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Álvarez-Salafranca M, Zaballos P. [Translated article] Dermoscopy of Squamous Cell Carcinoma: From Actinic Keratosis to Invasive Forms. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00650-1. [PMID: 39102978 DOI: 10.1016/j.ad.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 08/07/2024] Open
Abstract
When the dermoscopy of squamous cell carcinoma and its precursors we differentiate among keratin-related, vascular, and pigment-related criteria. Non-pigmented actinic keratoses are characterized by the "strawberry pattern". Pigmented actinic keratosis shows a significant dermatoscopic overlap with lentigo maligna, but the presence of pigmented scales, erythema, and prominent follicles favors its diagnosis. Bowen's disease is characterized by clustered glomerular vessels, white-yellowish scales, and brown or grey dots arranged in lines in its pigmented variant. Finally, dermoscopy allows us to detect invasive squamous cell carcinoma in its early stages and differentiate it from its precursors. Furthermore, its presentation may vary depending on the degree of differentiation, with keratin-associated criteria predominating in well-differentiated tumors, while an atypical vascular pattern will predominate in poorly differentiated tumors.
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Affiliation(s)
- M Álvarez-Salafranca
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - P Zaballos
- Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla, Tarragona, Spain
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2
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Liu H, Jiang H, Shan Q. Reflectance confocal microscopy versus dermoscopy for the diagnosis of cutaneous melanoma: a head-to-head comparative meta-analysis. Melanoma Res 2024; 34:355-365. [PMID: 38847651 DOI: 10.1097/cmr.0000000000000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
This meta-analysis aimed to evaluate the comparative diagnostic performance of reflectance confocal microscopy (RCM) and dermoscopy in detecting cutaneous melanoma patients. An extensive search was conducted in the PubMed and Embase databases to identify available publications up to December 2023. Studies were included if they evaluated the diagnostic performance of RCM and dermoscopy in patients with cutaneous melanoma. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Performance Studies (QUADAS-2) tool. A total of 14 articles involving 2013 patients were included in the meta-analysis. The overall sensitivity of RCM was 0.94 [95% confidence interval (CI), 0.87-0.98], while the overall sensitivity of dermoscopy was 0.84 (95% CI, 0.71-0.95). These results suggested that RCM has a similar level of sensitivity compared with dermoscopy ( P = 0.15). In contrast, the overall specificity of RCM was 0.76 (95% CI, 0.67-0.85), while the overall specificity of dermoscopy was 0.47 (95% CI, 0.31-0.63). The results indicated that RCM appears to have a higher specificity in comparison to dermoscopy ( P < 0.01). Our meta-analysis indicates that RCM demonstrates superior specificity and similar sensitivity to dermoscopy in detecting cutaneous melanoma patients. The high heterogeneity, however, may impact the evidence of the current study, further larger sample prospective research is required to confirm these findings.
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Affiliation(s)
- Huasheng Liu
- Departments of Burn Plastic and Cosmetic Surgery
| | - Hong Jiang
- Departments of Burn Plastic and Cosmetic Surgery
| | - Qianqian Shan
- Gynecology and Obstetric, Liaocheng People's Hospital, Liaocheng, China
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3
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Wang Y, Li J, Wang S. Clinical analysis of lupus miliaris disseminatus faciei: a cross-sectional study and literature review. Front Med (Lausanne) 2024; 11:1382526. [PMID: 38947242 PMCID: PMC11212452 DOI: 10.3389/fmed.2024.1382526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/09/2024] [Indexed: 07/02/2024] Open
Abstract
Background The clinical similarity of lupus miliaris disseminatus faciei (LMDF) and other papular granulomatous facial disorders often makes its correct diagnosis challenging. Diagnosis often requires the assistance of pathological examination, and dermoscopy can be used as an auxiliary and non-invasive examination method, however, the current findings remain incomplete. Objectives This study aimed to summarize the clinical, histopathological and dermoscopic features of LMDF in the Chinese Han population and aiming to provide practical significance to correct diagnosis. Methods 109 patients of LMDF were collected in the Department of Dermatology, the Second Affiliated Hospital of Xi'an Jiaotong University from August 2015 to August 2023. The clinical and histopathological manifestations of all patients, as well as the dermoscopic image features of 44 cases, including background, follicular findings, vessels, and other structures, were summarized and evaluated. Results The most significant histopathological features of LMDF in 109 cases is epithelioid granulomatous infiltrate in the superficial dermis, with or without caseation. The most significant dermoscopic features of LMDF in all 44 cases were orange structureless background (30/44), follicular plug (32/44), follicular white scar-like area (32/44), unspecific linear vessels (24/44), linear vessels with branch (24/44) and white streaks (18/44). Conclusion Histopathologically, LMDF is characterized by the presence of epithelioid granulomatous infiltrate in the superficial dermis, with or without caseation. Dermoscopically, it exhibits a distinctive orange structureless background, follicular plug, follicular white scar-like area, nonspecific linear vessels, linear vessels with branches, and white streaks.
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Affiliation(s)
| | | | - Shuang Wang
- Department of Dermatology, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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4
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Andersson E, Hult J, Troein C, Stridh M, Sjögren B, Pekar-Lukacs A, Hernandez-Palacios J, Edén P, Persson B, Olariu V, Malmsjö M, Merdasa A. Facilitating clinically relevant skin tumor diagnostics with spectroscopy-driven machine learning. iScience 2024; 27:109653. [PMID: 38680659 PMCID: PMC11053315 DOI: 10.1016/j.isci.2024.109653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 05/01/2024] Open
Abstract
In the dawning era of artificial intelligence (AI), health care stands to undergo a significant transformation with the increasing digitalization of patient data. Digital imaging, in particular, will serve as an important platform for AI to aid decision making and diagnostics. A growing number of studies demonstrate the potential of automatic pre-surgical skin tumor delineation, which could have tremendous impact on clinical practice. However, current methods rely on having ground truth images in which tumor borders are already identified, which is not clinically possible. We report a novel approach where hyperspectral images provide spectra from small regions representing healthy tissue and tumor, which are used to generate prediction maps using artificial neural networks (ANNs), after which a segmentation algorithm automatically identifies the tumor borders. This circumvents the need for ground truth images, since an ANN model is trained with data from each individual patient, representing a more clinically relevant approach.
