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Cinotti E, Bertello M, Dragotto M, Cartocci A, Tognetti L, Cappilli S, Peris K, Perrot JL, Del Marmol V, Rubegni P, Suppa M. Comparison of reflectance confocal microscopy and line-field optical coherence tomography for the identification of basal cell carcinoma. J Eur Acad Dermatol Venereol 2023; 37:e1147-e1150. [PMID: 37165928 DOI: 10.1111/jdv.19155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/24/2023] [Indexed: 05/12/2023]
Affiliation(s)
- E Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
- Société Française de Dermatologie, Groupe d'Imagerie Non Invasive de la Société Française de Dermatologie, Paris, France
| | - M Bertello
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - M Dragotto
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - A Cartocci
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - S Cappilli
- Dermatology Unit, Department of Medical and Surgical Sciences, A. Gemelli University Hospital Foundation - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - K Peris
- Dermatology Unit, Department of Medical and Surgical Sciences, A. Gemelli University Hospital Foundation - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - J L Perrot
- Société Française de Dermatologie, Groupe d'Imagerie Non Invasive de la Société Française de Dermatologie, Paris, France
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - M Suppa
- Société Française de Dermatologie, Groupe d'Imagerie Non Invasive de la Société Française de Dermatologie, Paris, France
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Marconi D, Botarelli L, Gennari M, Cartocci A, Vigiani N, Nante N, Messina G. Flu and Covid-19: is there adherence to vaccination in target groups? Eur J Public Health 2022. [PMCID: PMC9593456 DOI: 10.1093/eurpub/ckac130.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background In Italy, the flu vaccine is recommended and free for target groups (adults≥60 years old, fragile people, healthcare workers, pregnant women). During the 2020/2021 flu season, an increased vaccination coverage (+6,9%) was observed compared to the previous season, also due to the Covid-19 pandemic. We aimed to investigate how strong the adherence to the flu vaccine was by the vulnerable groups and assess if the Covid-19 vaccination campaign may have influenced the rate of flu vaccines. Methods At the beginning of autumn 2021 we conducted an online survey among the population of Tuscany. We collected data on demographics, health status (pregnancy, vulnerable), flu and COVID-19 vaccinations coverage and health information sources. In addition, we performed a descriptive and a risk factors analysis to assess correlation between our variables with R v 4.0.0. Significance level was set at p < 0.05. Results Among 408 participants, 248 (61%) belong to a vulnerable group and are recommended to receive the flu vaccine, 229 (56%) usually get the flu vaccine, 386 (95%) got the Covid-19 vaccine, 267 (65%) choose and trust the general practitioner (GP) as their health information source. There is a statistically significant association between being part of a vulnerable group and getting the seasonal flu vaccine (OR 6.63 95% CI 4.26-10.3 p < 0.001). In addition, getting the Covid-19 vaccine increases the likelihood of receiving the flu vaccine (2.90 95% CI 1.16-7.28 p = 0.018). Moreover, participants who trust their GP as their health information source (OR 1.63 CI 1.08-2.46 p = 0.019) are more likely to receive the flu vaccine; other information sources (TV, newspaper, social media) are not associated with the flu vaccine. Conclusions Our research shows that vulnerable groups get vaccinated against the flu. The increase in flu vaccine coverage may be due to the COVID-19 vaccines campaign. GPs play a crucial role in the health promotion, prevention and health literacy of patients. Key messages
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Affiliation(s)
- D Marconi
- Post Graduate School of Public Health, University of Siena , Siena, Italy
| | - L Botarelli
- Post Graduate School of Public Health, University of Siena , Siena, Italy
| | - M Gennari
- Post Graduate School of Public Health, University of Siena , Siena, Italy
| | - A Cartocci
- Department of Medical Biotechnology, University of Siena , Siena, Italy
| | - N Vigiani
- UOC Food and Nutrition Hygiene-East Area, Azienda USL Toscana Sud-Est , Arezzo, Italy
| | - N Nante
- Post Graduate School of Public Health, University of Siena , Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena , Siena, Italy
| | - G Messina
- Post Graduate School of Public Health, University of Siena , Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena , Siena, Italy
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3
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Cartocci A, Lucarelli V, Messina G, Nante N, Cevenini G, Barbini P. A time-varying SIRD model for dynamic vaccination strategies against COVID-19. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The COVID-19 pandemic has demonstrated how the optimal allocation of the limited doses of vaccine available represents one of the main useful measures to mitigate the transmission of the infection and reduce the mortality associated with it, especially at an early stage of the pandemic. The use of a compartmental model allows us to understand which population groups to vaccinate and to what extent to act depending on the type of health or social objective to be achieved.
