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Farabi B, Rao BK, Jain M. Identifying Pitfalls for Diagnosing Pigmented Bowen Disease on Reflectance Confocal Microscopy: Misleading Dendritic Cells. Dermatol Pract Concept 2023; 13:dpc.1301a30. [PMID: 36892388 PMCID: PMC9946061 DOI: 10.5826/dpc.1301a30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Banu Farabi
- Department of Dermatology, New York Medical College, Valhalla, New York, NY, USA
- Department of Dermatology, NYC Health + Hospitals/Metropolitan, New York, NY, USA
- Department of Dermatology, NYC Health + Hospitals/Coney Island, Brooklyn, NY, USA
| | - Babar K. Rao
- Department of Dermatology, Weil Cornell Medical School, NY, USA
| | - Manu Jain
- Department of Dermatology, Weil Cornell Medical School, NY, USA
- Dermatology Department, Memorial Sloan Kettering Cancer Center, NY, USA
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Lacarrubba F, Verzì AE, Caltabiano R, Micali G. Bowen's disease of the penile shaft presenting as a pigmented macule: dermoscopy, reflectance confocal microscopy and histopathological correlation. An Bras Dermatol 2021; 96:609-612. [PMID: 34284940 PMCID: PMC8441428 DOI: 10.1016/j.abd.2020.10.009] [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: 07/14/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 11/01/2022] Open
Abstract
The penile localization of pigmented Bowen's disease has been rarely reported and has been mostly related to human papillomavirus infection. Early diagnosis and treatment are important to prevent progression to invasive squamous cell carcinoma. However, diagnosis can be challenging because it may be difficult to distinguish from melanoma, even using dermoscopy. Reflectance confocal microscopy may be useful in suggesting the bedside diagnosis before the histopathological confirmation. A case of penile pigmented Bowen's disease is described along with its dermoscopy and reflectance confocal microscopy findings and their correlation with histopathology.
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Mazzilli S, Gamo-Villegas R, Pampin-Franco A, Lopez Estebaran JL, Pinedo F, Vollono L, Di Prete M, Campione E, Gonzalez S. Reflectance Confocal Microscopy of Pigmented Bowen's Disease: A Case Series of Difficult to Diagnose Lesions. Case Rep Dermatol 2020; 12:98-106. [PMID: 32518541 PMCID: PMC7265740 DOI: 10.1159/000507916] [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: 02/13/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022] Open
Abstract
Pigmented Bowen's disease is a rare variant of in situ squamous skin cell carcinoma. It mainly affects patients between 60 and 70 years of age. Its clinical features include well-demarcated, pigmented plaque arising in photo-exposed areas of the body. The best-characterized feature of the disease by histological examination is the presence of atypical keratinocytes, hyperpigmentation of the epidermis with trans-epidermal elimination of melanin and dermal melanophages. Precise diagnosis is often difficult, both clinically and dermoscopically, as Bowen's disease is often mistaken with keratinocyte tumors such as solar lentigines, seborrheic keratosis, Bowenoid papulosis, pigmented basal cell carcinoma, pigmented actinic keratosis; or even melanocytic lesions such as melanocytic nevus, pigmented epithelioid melanocytoma, and melanoma. Precise diagnosis often requires biopsy and histopathological examination of the tissue. Reflectance confocal microscopy is a noninvasive technique to diagnose pigmented skin lesions. To date, not much data are available regarding its use in the diagnosis of pigmented Bowen's disease. Herein, we report a well-represented case series of pigmented Bowen's disease imaged using dermoscopy and reflectance confocal microscopy.
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Affiliation(s)
- Sara Mazzilli
- Department of Dermatology, Tor Vergata Hospital, Rome, Italy
| | | | | | | | - Fernando Pinedo
- Department of Pathology, Fundation Alcorcon Hospital, Madrid, Spain
| | - Laura Vollono
- Department of Dermatology, Tor Vergata Hospital, Rome, Italy
| | - Monia Di Prete
- Department of Pathology, University of Rome Tor Vergata, Rome, Italy
| | - Elena Campione
- Department of Dermatology, Tor Vergata Hospital, Rome, Italy
| | - Salvador Gonzalez
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
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Rueter L, Ramadori P, Ulrich M, Jung S, Kardorff B, Lademann J. Reflectance confocal microscopy for noninvasive examination of nonmelanocytic tumors and virus-associated skin lesions in organ transplant recipients. Skin Res Technol 2019; 26:376-389. [PMID: 31802548 DOI: 10.1111/srt.12813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/20/2019] [Accepted: 11/09/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Drug-induced immunosuppression is necessary to prevent rejection of the foreign organ in transplanted patients, but neoplastic and virus-associated skin diseases are frequent complications. Reflectance confocal microscopy (RCM) recently emerged as a promising tool for the early diagnosis of skin lesions. MATERIALS AND METHODS A total of 61 skin lesions, among them 20 basal cell carcinomas, six Bowen's diseases, 23 actinic keratoses, and 12 verrucae, were analyzed. All lesions were clinically evaluated followed by RCM evaluation by two independent dermatologists and histological examination. RESULTS For the diagnosis of basal cell carcinoma, a sensitivity of 100% by both investigators (INV I + II) and a specificity of 100% by INV I and 80% by INV II were achieved. The sensitivity average rate for RCM features reached by both investigators ranged between 60% and 100%, and the specificity between 55% and 90%. For the diagnosis of actinic keratosis, a concordant sensitivity of 94.4% and a specificity of 80% (INV I) and 60% (INV II) were detected. The sensitivity average rate of specific RCM criteria ranged between 72.3% and 97.2%, whereas specificity ranged between 20% and 90%. Regarding verrucae, RCM confirmed the histological diagnosis with a sensitivity of 85.7% (INV I) and 100% (INV II), while specificity was 100% and 80%, respectively. CONCLUSION Reflectance confocal microscopy resulted to be a reliable tool for the noninvasive diagnosis of neoplastic and virus-associated skin changes in organ transplant recipients. Nevertheless, given the frequency and diagnostic complexity of the hyperkeratotic lesions occurring post-transplantation, larger cohorts of patients are required to confirm and consolidate these findings.
