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Haenssle HA, Fink C, Toberer F, Winkler J, Stolz W, Deinlein T, Hofmann-Wellenhof R, Lallas A, Emmert S, Buhl T, Zutt M, Blum A, Abassi MS, Thomas L, Tromme I, Tschandl P, Enk A, Rosenberger A. Man against machine reloaded: performance of a market-approved convolutional neural network in classifying a broad spectrum of skin lesions in comparison with 96 dermatologists working under less artificial conditions. Ann Oncol 2021; 31:137-143. [PMID: 31912788 DOI: 10.1016/j.annonc.2019.10.013] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Convolutional neural networks (CNNs) efficiently differentiate skin lesions by image analysis. Studies comparing a market-approved CNN in a broad range of diagnoses to dermatologists working under less artificial conditions are lacking. MATERIALS AND METHODS One hundred cases of pigmented/non-pigmented skin cancers and benign lesions were used for a two-level reader study in 96 dermatologists (level I: dermoscopy only; level II: clinical close-up images, dermoscopy, and textual information). Additionally, dermoscopic images were classified by a CNN approved for the European market as a medical device (Moleanalyzer Pro, FotoFinder Systems, Bad Birnbach, Germany). Primary endpoints were the sensitivity and specificity of the CNN's dichotomous classification in comparison with the dermatologists' management decisions. Secondary endpoints included the dermatologists' diagnostic decisions, their performance according to their level of experience, and the CNN's area under the curve (AUC) of receiver operating characteristics (ROC). RESULTS The CNN revealed a sensitivity, specificity, and ROC AUC with corresponding 95% confidence intervals (CI) of 95.0% (95% CI 83.5% to 98.6%), 76.7% (95% CI 64.6% to 85.6%), and 0.918 (95% CI 0.866-0.970), respectively. In level I, the dermatologists' management decisions showed a mean sensitivity and specificity of 89.0% (95% CI 87.4% to 90.6%) and 80.7% (95% CI 78.8% to 82.6%). With level II information, the sensitivity significantly improved to 94.1% (95% CI 93.1% to 95.1%; P < 0.001), while the specificity remained unchanged at 80.4% (95% CI 78.4% to 82.4%; P = 0.97). When fixing the CNN's specificity at the mean specificity of the dermatologists' management decision in level II (80.4%), the CNN's sensitivity was almost equal to that of human raters, at 95% (95% CI 83.5% to 98.6%) versus 94.1% (95% CI 93.1% to 95.1%); P = 0.1. In contrast, dermatologists were outperformed by the CNN in their level I management decisions and level I and II diagnostic decisions. More experienced dermatologists frequently surpassed the CNN's performance. CONCLUSIONS Under less artificial conditions and in a broader spectrum of diagnoses, the CNN and most dermatologists performed on the same level. Dermatologists are trained to integrate information from a range of sources rendering comparative studies that are solely based on one single case image inadequate.
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Affiliation(s)
- H A Haenssle
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany.
| | - C Fink
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - F Toberer
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - J Winkler
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - W Stolz
- Department of Dermatology, Allergology and Environmental Medicine II, Munich, Germany
| | - T Deinlein
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - R Hofmann-Wellenhof
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - S Emmert
- Department of Dermatology, University of Rostock, Rostock, Germany
| | - T Buhl
- Department of Dermatology, University of Göttingen, Göttingen, Germany
| | - M Zutt
- Department of Dermatology and Allergology, Klinikum Bremen-Mitte, Bremen, Germany
| | - A Blum
- Office Based Clinic of Dermatology, Konstanz, Germany
| | - M S Abassi
- Faculty of Computer Science and Mathematics, University of Passau, Passau, Germany
| | - L Thomas
- Department of Dermatology, Lyons Cancer Research Center, Lyon 1 University, Lyon, France
| | - I Tromme
- Department of Dermatology, Université Catholique de Louvain, St Luc University Hospital, Brussels, Belgium
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Enk
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - A Rosenberger
- Department of Genetic Epidemiology, University of Goettingen, Goettingen, Germany
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Blum A, Bosch S, Haenssle HA, Fink C, Hofmann-Wellenhof R, Zalaudek I, Kittler H, Tschandl P. [Artificial intelligence and smartphone program applications (Apps) : Relevance for dermatological practice]. Hautarzt 2020; 71:691-698. [PMID: 32720165 DOI: 10.1007/s00105-020-04658-4] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ADVANTAGES OF ARTIFICIAL INTELLIGENCE (AI) With responsible, safe and successful use of artificial intelligence (AI), possible advantages in the field of dermato-oncology include the following: (1) medical work can focus on skin cancer patients, (2) patients can be more quickly and effectively treated despite the increasing incidence of skin cancer and the decreasing number of actively working dermatologists and (3) users can learn from the AI results. POTENTIAL DISADVANTAGES AND RISKS OF AI USE: (1) Lack of mutual trust can develop due to the decreased patient-physician contact, (2) additional time effort will be necessary to promptly evaluate the AI-classified benign lesions, (3) lack of adequate medical experience to recognize misclassified AI decisions and (4) recontacting a patient in due time in the case of incorrect AI classifications. Still problematic in the use of AI are the medicolegal situation and remuneration. Apps using AI currently cannot provide sufficient assistance based on clinical images of skin cancer. REQUIREMENTS AND POSSIBLE USE OF SMARTPHONE PROGRAM APPLICATIONS Smartphone program applications (apps) can be implemented responsibly when the image quality is good, the patient's history can be entered easily, transmission of the image and results are assured and medicolegal aspects as well as remuneration are clarified. Apps can be used for disease-specific information material and can optimize patient care by using teledermatology.
