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Coco V, Cappilli S, Di Stefani A, Ricci C, Perino F, Di Nardo L, Longo C, Peris K. Confocal Assessment of Pigmented-Mucosal Lesions: A Monocentric, Retrospective Evaluation of Lip and Genital Area. Dermatol Pract Concept 2024; 14:dpc.1401a28. [PMID: 38364417 PMCID: PMC10868824 DOI: 10.5826/dpc.1401a28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Pigmentation of lip and/or genitalia is mainly due to the development of benign melanotic macules, with a less occurrence of melanocytic and other non-melanocytic lesions. Mucosal melanoma has worse prognosis compared with cutaneous counterpart, hence identification of atypical features for an early diagnosis is crucial. OBJECTIVES The aim of this study was to report further data of confocal features characterizing pigmented mucosal lesions of genital area and of the lips and test the diagnostic role of the reflectance confocal microscopy (RCM)lip score. METHODS Clinical, dermoscopic and RCM images of histologically proven pigmented lesions, involving the genital area (vulva or glans penis) and lip, were retrospectively reviewed. RCM images were evaluated for malignant criteria, and statistical analysis was conducted for categorical variables. RESULTS Seventy pigmented lesions were included in the study and divided into two groups based on the body area location: lip (17) and genital area (53). Architectural disarray (P = 0.002), dendritic (P = 0.031) and roundish cells in epidermis (P < 0.0001), interpapillary dendritic cells (P = 0.039) and junctional atypical cells (P = 0.002) were associated to genital melanoma. Melanoma involving the lip was characterized by roundish cells in epidermis, a criterion found in one labial benign lesion, only (P = 0.005). Main limitations of the study are the inclusion of low melanomas and the presence of epidermal dendritic cells in melanosis and melanoma, as a confusing factor in imaging. CONCLUSIONS Dermatologists should consider confocal microscopy as an adjunctive tool to dermoscopy in the differential diagnosis of pigmented mucosal lesions, especially in presence of clinical and dermoscopic findings suspicious for malignancy.
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Affiliation(s)
- Valeria Coco
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy
| | - Simone Cappilli
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Di Stefani
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Costantino Ricci
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Francesca Perino
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy
| | - Lucia Di Nardo
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
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Chiara FRANCESCHINI, Desmond MANDELV, Gary PETERSON, Valentina MANCIOCCO, Pascale GUITERA, Milind RAJADHYAKSHA, Marco ARDIGÒ. Role of reflectance confocal microscopy for in vivo investigation of oral disorders: White, red and pigmented lesions. Exp Dermatol 2023; 32:648-659. [PMID: 36710524 PMCID: PMC10159980 DOI: 10.1111/exd.14758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/06/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
In vivo reflectance confocal microscopy (RCM) is poorly investigated in oral pathology due to the peculiar anatomical and topographical oral mucosa features. A dedicated handheld confocal microscope with an intra-oral probe was developed for oral mucosa imaging. The main objective was to describe the healthy oral mucosa and the cytoarchitectural findings detectable in different oral disorders by means of the newly designed handheld confocal microscope. Secondary aim was to identify the main RCM criteria that differentiate oral lesions in order to provide algorithm for a rapid non-invasive evaluation. This observational retrospective study included all consecutive patients with oral disorders and volunteers with healthy oral mucosa who underwent RCM examination in our outpatient clinic from September 2018 to December 2021. Three different investigators examined together the RCM images to detect the key features and secondary criteria for each type of oral lesion collected. The study population included 110 patients affected by oral lesions and seven volunteers with healthy oral mucosae. A total of 15 oral disorders were imaged and divided in three main groups: white, red and pigmented lesions. Key features and secondary criteria were identified for every single type of oral disease. RCM permits a cytoarchitectural evaluation of the oral mucosae affected by inflammatory, dysplastic and neoplastic diseases, thus orienting the clinicians towards non-invasive diagnosis and enhancing the diagnostic management. The "tree diagrams" proposed allow a schematic and simplified view of confocal features for each type of oral disease, thus drastically reducing the diagnostic timing.