Methods
A time-varying susceptible-infected-recovered-deceased (SIRD) compartmental model, stratified into ten age groups, was developed on Italian data. Simulations were performed every 15 days from December 2020 to April 2021. An optimal vaccination strategy was achieved by minimizing deaths or infected, considering the total vaccine doses available.
Results
We showed how the effects of a vaccination campaign can be planned in a way that maximizes lives saved and/or minimizes infections. Regarding the minimization of deaths, the model prioritizes the elderly (>80 years) and then those between 60 and 80 years, in all simulations. Regarding the cost function of new infections, the first simulation assigns all available doses to those over 90 years of age. In the later simulations, the doses are assigned mainly to the 20-29-year-old and the 89+ year old.
Conclusions
Optimal allocation of available vaccine doses is useful in mitigating transmission of infection and reducing mortality. Application of the mathematical model can be useful at the beginning of an epidemic caused by a new pathogen, when data are scarce, and it is therefore necessary to introduce a standardized approach. This kind of simulation is useful to understand whether the implemented vaccination strategy needs to be recalibrated, too.
Key messages
• Time-varying compartmentalised models can be used both to continuously inform decision-makers about changes in epidemic traits and to simulate the effects of targeted pandemic containment strategies.
• The application of compartmental models can be very useful at the onset of an epidemic to more successfully contain it and structure the health, political, and economic plan.
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Affiliation(s)
- A Cartocci
- Department of Medical Biotechnology, University of Siena , Siena, Italy
| | - V Lucarelli
- Department of Molecular and Developmental Medicine, University of Siena , Siena, Italy
| | - G Messina
- Department of Molecular and Developmental Medicine, University of Siena , Siena, Italy
| | - N Nante
- Department of Molecular and Developmental Medicine, University of Siena , Siena, Italy
| | - G Cevenini
- Department of Medical Biotechnology, University of Siena , Siena, Italy
| | - P Barbini
- Department of Medical Biotechnology, University of Siena , Siena, Italy
- Department of Information Engineering and Mathematics, University of Siena , Siena, Italy
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Marzocchi C, Capezzone M, Sagnella A, Cartocci A, Caroli Costantini M, Brindisi L, Mancini V, Cantara S, Castagna MG. Pregnancy-associated plasma protein A mRNA expression as a marker for differentiated thyroid cancer: results from a "surgical" and a "cytological" series. J Endocrinol Invest 2022; 45:369-378. [PMID: 34350538 PMCID: PMC8783868 DOI: 10.1007/s40618-021-01655-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/29/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE Pregnancy-associated plasma protein A (PAPPA) is a metalloproteinase initially described for its role during pregnancy. PAPPA regulates IGF ligands 1 (IGF1) bioavailability through the degradation of IGF-binding protein 4 (IGFBP4). After the cleavage of IGFBP4, free IGF1 is able to bind IGF1 receptors (IGF1R) triggering the downstream signaling. Recently, PAPPA expression has been linked with development of several cancers. No data have been published on thyroid cancer, yet. METHODS We evaluated PAPPA, insulin-like growth factor (IGF1), IGF1 receptors (IGF1R) and IGF-binding protein 4 (IGFBP4) mRNA expression levels in a "Surgical series" of 94 thyroid nodules (64 cancers, 16 follicular adenomas and 14 hyperplastic nodules) and in a "Cytological series" of 80 nodules from 74 patients underwent to fine-needle aspiration cytology (FNAC). In tissues, PAPPA was also evaluated by western blot. RESULTS We found that PAPPA expression was increased in thyroid cancer specimen at mRNA and protein levels and that, adenomas and hyperplastic nodules had an expression similar to normal tissues. When applied on thyroid cytologies, PAPPA expression was able to discriminate benign from malignant nodules contributing to pre-surgical classification of the nodules. We calculated a cut-off with a good specificity (91%) which reached 100% when combined with molecular biology. CONCLUSION These results show that PAPPA could represent a promising diagnostic marker for differentiated thyroid cancer.