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Affiliation(s)
- Emil Andersson
- Centre for Environmental and Climate Science, Lund University, Lund, Sweden
| | - Jenny Hult
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Carl Troein
- Centre for Environmental and Climate Science, Lund University, Lund, Sweden
| | - Magne Stridh
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Benjamin Sjögren
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | | | | | - Patrik Edén
- Centre for Environmental and Climate Science, Lund University, Lund, Sweden
| | - Bertil Persson
- Department of Dermatology, Skåne University Hospital, Lund, Sweden
| | - Victor Olariu
- Centre for Environmental and Climate Science, Lund University, Lund, Sweden
| | - Malin Malmsjö
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
| | - Aboma Merdasa
- Department of Clinical Sciences Lund, Ophthalmology, Lund University, Lund, Sweden
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5
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Spadafora M, Megna A, Lippolis N, Cavicchi M, Borsari S, Piana S, Guida S, Kaleci S, Chester J, Pellacani G, Longo C. Dermoscopy and reflectance confocal microscopy of solitary flat pink lesions: A new combined score to diagnose amelanotic melanoma. J Eur Acad Dermatol Venereol 2024. [PMID: 38572809 DOI: 10.1111/jdv.19991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Differential diagnosis of amelanotic/hypomelanotic melanoma among solitary flat pink lesions is challenging, due to limited clinical and dermoscopic clues. Dermoscopy and reflectance confocal microscopy assessments improve diagnostic accuracy, but their combined capacity among solitary flat pink lesions is yet to be defined. OBJECTIVES To determine (i) whether diagnostic accuracy is improved with combined dermoscopy and reflectance confocal microscopy, (ii) a model to estimate probability of flat amelanotic/hypomelanotic melanoma among solitary flat pink lesions. METHODS A retrospective single-centre study of solitary flat pink lesions, excised for suspected malignancy between 2011 and 2022 was performed. Images were independently evaluated by two dermatologists, blinded to histopathological diagnosis. Diagnostic performance was evaluated on the receiver operating characteristic curve and the area under the curve. Predictive features were identified by univariate and multivariate logistic regression analyses. A final predictive nomogram of independent risk factors was calculated by backward likelihood ratio. Hypothesis being tested was formulated before data collection. RESULTS A total of 184 patients (87 females, 47.3%) were included; mean age was 57.6 years (19-95). Combined dermoscopy and reflectance confocal microscopy was more sensitive (83%, CI 69.2-92.4 and 91.5%, CI 79.6-97.6) than dermoscopy alone (76.6%, CI 62.0-87.7 and 85.1%, CI 71.7-93.8). Predictive features defined the new model, including linear irregular vessels (4.26-folds, CI 1.5-12.1), peripheral pigment network (6.07-folds, CI 1.83-20.15), remnants of pigmentation (4.3-folds, CI 1.27-14.55) at dermoscopy and atypical honeycomb (9.98-folds, CI 1.91-51.96), disarranged epidermal pattern (15.22-folds, CI 2.18-106.23), dendritic pagetoid cells in the epidermis (3.77-folds, CI 1.25-11.26), hypopigmented pagetoid cells (27.05-folds, CI 1.57-465.5), and dense and sparse nests (3.68-folds, CI 1.24-10.96) in reflectance confocal microscopy. Diagnostic accuracy of the model was high (AUC 0.91). CONCLUSIONS Adjunctive reflectance confocal microscopy increases diagnostic sensitivity of flat amelanotic/hypomelanotic melanoma differential diagnosis. The proposed model requires validation.
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Affiliation(s)
- M Spadafora
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - A Megna
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - N Lippolis
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - M Cavicchi
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Borsari
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Piana
- Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Guida
- School of Medicine, Vita-Salute San Raffaele Scientific Institute, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Kaleci
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - J Chester
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Pellacani
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Dermatology Clinic, Sapienza University of Rome, Rome, Italy
| | - C Longo
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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6
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Álvarez-Salafranca M, Zaballos P. Dermoscopy of Squamous Cell Carcinoma: From Actinic Keratosis to Invasive Forms. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00270-9. [PMID: 38556203 DOI: 10.1016/j.ad.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024] Open
Affiliation(s)
- M Álvarez-Salafranca
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - P Zaballos
- Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla, Tarragona, España
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Soare C, Cozma EC, Celarel AM, Rosca AM, Lupu M, Voiculescu VM. Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care. Cancers (Basel) 2024; 16:484. [PMID: 38339236 PMCID: PMC10854727 DOI: 10.3390/cancers16030484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
Non-melanocytic skin cancers represent an important public health problem due to the increasing incidence and the important local destructive potential. Thus, the early diagnosis and treatment of precancerous lesions (actinic keratoses) is a priority for the dermatologist. In recent years, non-invasive skin imaging methods have seen an important development, moving from simple observational methods used in clinical research, to true diagnostic and treatment methods that make the dermatologist's life easier. Given the frequency of these precancerous lesions, their location on photo-exposed areas, as well as the long treatment periods, with variable, imprecise end-points, the need to use non-invasive imaging devices is increasingly evident to complete the clinical observations in the diagnosis and treatment of these lesions, with the aim of increasing accuracy and decreasing the adverse effects due to long treatment duration. This is the first review that brings together all skin imaging methods (dermoscopy, reflectance confocal microscopy, ultrasonography, dermoscopy-guided high frequency ultrasonography, and optical coherence tomography) used in the evaluation of actinic keratoses and their response to different treatment regimens.
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Affiliation(s)
- Cristina Soare
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
| | - Elena Codruta Cozma
- Department of Pathophysiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
| | - Ana Maria Celarel
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
| | - Ana Maria Rosca
- Department of Dermatology, University Military Hospital “Dr. Carol Davila”, 010825 Bucharest, Romania;
| | - Mihai Lupu
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
| | - Vlad Mihai Voiculescu
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
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8
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Azimi A, Fernandez-Peñas P. Molecular Classifiers in Skin Cancers: Challenges and Promises. Cancers (Basel) 2023; 15:4463. [PMID: 37760432 PMCID: PMC10526380 DOI: 10.3390/cancers15184463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Skin cancers are common and heterogenous malignancies affecting up to two in three Australians before age 70. Despite recent developments in diagnosis and therapeutic strategies, the mortality rate and costs associated with managing patients with skin cancers remain high. The lack of well-defined clinical and histopathological features makes their diagnosis and classification difficult in some cases and the prognostication difficult in most skin cancers. Recent advancements in large-scale "omics" studies, including genomics, transcriptomics, proteomics, metabolomics and imaging-omics, have provided invaluable information about the molecular and visual landscape of skin cancers. On many occasions, it has refined tumor classification and has improved prognostication and therapeutic stratification, leading to improved patient outcomes. Therefore, this paper reviews the recent advancements in omics approaches and appraises their limitations and potential for better classification and stratification of skin cancers.
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Affiliation(s)
- Ali Azimi
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Department of Dermatology, Westmead Hospital, Westmead, NSW 2145, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW 2145, Australia
| | - Pablo Fernandez-Peñas
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Department of Dermatology, Westmead Hospital, Westmead, NSW 2145, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW 2145, Australia
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9
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Barthelmann S, Butsch F, Lang BM, Stege H, Großmann B, Schepler H, Grabbe S. Seborrheic keratosis. J Dtsch Dermatol Ges 2023; 21:265-277. [PMID: 36892019 DOI: 10.1111/ddg.14984] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/04/2022] [Indexed: 03/10/2023]
Abstract
Seborrheic keratosis (SK) is the most common benign epidermal tumor in clinical dermatological practice. This review summarizes current knowledge about the clinical and histological appearance, epidemiology, pathogenesis, and treatment of SK. There are different subtypes of SK based on clinical presentation and histologic findings. Several factors, including age, genetic predisposition, and possibly also exposure to ultraviolet radiation, are thought to contribute to the development of SK. The lesions can occur on all areas of the body except for the palms and soles, but the most common sites are the face and upper trunk. The diagnosis is usually made clinically, and in some cases by dermatoscopy or histology. Many patients prefer to have the lesions removed for cosmetic reasons although there is no medical indication. Treatment options include surgical therapy, laser therapy, electrocautery, cryotherapy, and topical drug therapy, which is currently in development. Treatment should be individualized depending on the clinical picture and patient preference.