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Affiliation(s)
- A Blum
- Hautarzt- und Lehrpraxis, Augustinerplatz 7, 78462, Konstanz, Deutschland.
| | - S Bosch
- Hautarztpraxis, Ludwigsburg, Deutschland
| | - H A Haenssle
- Universitäts-Hautklinik Heidelberg, Heidelberg, Deutschland
| | - C Fink
- Universitäts-Hautklinik Heidelberg, Heidelberg, Deutschland
| | - R Hofmann-Wellenhof
- Universitätsklinik für Dermatologie, Medizinische Universität Graz, Graz, Österreich
| | - I Zalaudek
- Dermatology Clinic, University Hospital of Trieste, Hospital Maggiore, Trieste, Italien
| | - H Kittler
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - P Tschandl
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
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Navarrete-Dechent C, Liopyris K, Molenda MA, Braun R, Curiel-Lewandrowski C, Dusza SW, Guitera P, Hofmann-Wellenhof R, Kittler H, Lallas A, Malvehy J, Marchetti MA, Oliviero M, Pellacani G, Puig S, Soyer HP, Tejasvi T, Thomas L, Tschandl P, Scope A, Marghoob AA, Halpern AC. Human surface anatomy terminology for dermatology: a Delphi consensus from the International Skin Imaging Collaboration. J Eur Acad Dermatol Venereol 2020; 34:2659-2663. [PMID: 32770737 DOI: 10.1111/jdv.16855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/29/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is no internationally vetted set of anatomic terms to describe human surface anatomy. OBJECTIVE To establish expert consensus on a standardized set of terms that describe clinically relevant human surface anatomy. METHODS We conducted a Delphi consensus on surface anatomy terminology between July 2017 and July 2019. The initial survey included 385 anatomic terms, organized in seven levels of hierarchy. If agreement exceeded the 75% established threshold, the term was considered 'accepted' and included in the final list. Terms added by the participants were passed on to the next round of consensus. Terms with <75% agreement were included in subsequent surveys along with alternative terms proposed by participants until agreement was reached on all terms. RESULTS The Delphi included 21 participants. We found consensus (≥75% agreement) on 361/385 (93.8%) terms and eliminated one term in the first round. Of 49 new terms suggested by participants, 45 were added via consensus. To adjust for a recently published International Classification of Diseases-Surface Topography list of terms, a third survey including 111 discrepant terms was sent to participants. Finally, a total of 513 terms reached agreement via the Delphi method. CONCLUSIONS We have established a set of 513 clinically relevant terms for denoting human surface anatomy, towards the use of standardized terminology in dermatologic documentation.
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Affiliation(s)
- C Navarrete-Dechent
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - K Liopyris
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Andreas Syggros Hospital of Cutaneous & Venereal Diseases, University of Athens, Athens, Greece
| | | | - R Braun
- Department of Dermatology, University Hospital Zürich, Zurich, Switzerland
| | - C Curiel-Lewandrowski
- Department of Dermatology, The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - S W Dusza
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - P Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | | | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - J Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - M A Marchetti
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Oliviero
- Dermatology Associates, Plantation, FL, USA
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - H P Soyer
- Dermatology Research Center, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - T Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - L Thomas
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Lyon 1 University and Cancer Research Center of Lyons INSERM U1052 - CNRS UMR5286, Lyon, France
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Scope
- The Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A A Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A C Halpern
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Deinlein T, Hofmann-Wellenhof R, Haenssle HA, Blum A. Dermatoskopie, sequenzielle Videodermatoskopie, Ganzkörperfotografie, künstliche Intelligenz – was bringt uns die Zukunft? Akt Dermatol 2020. [DOI: 10.1055/a-1072-6722] [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: 10/24/2022]
Abstract
ZusammenfassungDie Dermatoskopie ist mittlerweile ein fester Bestandteil einer jeden dermatologischen Untersuchung. Mit dieser Technik konnten die Früherkennung von Malignomen der Haut und deren Vorstufen deutlich verbessert und unnötige Exzisionen benigner Hautläsionen reduziert werden. Der Einsatz der Dermatoskopie umfasst mittlerweile auch die Beurteilung von entzündlichen und parasitären Dermatosen sowie Haarerkrankungen. Bei definierten Risikogruppen für ein Melanom sollte der Zwei-Schritte-Algorithmus, bestehend aus Ganzkörperfotografie und Videodermatoskopie, in entsprechenden Zeitintervallen zur Anwendung kommen. Mit dieser Methode können Melanome meist in einem sehr frühen Stadium entdeckt werden, da Veränderungen bestehender Muttermale sowie neu entstandene Läsionen früher festgestellt werden. In den letzten Jahren konnten mehrere Studien nachweisen, dass speziell geschulte neuronale Netzwerke Malignome der Haut, insbesondere Melanome, mit einer sehr hohen Treffsicherheit diagnostizieren können. Wie diese Computer-gestützte Diagnostik mithilfe einer künstlichen Intelligenz in den klinischen Alltag integriert werden kann und welche Vorteile sich hiervon ableiten lassen, ist derzeit noch nicht geklärt.