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Affiliation(s)
- C Marzocchi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - M Capezzone
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - A Sagnella
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - A Cartocci
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - M Caroli Costantini
- Department of Oncology and Pathological Anatomy, Azienda Ospedaliera, Universitario Senese, Siena, Italy
| | - L Brindisi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
| | - V Mancini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - S Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy.
| | - M G Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy
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Cinotti E, Tognetti L, Cartocci A, Lamberti A, Gherbassi S, Orte Cano C, Lenoir C, Dejonckheere G, Diet G, Fontaine M, Miyamoto M, Perez‐Anker J, Solmi V, Malvehy J, del Marmol V, Perrot JL, Rubegni P, Suppa M. Line-field confocal optical coherence tomography for actinic keratosis and squamous cell carcinoma: a descriptive study. Clin Exp Dermatol 2021; 46:1530-1541. [PMID: 34115900 PMCID: PMC9293459 DOI: 10.1111/ced.14801] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early and accurate diagnosis of cutaneous squamous cell carcinomas (SCCs) and actinic keratoses (AK) is fundamental to reduce their associated morbidity and to select the correct treatment. Line-field confocal optical coherence tomography (LC-OCT) is a new imaging device that can characterize healthy skin and basal cell carcinoma, but no large studies on keratinocyte cell tumours have yet been published. AIM To identify and describe LC-OCT criteria associated with SCC and AK, and to compare LC-OCT findings in these tumours. METHODS A retrospective observational multicentre study was conducted. Lesions were imaged with the LC-OCT device before surgery and examined histologically. LC-OCT criteria for AK/SCC were identified and their presence was evaluated in all study lesions. Univariate and multivariate analyses were performed to compare AK and SCCs, and to investigate differences between in situ and invasive tumours. RESULTS In total, 158 patients with 50 AK and 108 SCCs (62 in situ and 46 invasive) were included. Cytological and architectural alterations were found in most lesions, and differences were found between AK and SCCs. Although the visualization of the dermoepidermal junction (DEJ) was often hampered by hyperkeratosis and acanthosis, an outlined DEJ without broad strands was observed in almost all AK and almost all in situ SCCs, but in only three invasive SCCs (P < 0.001) when the DEJ was detectable. CONCLUSION Our results suggest that LC-OCT can help clinicians in the identification of AK and SCC and their differentiation, providing a real-time and noninvasive examination. Further studies are needed to confirm our data.