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Affiliation(s)
- FRANCESCHINI Chiara
- Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - MANDEL Victor Desmond
- Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - PETERSON Gary
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - MANCIOCCO Valentina
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute - IRCCS, Rome, Italy
| | - GUITERA Pascale
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
- The Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Melanoma institute Australia, and the University of Sydney, Sydney, Australia
| | | | - ARDIGÒ Marco
- Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
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Yang Y, Xu F, Chen J, Tao C, Li Y, Chen Q, Tang S, Lee HK, Shen W. Artificial intelligence-assisted smartphone-based sensing for bioanalytical applications: A review. Biosens Bioelectron 2023; 229:115233. [PMID: 36965381 DOI: 10.1016/j.bios.2023.115233] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/23/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Artificial intelligence (AI) has received great attention since the concept was proposed, and it has developed rapidly in recent years with applications in many fields. Meanwhile, newer iterations of smartphone hardware technologies which have excellent data processing capabilities have leveraged on AI capabilities. Based on the desirability for portable detection, researchers have been investigating intelligent analysis by combining smartphones with AI algorithms. Various examples of the application of AI algorithm-based smartphone detection and analysis have been developed. In this review, we give an overview of this field, with a particular focus on bioanalytical detection applications. The applications are presented in terms of hardware design, software algorithms, and specific application areas. We also discuss the existing limitations of AI-based smartphone detection and analytical approaches, and their future prospects. The take-home message of our review is that the application of AI in the field of detection analysis is restricted by the limitations of the smartphone's hardware as well as the model building of AI for detection targets with insufficient data. Nevertheless, at this juncture, while bioanalytical diagnostics and health monitoring have set the pace for AI-based smartphone applicability, the future should see the technology making greater inroads into other fields. In relation to the latter, it is likely that the ordinary or average person will play a greater participatory role.
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Affiliation(s)
- Yizhuo Yang
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Fang Xu
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Jisen Chen
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Chunxu Tao
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Yunxin Li
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Quansheng Chen
- College of Ocean Food and Biological Engineering, Jimei University, Xiamen, 361021, Fujian Province, China
| | - Sheng Tang
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China.
| | - Hian Kee Lee
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China; Department of Chemistry, National University of Singapore, 3 Science Drive 3, Singapore, 117543, Singapore.
| | - Wei Shen
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China.
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Navarrete-Dechent C, Cordova M, Sahu A, Liopyris K, Rishpon A, Chen C, Rajadhyaksha M, Busam KJ, Marghoob AA, Chen CSJ. Optical imaging guided- 'precision' biopsy of skin tumors: a novel approach for targeted sampling and histopathologic correlation. Arch Dermatol Res 2021; 313:517-529. [PMID: 32844312 PMCID: PMC10185006 DOI: 10.1007/s00403-020-02126-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/02/2020] [Accepted: 08/08/2020] [Indexed: 01/25/2023]
Abstract
Dermoscopy and reflectance confocal microscopy (RCM) are two noninvasive, optical imaging tools used to facilitate clinical diagnosis. A biopsy technique that produces exact correlation with optical imaging features is not previously reported. To evaluate the applications of a novel feature-focused 'precision biopsy' technique that correlates clinical-dermoscopy-RCM findings with histopathology. This was a prospective case-series performed during August 2017 and June 2019 at a tertiary care cancer. We included consecutive patients requiring a precise dermoscopy-RCM-histopathologic correlation. We performed prebiopsy dermoscopy and both wide probe and handheld RCM of suspicious lesions. Features of interest were isolated with the aid of paper rings and a 2 mm punch biopsy was performed in the dermoscopy- or RCM-highlighted area. Tissue was processed either en face or with vertical sections. One-to-one correlation with histopathology was obtained. Twenty-three patients with 24 lesions were included in the study. The mean age was 64.6 years (range 22-91 years); there were 16 (69.6%) males, 14 (58.3%) lesions biopsied were on head and neck region. We achieved tissue-conservation diagnosis in 100% (24/24), 13 (54.2%) were clinically equivocal lesions, six (25%) were selected for 'feature correlation' of structures on dermoscopy or RCM, and five (20.8%) for 'correlation of new/unknown' RCM features seen on follow-up. The precision biopsy technique described herein is a novel method that facilitates direct histopathological correlation of dermoscopy and RCM features. With the aids of optical imaging devices, accurate diagnosis may be achieved by minimally invasive tissue extraction.