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Affiliation(s)
- T. Deinlein
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Österreich
| | - R. Hofmann-Wellenhof
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Österreich
| | - H. A. Haenssle
- Universitätsklinik für Dermatologie und Venerologie, Universität Heidelberg, Heidelberg
| | - A. Blum
- Hautarzt- und Lehrpraxis Konstanz
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Fink C, Blum A, Buhl T, Mitteldorf C, Hofmann-Wellenhof R, Deinlein T, Stolz W, Trennheuser L, Cussigh C, Deltgen D, Winkler JK, Toberer F, Enk A, Rosenberger A, Haenssle HA. Diagnostic performance of a deep learning convolutional neural network in the differentiation of combined naevi and melanomas. J Eur Acad Dermatol Venereol 2020; 34:1355-1361. [PMID: 31856342 DOI: 10.1111/jdv.16165] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/26/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Deep learning convolutional neural networks (CNN) may assist physicians in the diagnosis of melanoma. The capacity of a CNN to differentiate melanomas from combined naevi, the latter representing well-known melanoma simulators, has not been investigated. OBJECTIVE To assess the diagnostic performance of a CNN when used to differentiate melanomas from combined naevi in comparison with dermatologists. METHODS In this study, a CNN with regulatory approval for the European market (Moleanalyzer-Pro, FotoFinder Systems GmbH, Bad Birnbach, Germany) was used. We attained a dichotomous classification (benign, malignant) in dermoscopic images of 36 combined naevi and 36 melanomas with a mean Breslow thickness of 1.3 mm. Primary outcome measures were the CNN's sensitivity, specificity and the diagnostic odds ratio (DOR) in comparison with 11 dermatologists with different levels of experience. RESULTS The CNN revealed a sensitivity, specificity and DOR of 97.1% (95% CI [82.7-99.6]), 78.8% (95% CI [62.8-89.1.3]) and 34 (95% CI [4.8-239]), respectively. Dermatologists showed a lower mean sensitivity, specificity and DOR of 90.6% (95% CI [84.1-94.7]; P = 0.092), 71.0% (95% CI [62.6-78.1]; P = 0.256) and 24 (95% CI [11.6-48.4]; P = 0.1114). Under the assumption that dermatologists use the CNN to verify their (initial) melanoma diagnosis, dermatologists achieve an increased specificity of 90.3% (95% CI [79.8-95.6]) at an almost unchanged sensitivity. The largest benefit was observed in 'beginners', who performed worst without CNN verification (DOR = 12) but best with CNN verification (DOR = 98). CONCLUSION The tested CNN more accurately classified combined naevi and melanomas in comparison with trained dermatologists. Their diagnostic performance could be improved if the CNN was used to confirm/overrule an initial melanoma diagnosis. Application of a CNN may therefore be of benefit to clinicians.
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Affiliation(s)
- C Fink
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - A Blum
- Public, Private and Teaching Practice, Konstanz, Germany
| | - T Buhl
- Department of Dermatology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - C Mitteldorf
- Department of Dermatology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - R Hofmann-Wellenhof
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - T Deinlein
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - W Stolz
- Department of Dermatology, Allergology and Environmental Medicine II, Hospital Thalkirchner Street, Munich, Germany
| | - L Trennheuser
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - C Cussigh
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - D Deltgen
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - J K Winkler
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - F Toberer
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - A Enk
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - A Rosenberger
- Department of Genetic Epidemiology, University Medical Center of Goettingen, Goettingen, Germany
| | - H A Haenssle
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
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Kupsa R, Narro-Bartenstein E, Hofmann-Wellenhof R. [Suspicious hyperpigmentation with parallel ridge pattern on acral skin : Three case reports]. Hautarzt 2019; 71:154-157. [PMID: 31781807 DOI: 10.1007/s00105-019-04511-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- R Kupsa
- Univ.-Klinik für Dermatologie und Venerologie, LKH-Univ. Klinikum Graz, Auenbruggerplatz 8, 8036, Graz, Österreich.
| | - E Narro-Bartenstein
- Univ.-Klinik für Dermatologie und Venerologie, LKH-Univ. Klinikum Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
| | - R Hofmann-Wellenhof
- Univ.-Klinik für Dermatologie und Venerologie, LKH-Univ. Klinikum Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
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Errichetti E, Zalaudek I, Kittler H, Apalla Z, Argenziano G, Bakos R, Blum A, Braun RP, Ioannides D, Lacarrubba F, Lazaridou E, Longo C, Micali G, Moscarella E, Paoli J, Papageorgiou C, Russo T, Scope A, Stinco G, Thomas L, Toncic RJ, Tschandl P, Cabo H, Hallpern A, Hofmann-Wellenhof R, Malvehy J, Marghoob A, Menzies S, Pellacani G, Puig S, Rabinovitz H, Rudnicka L, Vakirlis E, Soyer P, Stolz W, Tanaka M, Lallas A. Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non-neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society. Br J Dermatol 2019; 182:454-467. [PMID: 31077336 DOI: 10.1111/bjd.18125] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Over the last few years, several articles on dermoscopy of non-neoplastic dermatoses have been published, yet there is poor consistency in the terminology among different studies. OBJECTIVES We aimed to standardize the dermoscopic terminology and identify basic parameters to evaluate in non-neoplastic dermatoses through an expert consensus. METHODS The modified Delphi method was followed, with two phases: (i) identification of a list of possible items based on a systematic literature review and (ii) selection of parameters by a panel of experts through a three-step iterative procedure (blinded e-mail interaction in rounds 1 and 3 and a face-to-face meeting in round 2). Initial panellists were recruited via e-mail from all over the world based on their expertise on dermoscopy of non-neoplastic dermatoses. RESULTS Twenty-four international experts took part in all rounds of the consensus and 13 further international participants were also involved in round 2. Five standardized basic parameters were identified: (i) vessels (including morphology and distribution); (ii) scales (including colour and distribution); (iii) follicular findings; (iv) 'other structures' (including colour and morphology); and (v) 'specific clues'. For each of them, possible variables were selected, with a total of 31 different subitems reaching agreement at the end of the consensus (all of the 29 proposed initially plus two more added in the course of the consensus procedure). CONCLUSIONS This expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses. This tool, if adopted by clinicians and researchers in this field, is likely to enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology. What's already known about this topic? Over the last few years, several papers have been published attempting to describe the dermoscopic features of non-neoplastic dermatoses, yet there is poor consistency in the terminology among different studies. What does this study add? The present expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses. This consensus should enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology.