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Affiliation(s)
- E. Cinotti
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - L. Tognetti
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - A. Cartocci
- Department of Medical BiotechnologiesUniversity of SienaSienaItaly
| | - A. Lamberti
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - S. Gherbassi
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - C. Orte Cano
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - C. Lenoir
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - G. Dejonckheere
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - G. Diet
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - M. Fontaine
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - M. Miyamoto
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - J. Perez‐Anker
- Melanoma UnitHospital Clinic BarcelonaUniversity of BarcelonaBarcelonaSpain
- CIBER de Enfermedades RarasInstituto de Salud Carlos IIIBarcelonaSpain
| | - V. Solmi
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - J. Malvehy
- Melanoma UnitHospital Clinic BarcelonaUniversity of BarcelonaBarcelonaSpain
- CIBER de Enfermedades RarasInstituto de Salud Carlos IIIBarcelonaSpain
| | - V. del Marmol
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
| | - J. L. Perrot
- Department of DermatologyUniversity Hospital of Saint‐EtienneSaint‐EtienneFrance
| | - P. Rubegni
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - M. Suppa
- Department of DermatologyHôpital ErasmeUniversité Libre de BruxellesBrusselsBelgium
- Department of DermatologyInstitut Jules BordetUniversité Libre de BruxellesBrusselsBelgium
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Cartocci A, Messina G, Nante N, Cevenini G, Barbini P. An age grouped time-varying compartmental model for CoViD-19 vaccination strategy. Eur J Public Health 2021. [PMCID: PMC8574766 DOI: 10.1093/eurpub/ckab165.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Compartmental models are the simplest in the mathematical study of infectious disease dynamics. Using an age-stratified compartmental model allows us to understand which population groups to target and to what extent to act, in order to achieve predefined goals in line with policy and/or health choices. In fact, the vaccination strategies of most countries are age dependent. With this study we want to show that the optimal vaccination strategy should be different depending on the type of health or social objective to be achieved. Methods A time varying susceptible-infected-recovered-deceased (SIRD) compartmental models, stratified into ten age groups of ten years was developed on Italian data. An optimal vaccination strategy was obtained minimizing deaths or infectious starting from April 11, 2021, considering the total doses due to Italy by the European contract for each type of vaccine from April to June. The efficacy of each vaccine and the days between administration and the beginning of immunization were also considered. Results On April 11, about 75% of over-80 Italian population have received at least the first dose of vaccine. Concerning the minimization of death, the model gives the priority to the older people (>60-year-old). This confirms the Italian vaccination strategy by completing the remaining vaccinations of over-80s and then vaccinating those between 60 and 80. Instead, if the priority were to reduce the infected, the model would recommend vaccinating the most of over-80s and the classes aged 20-30 and 40-60. Conclusions In conclusion, the use of this model can help to vary vaccine strategies by adopting targeted approaches to effectively achieve specific objective. For example, given the different age destination of some vaccine types, a good vaccination strategy might have been to vaccinate the over 90s with one type of vaccine to protect them from high risk of death while simultaneously vaccinating younger people to contain the spread. Key messages The modelling approach is an excellent decision support tool for pandemic containment. The compartmentalized model stratified by age allows to act more efficiently on subpopulations.
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Affiliation(s)
- A Cartocci
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Contact:
| | - G Messina
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - N Nante
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - G Cevenini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - P Barbini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
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Brilli L, Danielli R, Campanile M, Secchi C, Ciuoli C, Calabrò L, Pilli T, Cartocci A, Pacini F, Di Giacomo AM, Castagna MG. Baseline serum TSH levels predict the absence of thyroid dysfunction in cancer patients treated with immunotherapy. J Endocrinol Invest 2021; 44:1719-1726. [PMID: 33367977 PMCID: PMC8285335 DOI: 10.1007/s40618-020-01480-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/27/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Immunotherapy against immune checkpoints has significantly improved survival both in metastatic and adjuvant setting in several types of cancers. Thyroid dysfunction is the most common endocrine adverse event reported. Patients who are at risk of developing thyroid dysfunction remain to be defined. We aimed to identify predictive factors for the development of thyroid dysfunction during immunotherapy. METHODS This is a retrospective study including a total of 68 patients who were treated with immune checkpoint inhibitors (ICIs) for metastatic or unresectable advanced cancers. The majority of patients were treated with anti-PD1 drugs in monotherapy or in combination with anti-CTLA4 inhibitors. Thyroid function and anti-thyroid antibodies, before starting immunotherapy and during treatment, were evaluated. Thyroid ultrasound was also performed in a subgroup of patients at the time of enrolment in the study. RESULTS Eleven out of 68 patients (16.1%) developed immune-related overt thyroid dysfunction. By ROC curve analysis, we found that a serum TSH cut-off of 1.72 mUI/l, at baseline, had a good diagnostic accuracy in identifying patients without overt thyroid dysfunction (NPV = 100%, p = 0.0029). At multivariate analysis, both TSH and positive anti-thyroid antibodies (ATAbs) levels, before ICIs treatment, were independently associated with the development of overt thyroid dysfunction during immunotherapy (p = 0.0001 and p = 0.009, respectively). CONCLUSIONS Pre-treatment serum TSH and ATAbs levels may help to identify patients at high risk for primary thyroid dysfunction. Our study suggests guidance for an appropriate timely screening and for a tailored management of thyroid dysfunctions in patients treated with ICIs.