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Affiliation(s)
- Cristian Navarrete-Dechent
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Miguel Cordova
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Aditi Sahu
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Konstantinos Liopyris
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Ayelet Rishpon
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Curtis Chen
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ashfaq A Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Chih-Shan Jason Chen
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA.
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De Pascalis A, Perrot JL, Tognetti L, Rubegni P, Cinotti E. Review of Dermoscopy and Reflectance Confocal Microscopy Features of the Mucosal Melanoma. Diagnostics (Basel) 2021; 11:diagnostics11010091. [PMID: 33429900 PMCID: PMC7827612 DOI: 10.3390/diagnostics11010091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/22/2020] [Accepted: 01/07/2021] [Indexed: 02/03/2023] Open
Abstract
Mucosal melanoma is a rare tumor with aggressive biological behavior and poor prognosis. Diagnosis is often performed at an advanced stage when the lesions become symptomatic. Although dermoscopy and reflectance confocal microscopy (RCM) are widely used techniques for the diagnosis of cutaneous tumors, their use for mucosal lesions is not well established, probably because the latter are rarer. The objective of this study was to evaluate current literature on these imaging techniques for mucosal melanoma. We searched in PubMed and Cochrane databases all studies up to October 2020 dealing with dermoscopy, RCM, and mucosal melanoma. We found that the most relevant dermoscopic features were structureless pattern and/or the presence of multiple colors. RCM examination mainly showed numerous basal hyper-reflective dendritic cells and loss of normal architecture of the papillae of the lamina propria. Although diagnostic algorithms have been proposed for both techniques, the limit of these methods is the absence of large studies and of standardized and shared diagnostic criteria.
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Affiliation(s)
- Andrea De Pascalis
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, 53100 Siena, Italy; (L.T.); (P.R.); (E.C.)
- Correspondence: ; Tel.: +39-0577-585428; Fax: +39-0577-585484
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, 42000 Saint-Etienne, France;
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, 53100 Siena, Italy; (L.T.); (P.R.); (E.C.)
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, 53100 Siena, Italy; (L.T.); (P.R.); (E.C.)
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, 53100 Siena, Italy; (L.T.); (P.R.); (E.C.)
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Chu YS, An HG, Oh BH, Yang S. Artificial Intelligence in Cutaneous Oncology. Front Med (Lausanne) 2020; 7:318. [PMID: 32754606 PMCID: PMC7366843 DOI: 10.3389/fmed.2020.00318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/01/2020] [Indexed: 12/22/2022] Open
Abstract
Skin cancer, previously known to be a common disease in Western countries, is becoming more common in Asian countries. Skin cancer differs from other carcinomas in that it is visible to our eyes. Although skin biopsy is essential for the diagnosis of skin cancer, decisions regarding whether or not to conduct a biopsy are made by an experienced dermatologist. From this perspective, it is easy to obtain and store photos using a smartphone, and artificial intelligence technologies developed to analyze these photos can represent a useful tool to complement the dermatologist's knowledge. In addition, the universal use of dermoscopy, which allows for non-invasive inspection of the upper dermal level of skin lesions with a usual 10-fold magnification, adds to the image storage and analysis techniques, foreshadowing breakthroughs in skin cancer diagnosis. Current problems include the inaccuracy of the available technology and resulting legal liabilities. This paper presents a comprehensive review of the clinical applications of artificial intelligence and a discussion on how it can be implemented in the field of cutaneous oncology.