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Affiliation(s)
- E Errichetti
- Institute of Dermatology, 'Santa Maria della Misericordia' University Hospital, Udine, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G Argenziano
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - R Bakos
- Department of Dermatology, Hospital de Clınicas de Porto Alegre, Porto, Alegre, Brazil
| | - A Blum
- Public, Private and Teaching Practice of Dermatology, Konstanz, Germany
| | - R P Braun
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - F Lacarrubba
- Dermatology Clinic, University of Catania, Catania, Italy
| | - E Lazaridou
- Second Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - J Paoli
- Department of Dermatology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - T Russo
- Dermatology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Scope
- Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Stinco
- Institute of Dermatology, 'Santa Maria della Misericordia' University Hospital, Udine, Italy
| | - L Thomas
- Department of Dermatology, Lyon University, Lyon, France
| | - R J Toncic
- Dermoscopy Unit, University of Zagreb, Zagreb, Croatia
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - H Cabo
- Dermatology Institute of Medical Research, University of Buenos Aires, Buenos Aires, Argentina
| | - A Hallpern
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, U.S.A
| | | | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - A Marghoob
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, U.S.A
| | - S Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - H Rabinovitz
- Skin and Cancer Associates, Plantation, FL, U.S.A
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - E Vakirlis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - P Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Woolloongabba, QLD, Australia
| | - W Stolz
- Department of Dermatology and Allergology and Environmental Medicine Clinic Thalkirchen, Hospital Munich, Munich, Germany
| | - M Tanaka
- Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Haenssle HA, Fink C, Stolz W, Braun RP, Hofmann-Wellenhof R, Deinlein T, Kreusch J, Zalaudek I, Blum A. Dermatoskopie in Sonderlokalisationen. Hautarzt 2019; 70:295-311. [DOI: 10.1007/s00105-019-4372-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Conforti C, Giuffrida R, Seabra Resende FS, Amaro Pereira A, Cerroni L, Zalaudek I, Hofmann-Wellenhof R. Dermoscopic features of nonpigmented eccrine poroma. Clin Exp Dermatol 2019; 44:937-938. [PMID: 30677158 DOI: 10.1111/ced.13913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- C Conforti
- Dermatology Clinic, Hospital Maggiore, University of Trieste, Trieste, Italy
| | - R Giuffrida
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - F S Seabra Resende
- Dermatology and Venereology Department, University of Graz, Graz, Austria
| | - A Amaro Pereira
- Anatomic Pathology Unit, University Hospital Polydoro Ernani de São Thiago, Santa Catarina Federal University, Florianópolis, Brazil
| | - L Cerroni
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Zalaudek
- Dermatology Clinic, Hospital Maggiore, University of Trieste, Trieste, Italy
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10
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Giuffrida R, Conforti C, Resende FSS, Hamilko de Barros M, Uranitsch M, Favero F, Deinlein T, Hofmann-Wellenhof R, Zalaudek I. Clinical and dermoscopic features of genital pigmented Bowen disease. Clin Exp Dermatol 2018; 43:813-816. [DOI: 10.1111/ced.13633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2017] [Indexed: 11/29/2022]
Affiliation(s)
- R. Giuffrida
- Department of Clinical and Experimental Medicine; Section of Dermatology; University of Messina; Messina Italy
| | - C. Conforti
- Department of Dermatology and Venereology; University of Graz; Graz Austria
| | - F. S. S. Resende
- Department of Dermatology and Venereology; University of Graz; Graz Austria
| | - M. Hamilko de Barros
- Professor Rubem David Azulay Institute; Charity Hospital of Rio de Janeiro; Rio de Janeiro Brazil
| | - M. Uranitsch
- Department of Dermatology and Venereology; University of Graz; Graz Austria
| | - F. Favero
- Department of Dermatology and Venereology; University of Graz; Graz Austria
| | - T. Deinlein
- Department of Dermatology and Venereology; Medical University of Graz; Graz Austria
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venereology; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venereology; University of Trieste; Ospedale Maggiore Trieste Italy
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11
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12
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Cinotti E, Labeille B, Debarbieux S, Carrera C, Lacarrubba F, Witkowski A, Moscarella E, Arzberger E, Kittler H, Bahadoran P, Gonzalez S, Guitera P, Agozzino M, Farnetani F, Hofmann-Wellenhof R, Ardigò M, Rubegni P, Tognetti L, Łudzik J, Zalaudek I, Argenziano G, Longo C, Ribero S, Malvehy J, Pellacani G, Cambazard F, Perrot J. Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna. J Eur Acad Dermatol Venereol 2018; 32:1284-1291. [DOI: 10.1111/jdv.14791] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/19/2017] [Indexed: 11/30/2022]
Affiliation(s)
- E. Cinotti
- Department of Dermatology; University Hospital of St-Etienne; Saint-Etienne France
- Department of Medical; Surgical and Neurological Science; Dermatology Section; University of Siena; S. Maria alle Scotte Hospital; Siena Italy
| | - B. Labeille
- Department of Dermatology; University Hospital of St-Etienne; Saint-Etienne France
| | - S. Debarbieux
- Departments of Dermatology; Centre Hospitalier Lyon Sud; Pierre Benite France
| | - C. Carrera
- Melanoma Unit; Department of Dermatology; Hospital Clínic de Barcelona; IDIBAPS; Barcelona University; Barcelona Spain
| | - F. Lacarrubba
- Dermatology Clinic; University of Catania; Catania Italy
| | - A.M. Witkowski
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - E. Moscarella
- Dermatology Unit; Second University of Naples; Nuovo Policlinico; Naples Italy
| | - E. Arzberger
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - H. Kittler
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - P. Bahadoran
- Department of Dermatology; Clinical Research Center; Hopital Archet 2; Nice France
| | - S. Gonzalez
- Medicine and Medical Specialities Department; Madrid and Dermatology Department; Alcalá University; Memorial Sloan-Kettering Cancer Center; New York NY USA