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Affiliation(s)
| | | | | | | | | | - Hadrian Schepler
- Skin clinic, Mainz University Hospital
- MVZ Dermatology Clinic, Koblenz
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10
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Barthelmann S, Butsch F, Lang BM, Stege H, Großmann B, Schepler H, Grabbe S. Seborrhoische Keratosen. J Dtsch Dermatol Ges 2023; 21:265-278. [PMID: 36929560 DOI: 10.1111/ddg.14984_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/04/2022] [Indexed: 03/18/2023]
Affiliation(s)
| | | | | | - Henner Stege
- Hautklinik und Poliklinik, Universitätsmedizin Mainz
| | | | - Hadrian Schepler
- Hautklinik und Poliklinik, Universitätsmedizin Mainz
- MVZ Fokus Haut, Emil-Schüller-Str., Koblenz
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11
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AI-Powered Diagnosis of Skin Cancer: A Contemporary Review, Open Challenges and Future Research Directions. Cancers (Basel) 2023; 15:cancers15041183. [PMID: 36831525 PMCID: PMC9953963 DOI: 10.3390/cancers15041183] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Skin cancer continues to remain one of the major healthcare issues across the globe. If diagnosed early, skin cancer can be treated successfully. While early diagnosis is paramount for an effective cure for cancer, the current process requires the involvement of skin cancer specialists, which makes it an expensive procedure and not easily available and affordable in developing countries. This dearth of skin cancer specialists has given rise to the need to develop automated diagnosis systems. In this context, Artificial Intelligence (AI)-based methods have been proposed. These systems can assist in the early detection of skin cancer and can consequently lower its morbidity, and, in turn, alleviate the mortality rate associated with it. Machine learning and deep learning are branches of AI that deal with statistical modeling and inference, which progressively learn from data fed into them to predict desired objectives and characteristics. This survey focuses on Machine Learning and Deep Learning techniques deployed in the field of skin cancer diagnosis, while maintaining a balance between both techniques. A comparison is made to widely used datasets and prevalent review papers, discussing automated skin cancer diagnosis. The study also discusses the insights and lessons yielded by the prior works. The survey culminates with future direction and scope, which will subsequently help in addressing the challenges faced within automated skin cancer diagnosis.
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12
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Infrared Macrothermoscopy Patterns-A New Category of Dermoscopy. J Imaging 2023; 9:jimaging9020036. [PMID: 36826955 PMCID: PMC9960988 DOI: 10.3390/jimaging9020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/13/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
(1) Background: The authors developed a new non-invasive dermatological infrared macroimaging analysis technique (MacroIR) that evaluates microvascular, inflammatory, and metabolic changes that may be dermoscopy complimentary, by analyzing different skin and mucosal lesions in a combined way-naked eye, polarized light dermatoscopy (PLD), and MacroIR-and comparing results; (2) Methods: ten cases were evaluated using a smartphone coupled with a dermatoscope and a macro lens integrated far-infrared transducer into specific software to capture and organize high-resolution images in different electromagnetic spectra, and then analyzed by a dermatologist; (3) Results: It was possible to identify and compare structures found in two dermoscopic forms. Visual anatomical changes were correlated with MacroIR and aided skin surface dermatological analysis, presenting studied area microvascular, inflammatory, and metabolic data. All MacroIR images correlated with PLD, naked eye examination, and histopathological findings; (4) Conclusion: MacroIR and clinic dermatologist concordance rates were comparable for all dermatological conditions in this study. MacroIR imaging is a promising method that can improve dermatological diseases diagnosis. The observations are preliminary and require further evaluation in larger studies.
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13
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Ning X, Wang H, Zheng Z, Wang Y, Cui Y. Sebaceoma on the nose mimicking basal cell carcinoma: Pitfalls of dermoscopy and reflectance confocal microscopy. Skin Res Technol 2022; 28:886-888. [PMID: 36325590 PMCID: PMC9907611 DOI: 10.1111/srt.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
Sebaceoma is a rare benign sebaceous tumor that usually occurs on the face and scalp. We report a case of a 3-mm solitary pink papule on the nose in an elderly woman. Dermoscopic examination showed yellow-pinkish background with a central yellow homogeneous structure, peripheral branching vessels (crown vessels), and scattered gray or reddish-brown irregular areas. Reflectance confocal microscopy (RCM) revealed tumor islands with massive dendritic cells and scattered bright fine granules in the dermis, a suspicious palisading arrangement at the periphery, and there seemed to be peritumoral dark spaces. The combined dermoscopic and RCM examination were highly suspicious for the diagnosis of basal cell carcinoma (BCC), so the lesion was excised completely, but was eventually diagnosed as sebaceoma by histopathology. This case suggests that there are some overlaps in both dermoscopic and RCM features between sebaceoma and BCC. The application of dermoscopy and RCM to the diagnosis of sebaceoma is challenging, further studies are needed in this field.
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Affiliation(s)
- Xiaoli Ning
- Peking University China‐Japan Friendship School of Clinical Medicine Beijing China
- Department of Dermatology China‐Japan Friendship Hospital Beijing China
| | - Huijing Wang
- Department of Dermatology China‐Japan Friendship Hospital Beijing China
- Graduate School Beijing University of Chinese Medicine Beijing China
| | - Zhancai Zheng
- Department of Dermatology China‐Japan Friendship Hospital Beijing China
| | - Ying Wang
- Department of Dermatology China‐Japan Friendship Hospital Beijing China
| | - Yong Cui
- Peking University China‐Japan Friendship School of Clinical Medicine Beijing China
- Department of Dermatology China‐Japan Friendship Hospital Beijing China
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14
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Fedorov Kukk A, Wu D, Gaffal E, Panzer R, Emmert S, Roth B. Multimodal system for optical biopsy of melanoma with integrated ultrasound, optical coherence tomography and Raman spectroscopy. JOURNAL OF BIOPHOTONICS 2022; 15:e202200129. [PMID: 35802400 DOI: 10.1002/jbio.202200129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
We introduce a new single-head multimodal optical system that integrates optical coherence tomography (OCT), 18 MHz ultrasound (US) tomography and Raman spectroscopy (RS), allowing for fast (<2 min) and noninvasive skin cancer diagnostics and lesion depth measurement. The OCT can deliver structural and depth information of smaller skin lesions (<1 mm), while the US allows to measure the penetration depth of thicker lesions (≥4 mm), and the RS analyzes the chemical composition from a small chosen spot (≤300 μm) that can be used to distinguish between benign and malignant melanoma. The RS and OCT utilize the same scanning and optical setup, allowing for co-localized measurements. The US on the other side is integrated with an acoustical reflector, which enables B-mode measurements on the same position as OCT and RS. The US B-mode scans can be translated across the sample by laterally moving the US transducer, which is made possible by the developed adapter with a flexible membrane. We present the results on custom-made liquid and agar phantoms that show the resolution and depth capabilities of the setup, as well as preliminary ex vivo measurements on mouse models with ∼4.3 mm thick melanoma.
