Woliner–van der Weg W, Peppelman M, Elshot YS, et al. - In this multicentre randomized controlled trial, researchers determined the diagnostic accuracy of reflectance confocal microscopy (RCM) compared with punch biopsy (PB) in diagnosing and subtyping basal cell carcinoma (BCC), as well as analyzed patient satisfaction and preferences. Between RCM and biopsy, patients with a clinically suspected primary BCC have been randomized. Conventional surgical excision or follow‐up has been used as a reference. Sensitivity and specificity for BCC diagnosis and subtyping for both methods were calculated. Using a questionnaire and a contingent valuation method, data on patient satisfaction and preferences were obtained. For BCC diagnosis, sensitivity was high and similar for both methods and specificity was lower for RCM. Biopsy outperforms RCM in the diagnosis and subtyping of clinically suspected primary BCC. This result does not support the regular clinical implementation of RCM as a substitute for PB in this patient group.