| | - P. Guitera
- Department of Dermatology; The University of Sydney; Sydney Melanoma Diagnostic Centre and Melanoma Institute Australia; Sydney NSW Australia
| | - M. Agozzino
- Dermatology Unit; Second University of Naples; Nuovo Policlinico; Naples Italy
| | - F. Farnetani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - M. Ardigò
- Clinical Dermatology; San Gallicano Dermatological Institute; Rome Italy
| | - P. Rubegni
- Department of Medical; Surgical and Neurological Science; Dermatology Section; University of Siena; S. Maria alle Scotte Hospital; Siena Italy
| | - L. Tognetti
- Department of Medical; Surgical and Neurological Science; Dermatology Section; University of Siena; S. Maria alle Scotte Hospital; Siena Italy
- Department of Medical Biotechnologies; University of Siena; Siena Italy
| | - J. Łudzik
- Department of Bioinformatics and Telemedicine; Jagiellonian University Medical College; Krakow Poland
| | - I. Zalaudek
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - G. Argenziano
- Dermatology Unit; Second University of Naples; Nuovo Policlinico; Naples Italy
| | - C. Longo
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova-IRCCS; Reggio Emilia Italy
| | - S. Ribero
- Department of Medical Sciences; University of Turin; Turin Italy
| | - J. Malvehy
- Melanoma Unit; Department of Dermatology; Hospital Clínic de Barcelona; IDIBAPS; Barcelona University; Barcelona Spain
| | - G. Pellacani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - F. Cambazard
- Department of Dermatology; University Hospital of St-Etienne; Saint-Etienne France
| | - J.L. Perrot
- Department of Dermatology; University Hospital of St-Etienne; Saint-Etienne France
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13
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Blum A, Kreusch J, Stolz W, Haenssle H, Braun R, Hofmann-Wellenhof R, Tschandl P, Zalaudek I, Kittler H. Dermatoskopie bei malignen und benignen Hauttumoren. Hautarzt 2017; 68:653-673. [DOI: 10.1007/s00105-017-4013-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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Richtig G, Byrom L, Kupsa R, Schaider H, Hofmann-Wellenhof R, Wolf IH, Soyer HP, Richtig E. Pregnancy as a driver for melanoma. Br J Dermatol 2017; 177:854-857. [PMID: 27718538 DOI: 10.1111/bjd.15124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 12/31/2022]
Abstract
Whether or not pregnancy favours the occurrence and growth of melanoma is a source of controversy in the literature. Several case reports have shown dramatic courses of diseases in pregnancy. We present a case of a 36-year-old woman with multiple naevi with one melanoma detected in 2009 in the first trimester and a second primary melanoma in 2010 in the third trimester of her pregnancy. Both lesions have been present for at least 5 years and have been interpreted as dysplastic naevi. Because of their growth during pregnancy they were removed. No metastatic disease has been found between 2010 and early 2017. This case shows the difficulty of detecting melanomas in pregnancy, particularly when they mimic dysplastic naevi in women with multiple naevi, who are at higher risk. Therefore, we suggest that pregnant women with numerous naevi should be precautious of any changes of their naevi in size, shape and colour. Every suspicious lesion should be either excised or documented/monitored carefully, for example with sequential digital dermoscopy imaging.
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Affiliation(s)
- G Richtig
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria.,Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria.,Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Woolloongabba, QLD, Australia
| | - L Byrom
- Translational Research Institute, University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, Australia.,Experimental Dermatology Group, University of Queensland Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia
| | - R Kupsa
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria
| | - H Schaider
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria
| | - R Hofmann-Wellenhof
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria
| | - I H Wolf
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria
| | - H P Soyer
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria.,Department of Dermatology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - E Richtig
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria
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15
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Wurm E, Pellacani G, Longo C, Soyer HP, Gonzalez S, Hofmann-Wellenhof R, Ahlgrimm-Siess V, Guitera P, Sinz C, Kittler H. The value of reflectance confocal microscopy in diagnosis of flat pigmented facial lesions: a prospective study. J Eur Acad Dermatol Venereol 2017; 31:1349-1354. [PMID: 28214381 DOI: 10.1111/jdv.14171] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 12/14/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Flat pigmented facial lesions are difficult to diagnose even with dermatoscopy. It is controversial how additional information obtained by in vivo reflectance confocal microscopy (RCM) impacts the diagnosis and management. OBJECTIVE To examine what in vivo reflectance confocal microscopy of flat pigmented facial lesions adds to clinical examination using dermatoscopy including digital dermatoscopic monitoring. METHODS We prospectively collected 70 cases of flat pigmented facial lesions and recorded diagnoses and management decisions by experts based on direct clinical examination aided by dermatoscopy including digital dermatoscopic monitoring and by remote experts who reviewed the corresponding confocal images. The expert confocal readers were blinded to the clinical and dermatoscopic appearance of the lesion. RESULTS The sensitivity of dermatoscopy plus digital dermatoscopic monitoring was 95.0% (95% CI 75.13% to 99.87%) and the specificity was 84.0% (95% CI 70.89% to 92.83%). The sensitivity of RCM was 95.0% (95% CI 75.13% to 99.87%) and the specificity was 82.0% (95% CI 68.56% to 91.42%). CONCLUSION Although most flat pigmented facial lesions can be managed by clinical examination and dermatoscopy alone, confocal microscopy is a useful adjunct in selected lesions. If RCM is not correlated with clinical and dermatoscopic information, there is risk of overdiagnosis of actinic keratosis, however.