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Affiliation(s)
- L Brilli
- Endocrinology Unit, Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, 53100, Italy
| | - R Danielli
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, 53100, Siena, Italy
| | - M Campanile
- Endocrinology Unit, Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, 53100, Italy
| | - C Secchi
- Endocrinology Unit, Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, 53100, Italy
| | - C Ciuoli
- Endocrinology Unit, Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, 53100, Italy
| | - L Calabrò
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, 53100, Siena, Italy
| | - T Pilli
- Endocrinology Unit, Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, 53100, Italy
| | - A Cartocci
- Department of Medical Biotechnologies, University of Siena, Siena, 53100, Italy
| | - F Pacini
- Department of Biomedical Sciences, Humanitas Clinical and Research Center, IRCCS, 20089, Rozzano, Milan, Italy
| | - A M Di Giacomo
- Center for Immuno-Oncology, Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, 53100, Siena, Italy
| | - M G Castagna
- Endocrinology Unit, Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, 53100, Italy.
- Department of Medical Sciences, University of Siena, Policlinico Santa Maria Alle Scotte, Viale Bracci 16, 53100, Siena, Italy.
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Cinotti E, Tognetti L, Campoli M, Liso F, Cicigoi A, Cartocci A, Rossi R, Rubegni P, Perrot JL. Super-high magnification dermoscopy can aid the differential diagnosis between melanoma and atypical naevi. Clin Exp Dermatol 2021; 46:1216-1222. [PMID: 33486758 DOI: 10.1111/ced.14566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/21/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Dermoscopy is the most widely used noninvasive imaging technique for the clinical diagnosis of melanoma (MM). Super-high (× 400) magnification dermoscopy (D400) has recently been developed; compared with traditional dermoscopy, it can reveal additional features, down to the identification of single melanocytes in the skin. OBJECTIVES To evaluate which structures are visible at D400 and to compare them in atypical naevi and MMs. METHODS A prospective observational multicentre study was conducted. We enrolled patients who were identified as having atypical melanocytic skin lesions by clinical and/or × 20 magnification dermoscopy (D20) examination, and who were assigned to either excision or follow-up. Lesions were imaged by videodermoscopy at D20 and D400. The presence of pigmented cells and their features were assessed at D400. RESULTS In total, there were 79 patients with 57 naevi and 31 MMs. Of the total 88 lesions, 63 (71.6%) were given a histological diagnosis, while the others were followed up for ≥ 12 months, during which they showed no change and were all diagnosed as naevi. Pigmented cells were identified in > 90% of the lesions at D400. Compared with naevi, MMs had a higher frequency of scattered, large, irregular (in shape and size), dendritic/roundish, violet/blue pigmented cells under D400 (P < 0.001). Moreover, dots (P < 0.01), out-of-focus blue structureless areas (P < 0.01) and vessels (P < 0.001) were also more frequent in MMs than in naevi at D400. CONCLUSIONS This study showed that D400 can reveal many elements not otherwise visible in traditional D20 dermoscopy, such as pigmented cells and their morphology, which could be useful for the diagnosis of MM.