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Affiliation(s)
- Anatoly Fedorov Kukk
- Hannover Centre for Optical Technologies, Leibniz University of Hannover, Hannover, Germany
| | - Di Wu
- Hannover Centre for Optical Technologies, Leibniz University of Hannover, Hannover, Germany
| | | | | | | | - Bernhard Roth
- Hannover Centre for Optical Technologies, Leibniz University of Hannover, Hannover, Germany
- Cluster of Excellence PhoenixD (Photonics, Optics and Engineering - Innovation Across Disciplines), Hannover, Germany
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15
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Dascalu A, Walker BN, Oron Y, David EO. Non-melanoma skin cancer diagnosis: a comparison between dermoscopic and smartphone images by unified visual and sonification deep learning algorithms. J Cancer Res Clin Oncol 2022; 148:2497-2505. [PMID: 34546412 PMCID: PMC8453469 DOI: 10.1007/s00432-021-03809-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Non-melanoma skin cancer (NMSC) is the most frequent keratinocyte-origin skin tumor. It is confirmed that dermoscopy of NMSC confers a diagnostic advantage as compared to visual face-to-face assessment. COVID-19 restrictions diagnostics by telemedicine photos, which are analogous to visual inspection, displaced part of in-person visits. This study evaluated by a dual convolutional neural network (CNN) performance metrics in dermoscopic (DI) versus smartphone-captured images (SI) and tested if artificial intelligence narrows the proclaimed gap in diagnostic accuracy. METHODS A CNN that receives a raw image and predicts malignancy, overlaid by a second independent CNN which processes a sonification (image-to-sound mapping) of the original image, were combined into a unified malignancy classifier. All images were histopathology-verified in a comparison between NMSC and benign skin lesions excised as suspected NMSCs. Study criteria outcomes were sensitivity and specificity for the unified output. RESULTS Images acquired by DI (n = 132 NMSC, n = 33 benign) were compared to SI (n = 170 NMSC, n = 28 benign). DI and SI analysis metrics resulted in an area under the curve (AUC) of the receiver operator characteristic curve of 0.911 and 0.821, respectively. Accuracy was increased by DI (0.88; CI 81.9-92.4) as compared to SI (0.75; CI 68.1-80.6, p < 0.005). Sensitivity of DI was higher than SI (95.3%, CI 90.4-98.3 vs 75.3%, CI 68.1-81.6, p < 0.001), but not specificity (p = NS). CONCLUSION Telemedicine use of smartphone images might result in a substantial decrease in diagnostic performance as compared to dermoscopy, which needs to be considered by both healthcare providers and patients.
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Affiliation(s)
- A Dascalu
- Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, 6 Matmon Cohen Street, 6209406, Tel Aviv, Israel.
| | - B N Walker
- Sonification Lab, School of Psychology and School of Interactive Computing, Georgia Institute of Technology, Atlanta, Georgia, United States
| | - Y Oron
- Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, 6 Matmon Cohen Street, 6209406, Tel Aviv, Israel
| | - E O David
- Department of Computer Science, Bar-Ilan University, Ramat-Gan, Israel
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16
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Amram D, Cignoni A, Banfi T, Ciuti G. From P4 medicine to P5 medicine: transitional times for a more human-centric approach to AI-based tools for hospitals of tomorrow. OPEN RESEARCH EUROPE 2022; 2:33. [PMID: 37645333 PMCID: PMC10445924 DOI: 10.12688/openreseurope.14524.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 08/31/2023]
Abstract
Within the debate on shaping future clinical services, where different robotics and artificial intelligence (AI) based technologies are integrated to perform tasks, the authors take the chance to provide an interdisciplinary analysis required to validate a tool aiming at supporting the melanoma cancer diagnosis. In particular, they focus on the ethical-legal and technical requirements needed to address the Assessment List on Trustworthy AI (ALTAI), highlighting some pros and cons of the adopted self-assessment checklist. The dialogue stimulates additionally remarks on the EU regulatory initiatives on AI in the healthcare systems.
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Affiliation(s)
- Denise Amram
- LIDER LAB - DIRPOLIS Institute EMbeDS Department of Excellence, Scuola Superiore Sant'Anna di Studi Universitari e di Perfezionamento, Pisa, Pisa, 56100, Italy
| | - Arianna Cignoni
- The BioRobotics Institute Department of Excellence in Robotics & AI,, Scuola Superiore Sant'Anna di Studi Universitari e di Perfezionamento, Pisa, Pisa, 56100, Italy
| | - Tommaso Banfi
- The BioRobotics Institute Department of Excellence in Robotics & AI,, Scuola Superiore Sant'Anna di Studi Universitari e di Perfezionamento, Pisa, Pisa, 56100, Italy
| | - Gastone Ciuti
- The BioRobotics Institute Department of Excellence in Robotics & AI,, Scuola Superiore Sant'Anna di Studi Universitari e di Perfezionamento, Pisa, Pisa, 56100, Italy
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17
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Spyridonos P, Gaitanis G, Likas A, Bassukas I. Characterizing Malignant Melanoma Clinically Resembling Seborrheic Keratosis Using Deep Knowledge Transfer. Cancers (Basel) 2021; 13:cancers13246300. [PMID: 34944920 PMCID: PMC8699430 DOI: 10.3390/cancers13246300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Malignant melanomas (MMs) with aypical clinical presentation constitute a diagnostic pitfall, and false negatives carry the risk of a diagnostic delay and improper disease management. Among the most common, challenging presentation forms of MMs are those that clinically resemble seborrheic keratosis (SK). On the other hand, SK may mimic melanoma, producing ‘false positive overdiagnosis’ and leading to needless excisions. The evolving efficiency of deep learning algorithms in image recognition and the availability of large image databases have accelerated the development of advanced computer-aided systems for melanoma detection. In the present study, we used image data from the International Skin Image Collaboration archive to explore the capacity of deep knowledge transfer in the challenging diagnostic task of the atypical skin tumors of MM and SK. Abstract Malignant melanomas resembling seborrheic keratosis (SK-like MMs) are atypical, challenging to diagnose melanoma cases that carry the risk of delayed diagnosis and inadequate treatment. On the other hand, SK may mimic melanoma, producing a ‘false positive’ with unnecessary lesion excisions. The present study proposes a computer-based approach using dermoscopy images for the characterization of SΚ-like MMs. Dermoscopic images were retrieved from the International Skin Imaging Collaboration archive. Exploiting image embeddings from pretrained convolutional network VGG16, we trained a support vector machine (SVM) classification model on a data set of 667 images. SVM optimal hyperparameter selection was carried out using the Bayesian optimization method. The classifier was tested on an independent data set of 311 images with atypical appearance: MMs had an absence of pigmented network and had an existence of milia-like cysts. SK lacked milia-like cysts and had a pigmented network. Atypical MMs were characterized with a sensitivity and specificity of 78.6% and 84.5%, respectively. The advent of deep learning in image recognition has attracted the interest of computer science towards improved skin lesion diagnosis. Open-source, public access archives of skin images empower further the implementation and validation of computer-based systems that might contribute significantly to complex clinical diagnostic problems such as the characterization of SK-like MMs.
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Affiliation(s)
- Panagiota Spyridonos
- Department of Medical Physics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
- Correspondence: (P.S.); (I.B.)
| | - George Gaitanis
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | - Aristidis Likas
- Department of Computer Science & Engineering, School of Engineering, University of Ioannina, 45110 Ioannina, Greece;
| | - Ioannis Bassukas
- Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
- Correspondence: (P.S.); (I.B.)