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Affiliation(s)
- E Wurm
- Department of General Dermatology, Medical University of Vienna, Vienna General Hospital (AKH), Vienna, Austria
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Longo
- Skin Cancer Unit, Arcispedale Santa Maria, Nuova-IRCCS, Reggio Emilia, Italy
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, QLD, Australia
| | - S Gonzalez
- Medicine Department, Alcalá University, Madrid, Spain.,Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - V Ahlgrimm-Siess
- Department of Dermatology, University Clinic Salzburg, Salzburg, Austria
| | - P Guitera
- Melanoma Institute Australia and the Sydney Melanoma Diagnostic Centre, and the Faculty of Dermatology, University of Sydney, Sydney, NSW, Australia
| | - C Sinz
- Department of General Dermatology, Medical University of Vienna, Vienna General Hospital (AKH), Vienna, Austria
| | - H Kittler
- Department of General Dermatology, Medical University of Vienna, Vienna General Hospital (AKH), Vienna, Austria
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16
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de Mestier Y, Moscarella E, Marchetti Cautela J, Lallas A, Longo C, Zalaudek I, Hofmann-Wellenhof R, Argenziano G. Clinicodermoscopic features of Spitz naevi by age and anatomical site: a study of 378 Spitz naevi. Br J Dermatol 2017; 177:e152-e153. [PMID: 28346660 DOI: 10.1111/bjd.15501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Y de Mestier
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - E Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - J Marchetti Cautela
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - A Lallas
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - C Longo
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
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17
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Arzberger E, Oliveira A, Massone C, Komericki P, Zalaudek I, Hofmann-Wellenhof R. Reflectance confocal microscopy as a noninvasive complementary tool in the diagnosis of psoriatic balanitis. Br J Dermatol 2016; 176:1360-1362. [PMID: 27514619 DOI: 10.1111/bjd.14960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E Arzberger
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - A Oliveira
- Department of Dermatology, British Hospital, Lisboa, Portugal
| | - C Massone
- Department of Dermatology, Medical University of Graz, Graz, Austria.,Department of Dermatology, Galliera Hospital, Genoa, Italy
| | - P Komericki
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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18
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Gülseren D, Arzberger E, Cerroni L, Hofmann-Wellenhof R, Richtig E. Reflectance confocal microscopy and dermatopathologic findings of cutaneous argyria after colloidal silver ingestion. J Eur Acad Dermatol Venereol 2016; 31:e178-e179. [PMID: 27527367 DOI: 10.1111/jdv.13881] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- D Gülseren
- Department of Dermatology, Polatlı State Hospital, Ankara, Turkey
| | - E Arzberger
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - L Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - E Richtig
- Department of Dermatology, Medical University of Graz, Graz, Austria
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19
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Oliveira A, Zalaudek I, Arzberger E, Hofmann-Wellenhof R. Seborrhoeic keratosis imaging in high-definition optical coherence tomography, with dermoscopic and reflectance confocal microscopic correlation. J Eur Acad Dermatol Venereol 2016; 31:e125-e127. [DOI: 10.1111/jdv.13874] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - I. Zalaudek
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - E. Arzberger
- Department of Dermatology; Medical University of Graz; Graz Austria
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20
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Massone C, Soyer HP, Hofmann-Wellenhof R, Di Stefani A, Lozzi GP, Gabler G, Dong H, Argenziano G, Ozdemir F, Fink-Puches R, Salmhofer W, Zalaudek I, Nunzi E, Kerl H. Two years' experience with Web-based teleconsulting in dermatology. J Telemed Telecare 2016; 12:83-7. [PMID: 16539755 DOI: 10.1258/135763306776084419] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A non-commercial teledermatology network based on store-and-forward operation was established in April 2002. The aim was to create an easy-to-use platform for teleconsultation services, where physicians could seek diagnostic advice in dermatology from a pool of expert consultants and where they could present and discuss challenging dermatology cases with special emphasis on diagnosis and therapy. An online moderated discussion forum was added in October 2003. During the first two years, 348 health-care professionals from 45 countries registered to use the Website. A total of 783 requests for consultations were answered; 285 requests concerned pigmented skin lesions, 440 requests were from the whole range of clinical dermatology and 58 requests were about non-melanoma skin cancer. Of a total of 133 requests analysed, 80 (60%) were answered within one day, 47 (35%) within one week, five (4%) within two weeks and one (1%) consultation was answered in more than two weeks. Our experience with a discretionary, non-commercial, multilingual Website for open-access teleconsulting in dermatology appears to be successful. The Website represents an example of user-generated content, together with active interaction between users, who can present and discuss cases with remote colleagues.
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Affiliation(s)
- C Massone
- Department of Dermatology, Medical University of Graz, Austria
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21
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Affiliation(s)
- M Wolf
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8010, Graz, Österreich
| | - G Ginter
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8010, Graz, Österreich
| | - E Propst
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8010, Graz, Österreich
| | - T Kern
- Hautfacharztpraxis, Sigmund Freud-Platz 1, 8330, Feldbach, Österreich
| | - T Deinlein
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8010, Graz, Österreich
| | - R Hofmann-Wellenhof
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8010, Graz, Österreich.
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22
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Lallas A, Tschandl P, Kyrgidis A, Stolz W, Rabinovitz H, Cameron A, Gourhant J, Giacomel J, Kittler H, Muir J, Argenziano G, Hofmann-Wellenhof R, Zalaudek I. Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis. Br J Dermatol 2016; 174:1079-85. [DOI: 10.1111/bjd.14355] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 11/26/2022]
Affiliation(s)
- A. Lallas
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - P. Tschandl
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - A. Kyrgidis
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - W. Stolz
- Department of Dermatology, Allergology and Environmental Medicine II; Hospital Thalkirchner Straße; Städtisches Klinikum Munich Munich Germany
| | | | - A. Cameron
- School of Medicine; University of Queensland; Brisbane Qld Australia
| | | | - J. Giacomel
- Skin Spectrum Medical Services; Como WA Australia
| | - H. Kittler
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - J. Muir
- School of Medicine; The University of Queensland; Brisbane Qld Australia
| | - G. Argenziano
- Dermatology Unit; Second University of Naples; Naples Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Non-Melanoma Skin Cancer Unit; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venerology; Non-Melanoma Skin Cancer Unit; Medical University of Graz; Graz Austria
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23
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Richtig E, Hoff M, Rehak P, Kapp K, Hofmann-Wellenhof R, Zalaudek I, Poschauko J, Uggowitzer M, Kohek P, Smolle J. Efficacy of superficial and deep regional hyperthermia combined with systemic chemotherapy and radiotherapy in metastatic melanoma. J Dtsch Dermatol Ges 2015; 1:635-42. [PMID: 16296154 DOI: 10.1046/j.1610-0387.2003.03719.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Response rates of cutaneous-subcutaneous or lymph node metastases of melanoma to systemic chemotherapy are rather low. We report our clinical experience with superficial and deep regional hyperthermia in combination with radiotherapy and/or chemotherapy with carboplatin. PATIENTS/METHODS We treated 15 patients with metastatic melanoma (6 men, 9 women; age 39-84 years, mean age 60 years) by using superficial or deep regional hyperthermia produced by electromagnetic energy. Superficial hyperthermia was delivered to skin or lymph node metastases in combination with radiochemotherapy in 12 patients, while deep regional hyperthermia was administered with an annular array applicator to lymph node metastases either in combination with radiochemotherapy (1 patient) or with carboplatin alone (2 patients). The clinical response was assessed by clinical evaluation and/or computer tomography and/or ultrasonography at monthly intervals. RESULTS Both superficial and deep regional hyperthermia was well tolerated. We observed 5 complete local remissions (34%), 6 partial local remissions (40%) and 2 patients with stable disease (13%). The best results were obtained in cutaneous or retroperitoneal metastases. CONCLUSIONS Local response can be achieved in inoperable metastatic melanoma using superficial or deep regional hyperthermia in combination with radiochemotherapy or chemotherapy.
