RCM images and to build estimators of its parameters, including labels indicating the class of each RCM image. The resulting algorithm is applied to synthetic data and to real images from a clinical study containing healthy and lentigo patients. The lentigo is a hyperplasia that affects the skin.