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Affiliation(s)
- Yu Seong Chu
- Department of Biomedical Engineering, Yonsei University, Wonju, South Korea
| | - Hong Gi An
- Department of Biomedical Engineering, Yonsei University, Wonju, South Korea
| | - Byung Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Sejung Yang
- Department of Biomedical Engineering, Yonsei University, Wonju, South Korea
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7
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Tognetti L, Cartocci A, Cinotti E, Moscarella E, Farnetani F, Lallas A, Tiodorovic D, Carrera C, Longo C, Puig S, Perrot JL, Argenziano G, Pellacani G, Cataldo G, Balistreri A, Cevenini G, Rubegni P. The impact of anatomical location and sun exposure on the dermoscopic recognition of atypical nevi and early melanomas: usefulness of an integrated clinical-dermoscopic method (iDScore). J Eur Acad Dermatol Venereol 2020; 35:650-657. [PMID: 32743829 DOI: 10.1111/jdv.16847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 07/09/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND The anatomical location of atypical melanocytic skin lesion (aMSL) was never combined into an algorithm for discriminating early melanomas (EM) from atypical nevi (AN). AIMS To investigate the impact of body location on the intuitive diagnosis performed in teledermoscopy by dermatologists of different skill levels. A further aim was to evaluate how the integration of the body location could improve an algorithm-aided diagnosis. METHODS We retrospectively collected 980 standardized dermoscopic images of aMSL cases (663 AN, 317 EM): data on the anatomical location were collected according to 15 body sites classified into 4 macro-areas of chronically/frequently/seldom/rarely exposure. Through a teledermatology web platform, 111 variously skilled dermoscopists performed either the intuitive diagnosis and 3 algorithm-assisted diagnostic tests (i.e. iDScore, 7-point checklist, ABCD rule) on each case, for a total of 3330 examinations. RESULTS In the rarely photoexposed area (side, bottom, abdomen), AN were the most tricky (i.e. highest quote of false positives), due to a frequent recognition of dermoscopic features usually considered as suggestive for melanoma in these lesions; the EM at these sites received the highest quote of false negatives, being generally interpreted as 'featureless' according to these traditional parameters, that were more frequently displayed on the chronically photoexposed area. In rarely and seldom photoexposed area, intuitive diagnosis fails to achieve adequate accuracy for all aMSLs, as the ABCD rule and the 7-point checklist; by applying the iDScore algorithm the diagnostic performance was increased by 15% in young and 17% in experts. CONCLUSIONS The body location of an aMSL can affect the quality of intuitive dermoscopic diagnosis, especially in sun-protected areas. Accuracy can be improved by using the iDScore algorithm that assigns a different partial score of each body site.
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Affiliation(s)
- L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - A Cartocci
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - E Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - F Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Tiodorovic
- Dermatology Clinic, Medical Faculty, Nis University, Nis, Serbia
| | - C Carrera
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - C Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Puig
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - J L Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Cataldo
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - A Balistreri
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - G Cevenini
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
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Chauvel-Picard J, Cinotti E, Huart E, Habougit C, Berot V, Perrot JL. [The role of ultra-high definition ultrasound in melanoma staging]. Ann Dermatol Venereol 2020; 147:900-904. [PMID: 32680710 DOI: 10.1016/j.annder.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 05/16/2020] [Accepted: 06/10/2020] [Indexed: 12/01/2022]
Affiliation(s)
- J Chauvel-Picard
- Service de chirurgie maxillo-faciale, plastique et stomatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
| | - E Cinotti
- Service de dermatologie, département des sciences médicales, chirurgicales et neurologiques, université de Sienne, hôpital S. Maria Alle-Scotte, Sienne, Italie
| | - E Huart
- Service de chirurgie viscérale et thoracique, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - C Habougit
- Service d'anatomo-pathologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - V Berot
- Service de dermatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - J-L Perrot
- Service de dermatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
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9
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Lacarrubba F, Borghi A, Verzì AE, Corazza M, Stinco G, Micali G. Dermoscopy of genital diseases: a review. J Eur Acad Dermatol Venereol 2020; 34:2198-2207. [PMID: 32531092 DOI: 10.1111/jdv.16723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/20/2020] [Indexed: 12/15/2022]
Abstract
The male and female external genital regions are anatomical areas in which various types of skin disorders may occur. Although most of these conditions can be diagnosed by means of clinical examination and an accurate medical history, in most cases further investigations with time-consuming and/or invasive procedures are needed in order to reach the correct diagnosis. Dermoscopy, as a modern non-invasive tool, is able to better diagnose pigmented and non-pigmented skin tumours along with various inflammatory and infectious skin and appendage disorders. The aim of this paper was to provide a review of the use of dermoscopy in genital disorders based on published data and to include personal experience gained from real life, focusing on any possible gender difference and whether disease mucosal/semimucosal dermoscopy features may differ from those observed on the skin. In conclusion, genital dermoscopy should always be considered during clinical inspection in order to enhance the diagnosis or to rule out those conditions that may look similar but that show a different dermoscopy pattern, thus narrowing down the differential diagnoses and avoiding unnecessary invasive investigations.