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Affiliation(s)
- E Richtig
- Department of Dermatology, University of Graz, Auenbruggerplatz 8, 8036 Graz, Austria.
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24
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Deinlein T, Fink-Puches R, Hofmann-Wellenhof R. [Orange-colored papules]. Hautarzt 2015; 66:388-9. [PMID: 25896583 DOI: 10.1007/s00105-015-3615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T Deinlein
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
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25
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Lallas A, Pyne J, Kyrgidis A, Andreani S, Argenziano G, Cavaller A, Giacomel J, Longo C, Malvestiti A, Moscarella E, Piana S, Specchio F, Hofmann-Wellenhof R, Zalaudek I. The clinical and dermoscopic features of invasive cutaneous squamous cell carcinoma depend on the histopathological grade of differentiation. Br J Dermatol 2015; 172:1308-15. [PMID: 25363081 DOI: 10.1111/bjd.13510] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Little is known about the variability of the dermoscopic criteria of squamous cell carcinoma (SCC) according to the histopathological differentiation grade. OBJECTIVES To evaluate whether specific dermoscopic criteria can predict the diagnosis of poorly differentiated SCC compared with well- and moderately differentiated SCC. METHODS Clinical and dermoscopic images of SCCs were retrospectively evaluated for the presence of predefined criteria. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver-operator characteristic curves. RESULTS Of 143 SCCs included, 48 (33·5%) were well differentiated, 45 (31·5%) were moderately differentiated and 50 (35·0%) were poorly differentiated. Flat tumours had a fourfold increased probability of being poorly differentiated. Dermoscopically, the presence of a predominantly red colour posed a 13-fold possibility of poor differentiation, whereas a predominantly white and white-yellow colour decreased the odds of poorly differentiated SCC by 97% each. The presence of vessels in more than 50% of the tumour's surface, a diffuse distribution of vessels and bleeding were significantly associated with poor differentiation, while scale/keratin was a potent predictor of well- or moderately differentiated tumours. CONCLUSIONS Dermoscopy may be regarded as a reliable preoperative tool to distinguish poorly from well- and moderately differentiated SCC. Given that poor differentiation of SCC represents an independent risk factor for recurrence, metastasis and disease-specific death, identifying poorly differentiated tumours in vivo may enhance their appropriate management.
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Affiliation(s)
- A Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - J Pyne
- School of Medicine, The University of Queensland, Brisbane, Australia
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - S Andreani
- Dermatology Service Hospital Salvador, Santiago, Chile
| | - G Argenziano
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | | | - J Giacomel
- Skin Spectrum Medical Services, Como, Western Australia, Australia
| | - C Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - A Malvestiti
- Albert Einstein Israelite Hospital, São Paulo, Brazil
| | - E Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - S Piana
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - F Specchio
- Department of Dermatology, University of Rome Tor Vergata, Italy
| | | | - I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Boone M, Suppa M, Pellacani G, Marneffe A, Miyamoto M, Alarcon I, Ruini C, Hofmann-Wellenhof R, Malvehy J, Jemec G, Del Marmol V. High-definition optical coherence tomography algorithm for discrimination of basal cell carcinoma from clinical BCC imitators and differentiation between common subtypes. J Eur Acad Dermatol Venereol 2015; 29:1771-80. [DOI: 10.1111/jdv.13003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/07/2015] [Indexed: 12/11/2022]
Affiliation(s)
- M.A.L.M. Boone
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - M. Suppa
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - G. Pellacani
- Department of Dermatology; University of Modena; Modena Italy
| | - A. Marneffe
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - M. Miyamoto
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - I. Alarcon
- Department of Dermatology; University of Barcelona; Barcelona Spain
| | - C. Ruini
- Department of Dermatology; University of Modena; Modena Italy
| | | | - J. Malvehy
- Department of Dermatology; University of Barcelona; Barcelona Spain
| | - G.B.E. Jemec
- Department of Dermatology; Health Sciences Faculty; Roskilde Hospital; University of Copenhagen; Roskilde Denmark
| | - V. Del Marmol
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
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Oliveira A, Arzberger E, Zalaudek I, Hofmann-Wellenhof R. Diagnosis of dermatofibrosarcoma protuberans and assessment of pre-surgical margins using high-definition optical coherence tomography imaging. J Eur Acad Dermatol Venereol 2015; 30:710-1. [PMID: 25683002 DOI: 10.1111/jdv.13007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Oliveira
- Department of Dermatology, Hospital de Curry Cabral - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - E Arzberger
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Zalaudek I, Nowotny T, Kittler H, Hofmann-Wellenhof R, Massone C. The Brown and Black rule: a simple clue to differentiate common naevi from spitzoid neoplasms with a dermoscopic uniform globular (clod) pattern. J Eur Acad Dermatol Venereol 2015; 30:875-6. [DOI: 10.1111/jdv.13041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I. Zalaudek
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - T. Nowotny
- Medtronic - Neuromodulation; Vienna Austria
| | - H. Kittler
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - C. Massone
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
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29
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Boone M, Marneffe A, Suppa M, Miyamoto M, Alarcon I, Hofmann-Wellenhof R, Malvehy J, Pellacani G, Del Marmol V. High-definition optical coherence tomography algorithm for the discrimination of actinic keratosis from normal skin and from squamous cell carcinoma. J Eur Acad Dermatol Venereol 2015; 29:1606-15. [DOI: 10.1111/jdv.12954] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 12/05/2014] [Indexed: 01/22/2023]