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Affiliation(s)
- E Cinotti
- Section of Dermatology, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - L Tognetti
- Section of Dermatology, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - M Campoli
- Section of Dermatology, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - F Liso
- Section of Dermatology, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - A Cicigoi
- Section of Dermatology, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - A Cartocci
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - R Rossi
- Department of Dermatology, Skin Center Senigallia, Senigallia, Italy
| | - P Rubegni
- Section of Dermatology, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy
| | - J L Perrot
- Department of Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
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Tognetti L, Cartocci A, Cinotti E, Moscarella E, Farnetani F, Lallas A, Tiodorovic D, Carrera C, Longo C, Puig S, Perrot JL, Argenziano G, Pellacani G, Cataldo G, Balistreri A, Cevenini G, Rubegni P. The impact of anatomical location and sun exposure on the dermoscopic recognition of atypical nevi and early melanomas: usefulness of an integrated clinical-dermoscopic method (iDScore). J Eur Acad Dermatol Venereol 2020; 35:650-657. [PMID: 32743829 DOI: 10.1111/jdv.16847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 07/09/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND The anatomical location of atypical melanocytic skin lesion (aMSL) was never combined into an algorithm for discriminating early melanomas (EM) from atypical nevi (AN). AIMS To investigate the impact of body location on the intuitive diagnosis performed in teledermoscopy by dermatologists of different skill levels. A further aim was to evaluate how the integration of the body location could improve an algorithm-aided diagnosis. METHODS We retrospectively collected 980 standardized dermoscopic images of aMSL cases (663 AN, 317 EM): data on the anatomical location were collected according to 15 body sites classified into 4 macro-areas of chronically/frequently/seldom/rarely exposure. Through a teledermatology web platform, 111 variously skilled dermoscopists performed either the intuitive diagnosis and 3 algorithm-assisted diagnostic tests (i.e. iDScore, 7-point checklist, ABCD rule) on each case, for a total of 3330 examinations. RESULTS In the rarely photoexposed area (side, bottom, abdomen), AN were the most tricky (i.e. highest quote of false positives), due to a frequent recognition of dermoscopic features usually considered as suggestive for melanoma in these lesions; the EM at these sites received the highest quote of false negatives, being generally interpreted as 'featureless' according to these traditional parameters, that were more frequently displayed on the chronically photoexposed area. In rarely and seldom photoexposed area, intuitive diagnosis fails to achieve adequate accuracy for all aMSLs, as the ABCD rule and the 7-point checklist; by applying the iDScore algorithm the diagnostic performance was increased by 15% in young and 17% in experts. CONCLUSIONS The body location of an aMSL can affect the quality of intuitive dermoscopic diagnosis, especially in sun-protected areas. Accuracy can be improved by using the iDScore algorithm that assigns a different partial score of each body site.
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Affiliation(s)
- L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - A Cartocci
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - E Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - F Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Tiodorovic
- Dermatology Clinic, Medical Faculty, Nis University, Nis, Serbia
| | - C Carrera
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - C Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Puig
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - J L Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Cataldo
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - A Balistreri
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - G Cevenini
- Bioengineering & Biomedical Data Science Lab, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
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10
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Cinotti E, Bovi C, Tonini G, Labeille B, Heusèle C, Nizard C, Schnebert S, Aubailly S, Barthélémy JC, Cambazard F, Cevenini G, Tognetti L, Cartocci A, Rubegni P, Perrot JL. Structural skin changes in elderly people investigated by reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2020; 34:2652-2658. [PMID: 32294278 DOI: 10.1111/jdv.16466] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Reflectance confocal microscopy (RCM) is particularly suitable for the study of skin ageing because it provides nearly histological information in vivo and non-invasively. However, there are no studies that evaluated RCM skin features of a large population older than 70 years. OBJECTIVES The aim of our investigation was to study age-related skin changes in an elderly population by RCM and to evaluate their topographical and gender differences. METHODS We obtained RCM images of photoprotected (volar arm) and chronic (face) and intermittently photoexposed (dorsal forearm) body sites of 209 volunteers (105 women and 104 men, mean age: 77.5, range 74-81 years). 15 previously reported and new RCM parameters related to skin ageing were assessed. RESULTS Photoexposed sites had thicker suprapapillary epidermis, more linear, distant and thin furrows, higher presence of mottled pigmentation, polycyclic papillae and coarse and huddled collagen and lower presence of dermal papillae than the photoprotected site. Irregular honeycomb pattern was not higher in photoexposed sites, indicating that it is probably more dependent on intrinsic ageing. Two ageing scores defined for facial skin ageing (epidermal disarray score and epidermal hyperplasia score) were found useful for the identification of photoageing. Gender differences only concerned some RCM parameters (i.e. thickness of different layers of the epidermis, furrows and collagen score) and some body sites, in line with the fact that women and men of our cohort had no major differences in clinically visible skin ageing. CONCLUSIONS Our study confirmed that RCM is a powerful non-invasive technique to microscopically quantify ageing signs and our observations contribute to highlight the differences between intrinsic and extrinsic ageing.