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Affiliation(s)
- F Lacarrubba
- Dermatology Clinic, University of Catania, Catania, Italy
| | - A Borghi
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - A E Verzì
- Dermatology Clinic, University of Catania, Catania, Italy
| | - M Corazza
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - G Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
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10
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Cinotti E, Bruzziches F, Habougit C, Berot V, Tognetti L, Rubegni P, Perrot JL. Fulguration-induced tattoo. Clin Exp Dermatol 2020; 45:911-912. [PMID: 32415991 DOI: 10.1111/ced.14288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 11/27/2022]
Affiliation(s)
- E Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - F Bruzziches
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - C Habougit
- Department of, Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - V Berot
- Departments of, Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - L Tognetti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - P Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - J L Perrot
- Departments of, Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
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Cinotti E, Campoli M, Grivet D, Perrot JL, Rubegni P. Noninvasive imaging for the diagnosis of melanocytic conjunctival tumor. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1762490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Elisa Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, Siena, Italy
| | - Marco Campoli
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, Siena, Italy
| | - Damien Grivet
- Department of Ophthalmology, University Hospital of Saint-Etienne, France
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, Siena, Italy
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12
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Gómez-Martín I, Collgros H, Ferguson PM, Barreiro A, Guitera P, Andrades-López E, Puig S, Pujol RM, Barranco C, Alòs L, Segura S. Diagnostic accuracy of pigmented labial macules by in vivo reflectance confocal microscopy and correlation among techniques. J Am Acad Dermatol 2020; 85:1151-1160. [PMID: 32147389 DOI: 10.1016/j.jaad.2020.02.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/28/2019] [Accepted: 02/22/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Pigmented labial macules (PLMs) are clinical, dermoscopic, and histopathologic challenges. OBJECTIVE To describe and evaluate the utility of reflectance confocal microscopy (RCM) in PLMs and to establish a correlation between dermoscopy, RCM, histopathology, and immunohistochemistry. METHODS Prospective study of PLMs from 4 tertiary referral dermatology centers. The study included 51 biopsy specimen-proven PLMs. Dermoscopic, RCM images, and histopathologic preparations were evaluated for malignant criteria. Diagnostic accuracy of RCM for melanoma diagnosis, RCM Lip Score previously reported, and κ values between techniques were calculated. RESULTS Included were 5 melanomas and 46 benign PLMs. Dermoscopically, melanomas exhibited more frequently ≥3 colors and ≥3 structures. With RCM, pagetoid spreading, epithelial disarray, continuous proliferation of atypical cells around papillae, nonhomogeneously distributed papillae, marked cellular atypia, and a higher number of dendritic cells per papillae were more frequent in melanomas. The RCM Lip Score was significantly higher in malignant lesions. Good κ values were observed in most of the evaluated features. A perfect sensitivity and specificity was obtained combining dermoscopy and RCM. LIMITATIONS A low number of melanomas were obtained. CONCLUSIONS RCM improves lip melanoma diagnosis, and the RCM Lip Score represents a useful tool for the evaluation of a PLM.
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Affiliation(s)
- Ignacio Gómez-Martín
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Departament de Medicina de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Helena Collgros
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Peter M Ferguson
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Alicia Barreiro
- Department of Dermatology, Hospital Clínic-Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Pascale Guitera
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Melanoma Institute Australia and Central Clinical School, Sydney University, New South Wales, Australia
| | | | - Susana Puig
- Department of Dermatology, Hospital Clínic-Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Departament de Medicina de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Carlos Barranco
- Department of Pathology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - Llúcia Alòs
- Department of Pathology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Sonia Segura
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Departament de Medicina de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
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14
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Waddell A, Star P, Guitera P. Advances in the use of reflectance confocal microscopy in melanoma. Melanoma Manag 2018; 5:MMT04. [PMID: 30190930 PMCID: PMC6122529 DOI: 10.2217/mmt-2018-0001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/12/2018] [Indexed: 12/15/2022] Open
Abstract
In vivo reflectance confocal microscopy (RCM) is a noninvasive high-resolution skin imaging tool that has become an important adjunct to clinical exam, dermoscopy and histopathology assessment, in the diagnosis and management of melanoma. RCM generates a horizontal view of the skin, whereby cellular and subcellular (e.g., nuclei, melanophages, collagen) structures, to the level of the upper dermis, are projected onto a screen at near-histological resolution. Morphologic descriptors, standardized terminology, and diagnostic algorithms are well established for the RCM assessment of melanoma, melanocytic, and nonmelanocytic lesions. Clinical applications of RCM in melanoma are broad and include diagnosis, assessment of large lesions on cosmetically sensitive areas, directing areas to biopsy, delineating margins prior to surgery, detecting response to treatment and assessing recurrence. This review will provide an overview of RCM technology, findings by melanoma subtype, clinical applications, as well as explore the accuracy of RCM for melanoma diagnosis, pitfalls and emerging uses of this technology ex vivo.