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Affiliation(s)
- Lena Rueter
- Department of Dermatology, Venerology and Allergology, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Pierluigi Ramadori
- Division of Chronic Inflammation and Cancer, German Cancer Research Center, Heidelberg, Germany
| | | | - Sora Jung
- Department of Dermatology, Venerology and Allergology, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Kardorff
- Gemeinschaftspraxis für Dermatologie, Allergologie, Phlebologie und Umweltmedizin Mönchengladbach, Mönchengladbach, Germany
| | - Juergen Lademann
- Department of Dermatology, Venerology and Allergology, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
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Ianoși SL, Batani A, Ilie MA, Tampa M, Georgescu SR, Zurac S, Boda D, Ianosi NG, Neagoe D, Calina D, Tutunaru C, Constantin C. Non-invasive imaging techniques for the in vivo diagnosis of Bowen's disease: Three case reports. Oncol Lett 2019; 17:4094-4101. [PMID: 30944602 PMCID: PMC6444281 DOI: 10.3892/ol.2019.10079] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/18/2018] [Indexed: 12/27/2022] Open
Abstract
Bowen's disease (BD) is a relatively frequent non-melanoma skin cancer occurring mostly in elderly people. Until now, the usual way to establish the diagnosis is histopathological examination of a skin biopsy. Dermoscopy and reflectance confocal microscopy (RCM) are modern alternative methods that can be used as quick and non-invasive diagnostic techniques and as follow-up instruments in cases in which a conservative treatment is chosen for the management of BD. There are no very specific dermoscopic criteria for the diagnosis of this disease, but some dermoscopic features (scaly surface, vascular structures and pigmentation) can be found more frequent and can be helpful for the diagnosis. RCM of BD shows an acanthotic epidermis with two types of targetoid cells: the first, a large cell with bright center and dark peripheral halo, the second, a cell with dark center and a bright rim surrounded by a dark hallo, related with dyskeratotic cells on histological examination. BD management could be improved by using non-invasive, in vivo imaging techniques that allow a fast and easy diagnosis and can be used as follow-up tools. However, larger studies are necessary for the validation of our observations.
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Affiliation(s)
- Simona Laura Ianoși
- Department of Dermatology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital, 200349 Craiova, Romania
| | - Alexandra Batani
- Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Mihaela Adriana Ilie
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Biochemistry, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mircea Tampa
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Simona-Roxana Georgescu
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Sabina Zurac
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Pathology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | | | - Daniela Neagoe
- Department of Internal Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Daniela Calina
- Department of Pharmacology, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Cristina Tutunaru
- Department of Dermatology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital, 200349 Craiova, Romania
| | - Caruntu Constantin
- Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.,Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Reflectance Confocal Microscopy Criteria of Pigmented Squamous Cell Carcinoma In Situ. Am J Dermatopathol 2018; 40:173-179. [DOI: 10.1097/dad.0000000000000938] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Karaarslan I, Tepret S, Yildiz S, Yaman B, Ozdemir F. The role of reflectance confocal microscopy in a case of Bowen's disease difficult to diagnose. Dermatol Pract Concept 2018; 8:63-65. [PMID: 29445580 PMCID: PMC5808377 DOI: 10.5826/dpc.0801a15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/20/2017] [Indexed: 11/24/2022] Open
Abstract
There have been limited reports describing reflectance confocal microscopy (RCM) features of Bowen’s disease (BD). Herein, we describe the RCM features of a pigmented BD with atypical dermoscopic features, mimicking a melanoma. This case highlights the importance of RCM in a challenging BD.
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Affiliation(s)
- Isil Karaarslan
- Department of Dermatology, Faculty of Medicine, University of Ege, Izmir, Turkey
| | - Sibel Tepret
- Department of Dermatology, Faculty of Medicine, University of Ege, Izmir, Turkey.,Department of Pathology, Faculty of Medicine, University of Ege, Izmir, Turkey
| | - Seda Yildiz
- Department of Dermatology, Faculty of Medicine, University of Ege, Izmir, Turkey
| | - Banu Yaman
- Department of Pathology, Faculty of Medicine, University of Ege, Izmir, Turkey
| | - Fezal Ozdemir
- Department of Dermatology, Faculty of Medicine, University of Ege, Izmir, Turkey
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