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Affiliation(s)
- E Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - C Bovi
- Dermatology Unit, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - G Tonini
- Dermatology Unit, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - B Labeille
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - C Heusèle
- LVMH Research, Saint-Jean-de-Braye, France
| | - C Nizard
- LVMH Research, Saint-Jean-de-Braye, France
| | | | - S Aubailly
- LVMH Research, Saint-Jean-de-Braye, France
| | - J C Barthélémy
- Clinical and Exercise Physiology Laboratory, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F Cambazard
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - G Cevenini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - A Cartocci
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy
| | - J L Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
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11
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Tognetti L, Cevenini G, Moscarella E, Cinotti E, Farnetani F, Lallas A, Tiodorovic D, Carrera C, Puig S, Perrot J, Longo C, Argenziano G, Pellacani G, Smargiassi E, Cataldo G, Cartocci A, Balistreri A, Rubegni P. Validation of an integrated dermoscopic scoring method in an European teledermoscopy web platform: the
iDScore
project for early detection of melanoma. J Eur Acad Dermatol Venereol 2019; 34:640-647. [DOI: 10.1111/jdv.15923] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/07/2019] [Indexed: 01/13/2023]
Affiliation(s)
- L. Tognetti
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
- Department of Medical Biotechnologies University of Siena Siena Italy
| | - G. Cevenini
- Department of Medical Biotechnologies University of Siena Siena Italy
| | - E. Moscarella
- Dermatology Unit University of Campania Luigi Vanvitelli Naples Italy
| | - E. Cinotti
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
| | - F. Farnetani
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
| | - A. Lallas
- First Department of Dermatology Aristotele University Thessaloniki Greece
| | - D. Tiodorovic
- Dermatology Clinic Medical Faculty Nis University Nis Serbia
| | - C. Carrera
- Dermatology Clinic Medical Faculty Nis University Nis Serbia
| | - S. Puig
- Dermatology Clinic Medical Faculty Nis University Nis Serbia
- Melanoma Unit Department of Dermatology University of Barcelona Barcelona Spain
| | - J.L. Perrot
- Dermatology Unit University Hospital of St‐Etienne Saint Etienne France
| | - C. Longo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
- Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia Reggio Emilia Italy
| | - G. Argenziano
- Dermatology Unit University of Campania Luigi Vanvitelli Naples Italy
| | - G. Pellacani
- First Department of Dermatology Aristotele University Thessaloniki Greece
| | - E. Smargiassi
- Department of Medical Biotechnologies University of Siena Siena Italy
| | - G. Cataldo
- Department of Medical Biotechnologies University of Siena Siena Italy
| | - A. Cartocci
- Department of Medical Biotechnologies University of Siena Siena Italy
| | - A. Balistreri
- Department of Medical Biotechnologies University of Siena Siena Italy
| | - P. Rubegni
- Dermatology Unit Department of Medical, Surgical and Neurosciences University of Siena Siena Italy
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