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18
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Xiang K, Peng L, Yang H, Li M, Cao Z, Jiang S, Qu G. A novel weight pruning strategy for light weight neural networks with application to the diagnosis of skin disease. Appl Soft Comput 2021. [DOI: 10.1016/j.asoc.2021.107707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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19
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Janowska A, Oranges T, Iannone M, Romanelli M, Dini V. Seborrheic keratosis-like melanoma: a diagnostic challenge. Melanoma Res 2021; 31:407-412. [PMID: 34132226 DOI: 10.1097/cmr.0000000000000756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This article summarizes the main epidemiologic and diagnostic features of seborrheic keratosis-like (SK-like) melanoma. We performed a review of the current literature. The real and current incidence and prevalence of SK-like melanoma are unknown. Many lesions are misdiagnosed and not excised with histopathologic confirmation, or excised without an appropriate surgical approach due to a benign clinical and dermoscopic appearance. SK-like melanoma presents both melanoma and SK features. SK-like melanoma and SK are often clinically indistinguishable even for experienced dermatologists. Clinically, it develops as a black-dark brown or light slightly elevated, papule, nodule or plaque with rapid growth and a regular or irregular shape. SK-like melanoma presents melanocytic and nonmelanocytic dermoscopic features. Irregular dark-brown dots/globules, a blue-grayish veil, streaks, irregular pigmentation or network and brown lines point to a melanoma diagnosis. Among the nonmelanocytic features, milia-like cysts and comedo-like openings have been highlighted. The association of polarized and nonpolarized dermoscopic techniques is more accurate for studying the dermoscopic features of SK-like melanoma. If the dermoscopic features are unclear, further investigations with reflectance confocal microscopy (RCM) or biopsy with histologic examination are essential. SK-like melanoma is a dermatologic challenge. Careful clinical and dermoscopic evaluation favor a correct diagnosis. In unclear cases, it is important to perform a biopsy with histologic examination to confirm the correct diagnosis.
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Affiliation(s)
| | - Teresa Oranges
- Department of Dermatology, University of Pisa, Pisa
- Department of Pediatrics, Dermatology Unit, Meyer Children's University Hospital, Florence, Italy
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20
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Massone C, Hofman-Wellenhof R, Chiodi S, Sola S. Dermoscopic Criteria, Histopathological Correlates and Genetic Findings of Thin Melanoma on Non-Volar Skin. Genes (Basel) 2021; 12:1288. [PMID: 34440462 PMCID: PMC8391530 DOI: 10.3390/genes12081288] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022] Open
Abstract
Dermoscopy is a non-invasive, in vivo technique that allows the visualization of subsurface skin structures in the epidermis, at the dermoepidermal junction, and in the upper dermis. Dermoscopy brought a new dimension in evaluating melanocytic skin neoplasms (MSN) also representing a link between clinical and pathologic examination of any MSN. However, histopathology remains the gold standard in diagnosing MSN. Dermoscopic-pathologic correlation enhances the level of quality of MSN diagnosis and increases the level of confidence of pathologists. Melanoma is one of the most genetically predisposed among all cancers in humans. The genetic landscape of melanoma has been described in the last years but is still a field in continuous evolution. Melanoma genetic markers play a role not only in melanoma susceptibility, initiation, and progression but also in prognosis and therapeutic decisions. Several studies described the dermoscopic specific criteria and predictors for melanoma and their histopathologic correlates, but only a few studies investigated the correlation among dermoscopy, pathology, and genetic of MSN. The aim of this work is to review the published data about dermoscopic features of melanoma, their histopathological correlates with regards also to genetic alterations. Particularly, this review will focus on low-CSD (cumulative sun damage) melanoma or superficial spreading melanoma, high-CSD melanoma, and nevus-associated melanoma.
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Affiliation(s)
| | | | | | - Simona Sola
- Surgical Pathology, Galliera Hospital, 16128 Genoa, Italy;
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21
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Krueger L, Saizan A, Stein JA, Elbuluk N. Dermoscopy of acquired pigmentary disorders: a comprehensive review. Int J Dermatol 2021; 61:7-19. [PMID: 34235719 DOI: 10.1111/ijd.15741] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/20/2021] [Accepted: 05/28/2021] [Indexed: 12/17/2022]
Abstract
Dermoscopy has traditionally been used for the diagnosis of neoplasms and more recently in the evaluation of inflammatory conditions. Recent observational studies have suggested a role for dermoscopy in identifying and differentiating acquired pigmentary disorders. This comprehensive review will summarize the growing literature on the use of dermoscopy for pigmentary disorders. A literature review was performed on PubMed dating from inception to October 2020. The following pigmentary disorders were included in this study: melasma, solar lentigines, poikiloderma of Civatte, exogenous ochronosis, lichen planus pigmentosus, erythromelanosis follicularis faciei et colli, pigmented contact dermatitis, Riehl's melanosis, postinflammatory hyperpigmentation, erythema dyschromicum perstans, ashy dermatosis, confluent and reticulated papillomatosis, acanthosis nigricans, pityriasis versicolor, tinea versicolor, idiopathic guttate hypomelanosis, and vitiligo. Search terms used included each pigmentary disorder along with the terms "dermoscopy" or "dermatoscopy." Relevant case reports and case series were included. Many pigmentary disorders have unique and distinguishable features on dermoscopy. Given that these disorders can be clinically challenging for clinicians and emotionally distressing for patients, dermoscopy provides an additional, useful tool in the evaluation and assessment process.
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Affiliation(s)
- Loren Krueger
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Autumn Saizan
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.,Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Jennifer A Stein
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Nada Elbuluk
- Keck School of Medicine of University of Southern California, Los Angeles, California, USA
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22
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LALLAS A, PASCHOU E, MANOLI SM, PAPAGEORGIOU C, SPYRIDIS I, LIOPYRIS K, BOBOS M, MOUTSOUDIS A, LAZARIDOU E, APALLA Z. Dermatoscopy of melanoma according to type, anatomic site and stage. Ital J Dermatol Venerol 2021; 156:274-288. [DOI: 10.23736/s2784-8671.20.06784-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Michalak-Stoma A, Małkińska K, Krasowska D. Usefulness of Dermoscopy to Provide Accurate Assessment of Skin Cancers. Clin Cosmet Investig Dermatol 2021; 14:733-746. [PMID: 34234499 PMCID: PMC8254521 DOI: 10.2147/ccid.s305924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/13/2021] [Indexed: 11/23/2022]
Abstract
Seborrheic keratosis (SK) is the most common benign tumour of epidermal origin. In most cases, it is simple to recognize in the clinical examination. However, sometimes SK can be a problematic lesion. We present the cases of two patients with seborrheic keratosis in whom we diagnosed the skin cancer through dermoscopic and histopathological examinations. The article aims to draw attention to the need for dermoscopic examinations to be included for an accurate assessment of the nevi not only by dermatologists but also not-specialized doctors. We would like to underline that many skin cancers share the similar features of malignancy, and competence and capability to interpret the dermoscopic pictures correctly are important for early recognition of malignant lesion. Very often malignant skin cancers can be hidden among benign lesions like seborrheic keratosis or they can be imitators of benign lesions. Amongst all cases of imposing SK, basal cell carcinoma, squamous cell carcinoma, melanoma is the most important differential diagnosis, of which their dermoscopic features will be discussed in this article.