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Affiliation(s)
- Andréanne Waddell
- Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Department of Medicine/Division of Dermatology, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Department of Medicine/Division of Dermatology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Phoebe Star
- Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.,Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia
| | - Pascale Guitera
- Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney Medical School, Sydney, New South Wales, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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15
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Bombeccari GP, Garagiola U, Pallotti F, Rossi M, Porrini M, Giannì AB, Spadari F. Hyperpigmentation of the hard palate mucosa in a patient with chronic myeloid leukaemia taking imatinib. Maxillofac Plast Reconstr Surg 2017; 39:37. [PMID: 29230387 PMCID: PMC5714941 DOI: 10.1186/s40902-017-0136-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 12/25/2022] Open
Abstract
Background Imatinib mesylate is an inhibitor of the tyrosine kinase Bcr–Abl and a first-line treatment for Philadelphia chromosome-positive chronic myeloid leukaemia (CML). Dermatological side effects include superficial oedema, pustular eruption, lichenoid reactions, erythroderma, and skin rash. Depigmentation of the skin and/or mucosa is uncommon, and hyperpigmentation is rare. Case presentation We present the case of a 63-year-old Caucasian male with widespread hyperpigmentation of the hard palate associated with a 9-year history of imatinib therapy to treat CML. He did not complain of any symptoms. Clinical examination did not reveal any abnormal pigmentation of the skin or other region of the oral mucosa. He did not smoke cigarettes or drink alcohol. His medication regimen was a proton pump inhibitor, a beta-blocker, cardioaspirin, atorvastatin, and imatinib 400 mg/day. Histopathologically, melanin and haemosiderin deposits were evident in the lamina propria. The lesion persisted, with no clinical change, through several follow-ups. We reviewed the literature to explore the possible relationship between oral hyperpigmentation and long-term imatinib mesylate treatment. Conclusions We diagnosed oral pigmentation associated with imatinib intake based on the medical history and clinical features of the pigmented macules. Oral pigmentation may have a variety of causes, and differential diagnosis requires nodal analysis. Clinicians should be aware of possible oral mucosal hyperpigmentation in patients taking imatinib mesylate. Such pigmentation is benign and no treatment is needed, but surveillance is advisable.
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Affiliation(s)
- Gian Paolo Bombeccari
- Maxillo-Facial and Dental Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Umberto Garagiola
- Maxillo-Facial and Dental Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Francesco Pallotti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Unit of Anatomical Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy
| | - Margherita Rossi
- Maxillo-Facial and Dental Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy
| | - Massimo Porrini
- Maxillo-Facial and Dental Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy
| | - Aldo Bruno Giannì
- Maxillo-Facial and Dental Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Francesco Spadari
- Maxillo-Facial and Dental Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122 Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Uribe P, Collgros H, Scolyer RA, Menzies SW, Guitera P. In Vivo Reflectance Confocal Microscopy for the Diagnosis of Melanoma and Melanotic Macules of the Lip. JAMA Dermatol 2017; 153:882-891. [PMID: 28467525 DOI: 10.1001/jamadermatol.2017.0504] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Benign melanotic macules (MAC) are the most frequent cause of lip pigmentation and sometimes difficult to differentiate from lip melanoma (MEL). Objectives To report in vivo reflectance confocal microscopy (RCM) features of normal lips of different phototypes and to identify features that assist in distinguishing MEL from MAC using dermoscopy and RCM. Design, Setting, and Participants For this retrospective observational study, 2 groups of patients from 2 tertiary referral centers for melanoma (Sydney Melanoma Diagnostic Centre and Melanoma Institute Australia) were recruited between June 2007 and January 2015. Group 1 included patients with normal lips and different phototypes, and Group 2 consisted of patients with MAC and MEL; RCM and dermoscopy were used for lips analysis. Main Outcomes and Measures Overall, 92 RCM features were correlated with clinical history, dermoscopic images, and histopathology in all patients with MEL and 5 patients with MAC. Results Images from the vermillion and/or mucosal part of the lip were recorded from 10 patients with clinically normal lips (mean [SD] age, 34.5 [6.1] years), 16 patients with MAC (mean [SD] age, 49.6 [17.9] years), and 5 patients with 6 cases of MEL (1 patient had a recurrent lesion; mean [SD] age, 56.2 [15.5] years). In normal lips, the draped pattern-a previously described MAC RCM feature-was identified in all cases. In MEL, the following findings were frequent and significantly different from MAC: epidermal disarray; pagetoid infiltration of dendritic and/or round cells; a nonspecific architectural pattern at the dermoepidermal junction (DEJ); nonhomogenously distributed papillae; continuous (lentiginous) proliferation of cells with marked atypia at the DEJ, especially in interpapillary spaces; a higher number of dendritic cells (especially roundish); and atypical round cells at the DEJ. The cellular body area of dendritic cells was about the double in MEL compared with MAC. An RCM lip algorithm was developed that provided 100% sensitivity and 88% specificity for the diagnosis of MEL of the vermillion and mucosal part of the lip. With dermoscopy, MAC were correctly classified as benign in 13 of 16 cases (81%) and MEL were classified as equivocal or malignant in 5 of 6 cases (83%). Conclusions and Relevance Reflectance confocal microscopy can assist in the differential diagnosis of lip MEL and MAC. An RCM Lip Score that we developed based on study results is proposed and needs to be validated on an independent data set.
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Affiliation(s)
- Pablo Uribe
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Helena Collgros
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, Sydney, New South Wales, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Scott W Menzies
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Pascale Guitera
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia.,Melanoma Institute Australia, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
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17
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Vaccari S, Barisani A, Preti EP, Dika E, Fanti PA, Patrizi A, Tosti G. Dermoscopic features of pigmented vulvar intraepithelial neoplasia. Clin Exp Dermatol 2017; 43:63-65. [DOI: 10.1111/ced.13245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- S. Vaccari
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Policlinico Sant'Orsola - Malpighi Hospital; University of Bologna; via Massarenti 1 Bologna Italy
| | - A. Barisani
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Policlinico Sant'Orsola - Malpighi Hospital; University of Bologna; via Massarenti 1 Bologna Italy
| | - E. P. Preti
- Preventive Gynaecology Unit; Istituto Europeo di Oncologia; Milan Italy
| | - E. Dika
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Policlinico Sant'Orsola - Malpighi Hospital; University of Bologna; via Massarenti 1 Bologna Italy
| | - P. A. Fanti
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Policlinico Sant'Orsola - Malpighi Hospital; University of Bologna; via Massarenti 1 Bologna Italy
| | - A. Patrizi
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Policlinico Sant'Orsola - Malpighi Hospital; University of Bologna; via Massarenti 1 Bologna Italy
| | - G. Tosti
- Melanoma Division; Istituto Europeo di Oncologia; Milano Italy
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18
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Noninvasive RCM for Differentiation of Melanotic Macules From Melanocytic Lesions-Blinded Evaluation of a Series of 42 Pigmented Macules. Dermatol Surg 2017; 43:911-919. [PMID: 28430732 DOI: 10.1097/dss.0000000000001110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Differentiation of melanotic macules from melanocytic lesions, most importantly of melanoma, is a common problem on clinical-dermoscopic examination. OBJECTIVE To assess the value of noninvasive reflectance confocal microscopy (RCM) in the differential diagnosis of melanotic macules and melanocytic lesions. PATIENTS AND METHODS Reflectance confocal microscopy images of 42 pigmented macules on mucocutaneous junctions of genitalia and lips, including 31 melanotic macules, 6 nevi, and 5 melanomas, were retrospectively and independently assessed in a blinded manner by one expert observer and 2 less experienced observers together. RESULTS The authors differentiated 3 subtypes of melanotic macules; 2 subtypes ("solar lentigo type" and regular subtype of "dendritic type" melanotic macules) could be classified with confidence as benign by all RCM investigators, comprising 64% of melanotic macules. The third subtype (irregular subtype of "dendritic type" melanotic macules; 36%) displaying RCM features overlapping with melanoma was difficult to differentiate and should be biopsied not to miss a melanoma. The RCM differentiation between melanotic macules and nevi was easily performed. CONCLUSION RCM has the potential to increase the diagnostic accuracy in the noninvasive differentiation of pigmented macules on mucocutaneous junctions.