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Affiliation(s)
- Anna Michalak-Stoma
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, 20-080, Poland
| | - Katarzyna Małkińska
- Department of Dermatology, Venereology and Paediatric Dermatology, Samodzielny Publiczny Szpital Kliniczny No 1, Lublin, 20-080, Poland
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, 20-080, Poland
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24
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Moscarella E, Brancaccio G, Briatico G, Ronchi A, Piana S, Argenziano G. Differential Diagnosis and Management on Seborrheic Keratosis in Elderly Patients. Clin Cosmet Investig Dermatol 2021; 14:395-406. [PMID: 33953590 PMCID: PMC8088980 DOI: 10.2147/ccid.s267246] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/15/2021] [Indexed: 11/23/2022]
Abstract
Seborrheic keratoses are exceedingly common in the elderly and usually are easy to diagnose and do not require treatment. However, given their great variety of clinical presentation, they may give rise to false-positive cases, meaning that they may at times mimic melanoma, squamous cell carcinoma and basal cell carcinoma. On the other hand, melanoma may mimic seborrheic keratosis, leading to incorrect patient management. With this review, we would like to summarize the current knowledge about epidemiology, clinical, dermoscopic and reflectance confocal microscopy imaging of this common entity, and we also summarize the currently available treatment options.
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Affiliation(s)
| | | | | | - Andrea Ronchi
- Pathology Unit, University of Campania, Naples, Italy
| | - Simonetta Piana
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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25
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Blundo A, Cignoni A, Banfi T, Ciuti G. Comparative Analysis of Diagnostic Techniques for Melanoma Detection: A Systematic Review of Diagnostic Test Accuracy Studies and Meta-Analysis. Front Med (Lausanne) 2021; 8:637069. [PMID: 33968951 PMCID: PMC8103840 DOI: 10.3389/fmed.2021.637069] [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: 12/02/2020] [Accepted: 03/17/2021] [Indexed: 11/24/2022] Open
Abstract
Melanoma has the highest mortality rate among skin cancers, and early-diagnosis is essential to maximize survival rate. The current procedure for melanoma diagnosis is based on dermoscopy, i.e., a qualitative visual inspection of lesions with intrinsic limited diagnostic reliability and reproducibility. Other non-invasive diagnostic techniques may represent valuable solutions to retrieve additional objective information of a lesion. This review aims to compare the diagnostic performance of non-invasive techniques, alternative to dermoscopy, for melanoma detection in clinical settings. A systematic review of the available literature was performed using PubMed, Scopus and Google scholar databases (2010-September 2020). All human, in-vivo, non-invasive studies using techniques, alternative to dermoscopy, for melanoma diagnosis were included with no restriction on the recruited population. The reference standard was histology but dermoscopy was accepted only in case of benign lesions. Attributes of the analyzed studies were compared, and the quality was evaluated using CASP Checklist. For studies in which the investigated technique was implemented as a diagnostic tool (DTA studies), the QUADAS-2 tool was applied. For DTA studies that implemented a melanoma vs. other skin lesions classification task, a meta-analysis was performed reporting the SROC curves. Sixty-two references were included in the review, of which thirty-eight were analyzed using QUADAS-2. Study designs were: clinical trials (13), retrospective studies (10), prospective studies (8), pilot studies (10), multitiered study (1); the remain studies were proof of concept or had undefined study type. Studies were divided in categories based on the physical principle employed by each diagnostic technique. Twenty-nine out of thirty-eight DTA studies were included in the meta-analysis. Heterogeneity of studies' types, testing strategy, and diagnostic task limited the systematic comparison of the techniques. Based on the SROC curves, spectroscopy achieved the best performance in terms of sensitivity (93%, 95% CI 92.8-93.2%) and specificity (85.2%, 95%CI 84.9-85.5%), even though there was high concern regarding robustness of metrics. Reflectance-confocal-microscopy, instead, demonstrated higher robustness and a good diagnostic performance (sensitivity 88.2%, 80.3-93.1%; specificity 65.2%, 55-74.2%). Best practice recommendations were proposed to reduce bias in future DTA studies. Particular attention should be dedicated to widen the use of alternative techniques to conventional dermoscopy.
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Affiliation(s)
- Alessia Blundo
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Arianna Cignoni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Tommaso Banfi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Gastone Ciuti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
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26
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Sonthalia S, Agrawal M, Bhatia J, Zeeshan M, Elsamanoudy S, Tiwary P, Bhat YJ, Jha A, Bosseila M. Entodermoscopy Update: A Contemporary Review on Dermoscopy of Cutaneous Infections and Infestations. Indian Dermatol Online J 2021; 12:220-236. [PMID: 33959518 PMCID: PMC8088165 DOI: 10.4103/idoj.idoj_559_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/16/2020] [Accepted: 12/20/2020] [Indexed: 01/11/2023] Open
Abstract
Infectious cutaneous diseases are very common, especially in certain geographic and tropical regions. Sometimes they may simulate other dermatoses, ordering verification of diagnosis with particular investigations. Dermoscopy is among one of the most important tools readily available in the outpatient setting for the dermatologist to confirm the diagnosis. In this up-to date review, literature concerning the various dermoscopic features of parasitic, viral, dermatophytic and bacterial cutaneous infections is composed. In addition artefacts as well as practical issues in dermoscopy usage are discussed; with the aim to empower dermatologists to promptly and non-invasively diagnose and manage cutaneous infections and infestations.
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Affiliation(s)
| | - Mahima Agrawal
- Department of Dermatology and STD, Lady Hardinge Medical College and ASS Hospitals, New Delhi, India
| | | | - Md Zeeshan
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Solwan Elsamanoudy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Pankaj Tiwary
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Yasmeen Jabeen Bhat
- Department of Dermatology, Venereology & Leprosy, Government Medical College, Srinagar, J&K, India
| | - Abhijeet Jha
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Manal Bosseila
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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27
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Roh D, Ha DL, Kim Y, Shin K, Kim HS, Ko HC, Kim BS, Kim MB. Comparison of Dermoscopic Features Between Melanoacanthomas and Melanoacanthoma-Like Malignant Melanomas in Korean Patients. J Cutan Med Surg 2020; 25:243-248. [PMID: 33242988 DOI: 10.1177/1203475420977470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A melanoacanthoma (MA) is a pigmented variant of seborrheic keratosis. Owing to the pigmentation, MAs may mimic the clinical appearance of malignant melanomas (MMs). However, the dermoscopic patterns of MAs and MA-like MMs have rarely been compared. OBJECTIVE To elucidate the clinical and dermoscopic differences between MAs and MA-like MMs. METHODS This study included 77 MA and 33 MA-like MM patients. We retrospectively reviewed the medical records, clinical findings, and dermoscopic findings of the two groups. RESULTS Crypts and comedo-like openings (71.4%) in MAs and the blue-white veil (60.6%) in MMs were the most common dermoscopic findings. Crypts, comedo-like opening, milia-like cysts, fissures, and hairpin vessels appeared more frequently in MAs (P < .05). However, atypical pigment networks, blue-white veils, pseudopods and streaks, and atypical vessels were more common in MMs (P < .05). MAs often showed melanoma-specific dermoscopic findings, especially blue-white veils (22.1%). Furthermore, fissures (42.4%), crypts (21.2%), and comedo-like openings (15.2%) were observed in MMs, although they are typically benign patterns. CONCLUSION Differences in dermoscopic patterns might provide important clues for the differential diagnosis of MA-like lesions. However, MAs such as MMs and true-benign MAs may overlap clinically in appearance and on dermoscopy. Several benign patterns were frequently observed in MMs (fissures, globular pattern, crypts, comedo-like openings, cerebriform appearance, and milia-like cysts), and several malignant patterns were observed in MAs (blue-white veil, pseudopod, and atypical pigment network). Importantly, if any of the melanoma-associated features or atypical vessels are present, the lesion should be biopsied to establish a diagnosis.
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Affiliation(s)
- Dongyoung Roh
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,34996 Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dae-Lyong Ha
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yeona Kim
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Kihyuk Shin
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hoon-Soo Kim
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hyun-Chang Ko
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,34996 Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Byung-Soo Kim
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- 220312 Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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28
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Manoli SM, Moutsoudis A, Papageorgiou C, Lallas K, Rigas HM, Kyrmanidou E, Papadimitriou I, Paschou E, Spyridis I, Gkentsidi T, Sotiriou E, Vakirlis E, Ioannidis D, Apalla Z, Lallas A. Real-life data on basal cell carcinoma treatment: Insights on clinicians' therapeutic choices from an institutional hospital registry. Dermatol Ther 2020; 33:e14414. [PMID: 33064345 DOI: 10.1111/dth.14414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer in white skin individuals. The treatment of choice is surgical excision, but several other therapeutic choices are available and might also be efficient and cost-effective in selected cases of low-risk BCC or when surgery is complicate or contraindicated. The aim of the current study was to analyze the applied treatments for BCC in the real-life practice of a tertiary hospital, and investigate factors associated to the tumor and the patients that might influence the treatment selection of clinicians. Data on all BCCs treated from 1st January 2018 to 31st December 2019 were extracted. A total of 751 BCCs from 585 patients were included. The baseline characteristics of patients and tumors, the type of applied treatment and the histopathologic report when available were analyzed. Most tumors were located on the head/neck (64.2%). The most frequently applied treatment was surgical excision (580/751, 77.2%). In 22.8% of tumors a nonsurgical treatment was selected. The most frequently selected alternative treatments were, imiquimod, cryosurgery, their combination (immunocryosurgery), and vismodegib. A pretreatment diagnosis of superficial BCC was associated with a 12-fold increased probability of selecting a nonsurgical treatment except of vismodegib. Every added year of age increased the probability of selecting a nonsurgical treatment by 3-fold. Every added mm of diameter increased the possibility of vismodegib use by 4%. Surgery is the most frequently applied BCC treatment, but nonsurgical modalities do also have an essential role in real settings.
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Affiliation(s)
| | - Andreas Moutsoudis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | | | - Eirini Kyrmanidou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Eleni Paschou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Ioannis Spyridis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Elena Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | - Zoe Apalla
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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29
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Ye C, Yi J, Lai W, Zheng Y. Skin barrier damaging and repairing process: A new application field of dermoscopy. J Cosmet Dermatol 2020; 20:897-905. [PMID: 32892490 DOI: 10.1111/jocd.13643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although more and more noninvasive detection technologies have been used in assessing skin barrier integrity and functions, more accurate, intuitive, and convenient detective methods still needed to be explored and developed. AIMS To investigate the characteristic image changes under the dermoscopy and to explore the relationship with skin physiological indexes in skin barrier damaging and repairing process. PATIENTS/METHODS 25 healthy subjects with normal skin in forearm were included and divided into different groups according to the operated strips numbers (30, 35, and 40 times). Before tape stripping, and immediately, 3, 7, 14, and 21 days after tape stripping, dermoscopic examination and skin transepidermal water loss (TEWL), surface hydration, and L*a*b* value were simultaneously tested in the same region. RESULTS Immediately after different times tape stripping, the amount of cuticle cells residues and the microvascular images were different. In skin barrier repairing process, the scab forming time observed under dermoscopy was day 14, day 7, and day 3 on 30 times, 35 times, and 40 times stripped skin, respectively. A small amount of cuticle cells and blurry vessels could be identified in hydration value <40 group, while there was no cuticle cell residue, and the branching vessels were obvious in hydration value >40 group. CONCLUSIONS Unique manifestations could be observed under dermoscopy in different time points of skin barrier with various degree of injury and in skin barrier repairing process. By combining dermoscopy and skin indexes assessing technologies, the skin barrier integrity and function could be observed and evaluated more accurately and precisely.
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Affiliation(s)
- CongXiu Ye
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - JinLing Yi
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei Lai
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yue Zheng
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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30
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Attia ABE, Bi R, Dev K, Du Y, Olivo M. Clinical noninvasive imaging and spectroscopic tools for dermatological applications: Review of recent progress. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.202000010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Amalina Binte Ebrahim Attia
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
| | - Renzhe Bi
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
| | - Kapil Dev
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
| | | | - Malini Olivo
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
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31
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Grajdeanu IA, Vata D, Statescu L, Adriana Popescu I, Porumb-Andrese E, Ionela Patrascu A, Stincanu A, Taranu T, Crisan M, Gheuca Solovastru L. Use of imaging techniques for melanocytic naevi and basal cell carcinoma in integrative analysis (Review). Exp Ther Med 2020; 20:78-86. [PMID: 32508998 PMCID: PMC7271701 DOI: 10.3892/etm.2020.8620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 02/27/2020] [Indexed: 12/31/2022] Open
Abstract
Early detection of skin cancer is essential in order to obtain an improved prognosis. Clinicians need more objective and non-invasive examination methods to support their decision whether to biopsy or not tumoral lesions. These may include several imaging techniques such as dermoscopy, videodermoscopy, also known as sequential digital dermoscopy (SDD), computer-aided diagnosis (CAD), total body photography, imaging and high-frequency ultrasonography (HFUS), reflectance confocal microscopy, multiphoton tomography, electrical impedance spectroscopy, Raman spectroscopy, stepwise two-photon-laser spectroscopy and quantitative dynamic infrared. This review summarizes the current developments in the field of melanocytic lesions, such as naevi and basal cell carcinoma (BCC) imaging techniques. The aim was to collect and analyze data concerning types, indications, advantages and disadvantages of modern imaging techniques for in vivo skin tumor diagnosis. Two main methods were focused on, namely videodermoscopy and HFUS, which can be included in daily dermatologists' practice. In skin tumors HFUS allows the assessment of tumoral lesions with depth smaller than 1.5 cm, being described a correlation between ultrasonographic depth and the histologic index.
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Affiliation(s)
- Ioana-Alina Grajdeanu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania
| | - Dan Vata
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Laura Statescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Adriana Popescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Elena Porumb-Andrese
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Ionela Patrascu
- Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Alina Stincanu
- Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Tatiana Taranu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Dental Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, CF Iasi Hospital, 700506 Iasi, Romania
| | - Maria Crisan
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Laura Gheuca Solovastru
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
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32
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Conforti C, Giuffrida R, Vezzoni R, Resende FSS, di Meo N, Zalaudek I. Dermoscopy and the experienced clinicians. Int J Dermatol 2020; 59:16-22. [PMID: 31222814 DOI: 10.1111/ijd.14512] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/27/2019] [Accepted: 05/13/2019] [Indexed: 01/24/2023]
Abstract
For several decades, melanoma diagnosis was based on symptoms rather than clinical features. In fact, until the 1970s melanoma was widely not recognized and only diagnosed when presenting as a large, ulcerated, and bleeding nodule. Today it is well known that ulceration and bleeding are symptoms of an advanced stage; thus, it comes not as a surprise that the prognosis of melanoma at that time was very poor. This paper was developed to recognize dermoscopy as an integrative part of the clinical examination, bearing in mind that naked eye diagnosis can change after dermoscopy outcomes, and to help clinicians avoid the concept: "If in doubt, cut it out".