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Perrot JL, Labeille B, Richard Coulet E, Cochin S, Biron Schneider AC, Rubegni P, Cambazard F, Cinotti E. [Contribution of reflectance confocal microscopy in the diagnosis of uterine cervix melanoma: First case report]. Ann Dermatol Venereol 2017; 144:567-569. [PMID: 28668262 DOI: 10.1016/j.annder.2017.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/31/2017] [Indexed: 11/27/2022]
Affiliation(s)
- J L Perrot
- Service de dermatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - B Labeille
- Service de dermatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - E Richard Coulet
- SIPATH-anatomie et cytopathologie pathologique, 73, rue Général-Giraud, 42300 Roanne, France
| | - S Cochin
- Clinique du Renaison, 75, rue Général-Giraud, 42300 Roanne, France
| | - A-C Biron Schneider
- Service de dermatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - P Rubegni
- Service de dermatologie, hôpital universitaire S. Maria alle Scotte, 16, viale Bracci, 53100 Siena, Italie
| | - F Cambazard
- Service de dermatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - E Cinotti
- Service de dermatologie, hôpital universitaire S. Maria alle Scotte, 16, viale Bracci, 53100 Siena, Italie.
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Abstract
Melanomas are a wide range of tumors that differ in their epidemiology, morphology, genetic profile, and biological behavior. They can be grouped as superficial spreading melanoma, lentigo maligna, and nodular melanoma. Reflectance confocal microscopy is useful for the evaluation of skin lesions that are dermoscopically doubtful by increasing diagnostic accuracy and specificity. This article provides a comprehensive overview of the different confocal main morphologies of distinct melanoma types as a function of the anatomic location of the tumor.
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Affiliation(s)
- Caterina Longo
- Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Viale Risorgimento, 80, Reggio Emilia 42100, Italy.
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21
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Paolino G, Garelli V, Didona D, Cantisani C, Rossi A, Donati P, Muscardin LM. Melanosis of the lower lip subverted by filler injection: a simulator of early mucosal melanoma. Australas J Dermatol 2017; 58:71-72. [PMID: 28195323 DOI: 10.1111/ajd.12475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Dario Didona
- Prima Divisione Dermatologica, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | | | - Alfredo Rossi
- Dermatological Clinic, Sapienza University of Roma, Rome, Italy
| | - Pietro Donati
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Luca M Muscardin
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
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22
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Cinotti E, Labeille B, Cambazard F, Perrot JL. Confocal Microscopy for Special Sites and Special Uses. Dermatol Clin 2016; 34:477-485. [DOI: 10.1016/j.det.2016.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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In vivo reflectance confocal microscopy for evaluating melanoma of the lip and its differential diagnoses. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:84-94. [PMID: 27720652 DOI: 10.1016/j.oooo.2016.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/18/2016] [Accepted: 08/11/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To improve prebiopsy diagnostic accuracy and surgical management of pigmented appearing lesions on the lips, particularly melanoma, using in vivo reflectance confocal microscopy (RCM). STUDY DESIGN Prospective case series over a 12-month period between 2015 and 2016. The setting was two specialist dermatology referral centers with expertise in confocal microscopy. The study population was a consecutive sample of patients with pigmentation of the lip for which the cause was uncertain clinically, whose differential diagnosis included melanoma, and who had undergone both in vivo RCM and subsequent biopsy. The outcome measures were RCM features, dermoscopy features, and histopathological diagnosis. Results were reported by descriptive analysis and correlations made between RCM features and histopathology. RESULTS Eight patients were recruited for the study. In vivo RCM facilitated the targeting of small biopsies to identify two in situ oral melanoma recurrences and successfully mapped an in situ oral melanoma before wide excision. Suprabasal dendritic pagetoid cells and epidermal disarray on RCM were useful indicators for in situ melanoma of the lip. Previously described dermoscopy features for mucosal melanoma were not very helpful in diagnosing melanoma in our series. Challenges included evaluating inflamed lesions with pigment incontinence. CONCLUSIONS RCM can assist in the diagnosis and management of pigmented lip lesions, but additional studies are required to further evaluate these initial observations.
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