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Affiliation(s)
- Claudio Conforti
- Dermatology Clinic, Ospedale Maggiore, University of Trieste, Trieste, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Roberta Vezzoni
- Dermatology Clinic, Ospedale Maggiore, University of Trieste, Trieste, Italy
| | | | - Nicola di Meo
- Dermatology Clinic, Ospedale Maggiore, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Ospedale Maggiore, University of Trieste, Trieste, Italy
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33
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Mancera N, Smalley KSM, Margo CE. Melanoma of the eyelid and periocular skin: Histopathologic classification and molecular pathology. Surv Ophthalmol 2019; 64:272-288. [PMID: 30578807 DOI: 10.1016/j.survophthal.2018.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 12/29/2022]
Abstract
Cutaneous melanoma, a potentially lethal malignancy of the periocular skin, represents only a small proportion of the roughly 87,000 new cases of cutaneous melanoma diagnosed annually in the United States. Most of our understanding of melanoma of the eyelid skin is extrapolated from studies of cutaneous melanoma located elsewhere. Recent years have witnessed major breakthroughs in molecular biology and genomics of cutaneous melanoma, some of which have led to the development of targeted therapies. The molecular insights have also kindled interest in rethinking how cutaneous melanomas are classified and assessed for risk. We provide a synopsis of the epidemiology, histopathologic classification, and clinical experience of eyelid melanoma since 1990 and then review major advances in the molecular biology of cutaneous melanoma, exploring how this impacts our understanding of classification and predicting risk.
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Affiliation(s)
- Norberto Mancera
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
| | - Keiran S M Smalley
- Departments of Tumor Biology, The Moffitt Cancer Center & Research Institute, Tampa, Florida, USA; Cutaneous Oncology The Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Curtis E Margo
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA; Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
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34
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Okabe T, Fujimura T, Okajima J, Kambayashi Y, Aiba S, Maruyama S. First-in-human clinical study of novel technique to diagnose malignant melanoma via thermal conductivity measurements. Sci Rep 2019; 9:3853. [PMID: 30846837 PMCID: PMC6405870 DOI: 10.1038/s41598-019-40444-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/14/2019] [Indexed: 11/21/2022] Open
Abstract
Melanoma is an aggressive skin cancer that originates from melanocytes and, especially in the case of early-stage melanoma, is distributed adjacent to the epidermis and superficial dermis. Although early-stage melanoma can be distinguished from benign nevus via a dermoscopy, it is difficult to distinguish invasive melanoma in its early stages from in situ melanoma. Because invasive melanoma must undergo a sentinel lymph node biopsy to be diagnosed, a non-invasive method to detect the micro-invasion of early-stage melanoma is needed for dermato-oncologists. This paper proposes a novel quantitative melanoma identification method based on accurate measurements of thermal conductivity using a pen-shaped device. This method requires skin temperature data for one minute to determine the effective thermal conductivity of the skin, allowing it to distinguish melanoma lesions from healthy skin. Results suggest that effective thermal conductivity was negative for in situ melanoma. However, in accordance with tumour progression, effective thermal conductivity was larger in invasive melanoma. The proposed thermal conductivity measurement is a novel tool that detects the micro-invasion of melanoma.
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Affiliation(s)
- Takahiro Okabe
- Graduate School of Science and Technology, Hirosaki University, Hirosaki, Japan.
| | - Taku Fujimura
- Graduate School of Medicine, Tohoku University, Sendai, Japan.
| | | | - Yumi Kambayashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Setsuya Aiba
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shigenao Maruyama
- National Institute of Technology, Hachinohe College, Hachinohe, Japan
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35
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Mir-Bonafé JF, Rozas-Muñoz E, Dalmau J, Mir-Bonafé M, Iznardo H, García-Melendo C, Puig L. Iceberg sign as a dermoscopic clue of actinic keratosis neglecta. J Eur Acad Dermatol Venereol 2019; 33:e254-e256. [PMID: 30742717 DOI: 10.1111/jdv.15484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J F Mir-Bonafé
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - E Rozas-Muñoz
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - J Dalmau
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - M Mir-Bonafé
- Dermatology Department, Hospital Universitario Central de Asturias, Av. Roma, s/n, 33011, Oviedo, Spain
| | - H Iznardo
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - C García-Melendo
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - L Puig
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
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36
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Zaballos P, del Pozo L, Argenziano G, Medina C, Lacarrubba F, Ferrer B, Martin J, Llambrich A, Zalaudek I, Bañuls J. Dermoscopy of cutaneous smooth muscle neoplasms: a morphological study of 136 cases. J Eur Acad Dermatol Venereol 2019; 33:693-699. [DOI: 10.1111/jdv.15392] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/12/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P. Zaballos
- Dermatology Department Hospital Sant Pau i Santa Tecla Tarragona Spain
| | - L.J. del Pozo
- Dermatology Department Hospital Universitari Son Espases Palma Mallorca Spain
| | - G. Argenziano
- Dermatology Department Second University of Naples Naples Italy
| | - C. Medina
- Dermatology Department Hospital Universitario de Gran Canaria “Doctor Negrín” Gran Canaria Spain
| | - F. Lacarrubba
- Dermatology Department University of Catania Catania Italy
| | - B. Ferrer
- Dermatology Department Hospital General Universitario de Valencia Valencia Spain
| | - J.M. Martin
- Dermatology Department Hospital Clínico Universitario Valencia Spain
| | - A. Llambrich
- Dermatology Department Hospital de Son Llatzer Palma de Mallorca Spain
| | - I. Zalaudek
- Dermatology Department University of Trieste Trieste Italy
| | - J. Bañuls
- Dermatology Department Hospital Universitario de Alicante ISABIAL Miguel Hernandez University Sant Joan de Alicante Spain
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37
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Pileri A, Agostinelli C, Sabattini E, Tabanelli M, Gaspari V, Leuzzi M, Patrizi A, Savoia F. Primary cutaneous small/medium-sized pleomorphic T-cell lymphoproliferative disorder shows a common vascular pattern at dermoscopy. J Eur Acad Dermatol Venereol 2018; 32:e318-e321. [DOI: 10.1111/jdv.14872] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Pileri
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
- Dermatology Section; Department of Surgery and Translational Medicine; University of Florence; Viale Michelangielo 41 Florence Italy
| | - C. Agostinelli
- Hematopathology Unit; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; via Massarenti 9 Bologna Italy
| | - E. Sabattini
- Hematopathology Unit; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; via Massarenti 9 Bologna Italy
| | - M. Tabanelli
- Dermatology Unit; AUSL della Romagna; Viale Randi 5 Ravenna Italy
| | - V. Gaspari
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
| | - M. Leuzzi
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
| | - A. Patrizi
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
| | - F. Savoia
- Dermatology Unit; Department of Experimental, Diagnostic and Specialty Medicine; Università degli Studi di Bologna Azienda Ospedaliera Sant'Orsola-Malpighi; University of Bologna; via Massarenti 1 40138 Bologna Italy
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