Affiliation(s)
- M.A.L.M. Boone
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme; Brussels Belgium
| | - A. Marneffe
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme; Brussels Belgium
| | - M. Suppa
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme; Brussels Belgium
| | - M. Miyamoto
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme; Brussels Belgium
| | - I. Alarcon
- Department of Dermatology; University of Barcelona; Barcelona Spain
| | | | - J. Malvehy
- Department of Dermatology; University of Barcelona; Barcelona Spain
| | - G. Pellacani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - V. Del Marmol
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme; Brussels Belgium
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30
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Moscarella E, Al Jalbout S, Piana S, Argenziano G, Lallas A, Longo C, Hofmann-Wellenhof R, Zalaudek I. The stars within the melanocytic garden: unusual variants of Spitz naevi. Br J Dermatol 2015; 172:1045-51. [DOI: 10.1111/bjd.13347] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 11/28/2022]
Affiliation(s)
- E. Moscarella
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - S. Al Jalbout
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - S. Piana
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - G. Argenziano
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - A. Lallas
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - C. Longo
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venereology; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venereology; Medical University of Graz; Graz Austria
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31
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Zalaudek I, Schmid K, Niederkorn A, Fink-Puches R, Richtig E, Wolf I, Hofmann-Wellenhof R. Proposal for a clinical-dermoscopic classification of scalp naevi. Br J Dermatol 2015; 170:1065-72. [PMID: 24641327 DOI: 10.1111/bjd.12722] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2013] [Indexed: 01/05/2023]
Abstract
BACKGROUND Recent research suggests that scalp naevi differ with respect to their epidemiology, patient characteristics and morphological patterns, but currently a classification of scalp naevi is lacking. OBJECTIVES To investigate the prevalence, together with clinical and dermoscopic features, of scalp naevi detected in persons attending a skin cancer screening programme, and to elaborate a classification of scalp naevi based on their most common morphological patterns. METHODS Participants were recruited during the melanoma prevention programme 'sun watch' of Austrian Cancer Aid in Styria. Each participant received a clinical and dermoscopic total-body skin examination including the scalp. For each participant, demographics and clinical characteristics including number of scalp naevi were recorded. Clinical and dermoscopic photographs of at least one scalp naevus per participant were taken and evaluated for specific clinical and dermoscopic features. RESULTS In total 867 subjects, including 119 participants (13·7%) with scalp naevi, participated in the study. Compared with those without scalp naevi, subjects with scalp naevi were significantly younger, were more often men and more often exhibited congenital naevi on the body (P < 0·01 for all). Analysis of the clinical and dermoscopic variability of scalp naevi allowed for a proposal to classify scalp naevi into six main groups, namely common, papillomatous, eclipse, congenital, blue and atypical naevus. CONCLUSIONS Scalp naevi can be classified into six morphological groups; scalp lesions deviating from these six main patterns should be carefully managed to rule out melanoma.
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Affiliation(s)
- I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria; Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
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Richtig E, Arzberger E, Hofmann-Wellenhof R, Fink-Puches R. Assessment of changes in lentigo maligna during radiotherapy by in-vivo reflectance confocal microscopy: a pilot study. Br J Dermatol 2014; 172:81-7. [PMID: 24889911 DOI: 10.1111/bjd.13141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Radiotherapy is an effective treatment for therapy of lentigo maligna (LM). OBJECTIVES To investigate the usefulness of in-vivo reflectance confocal microscopy (RCM) in radiotherapy of LM and document the changes within the lesions during treatment. METHODS A total of six lesions in six patients were investigated by RCM before, during and after radiotherapy. For diagnostic assessment three observers with experience in RCM diagnosis, blinded as to the stage of treatment, assessed the RCM images of each lesion and documented the findings by consensus. RESULTS Epidermal disarray worsened in three patients during radiotherapy and superficial necrosis was observed in four patients. Large pagetoid round/dendritic cells decreased or even vanished during or after radiotherapy. Dilated vessels and apoptotic cells were seen in all patients during radiotherapy as well as an increase of inflammatory cells in the epidermis and dermis in most of the patients. Dendritic cells with small dendrites were observed during radiotherapy in all patients with an increase in number in three patients. Melanophages appeared in five patients at least once during the examination period. All RCM images were assessed correctly by the three observers. CONCLUSIONS Reflectance confocal microscopy is a useful method to visualize changes during and after radiotherapy and might also be used for early detection of potential treatment failures. In addition, it might be helpful in planning radiotherapy.
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Affiliation(s)
- E Richtig
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria
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33
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Moscarella E, Kyrgidis A, Sperduti I, Abramavicus A, Argenziano G, Cota C, Eibenschutz L, De Simone P, Longo C, Hofmann-Wellenhof R, Zalaudek I. Age-related prevalence and morphological appearance of facial skin tumours: a prospective, cross-sectional, observational, multicentre study with special emphasis on melanocytic tumours. J Eur Acad Dermatol Venereol 2014; 29:1331-8. [DOI: 10.1111/jdv.12844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- E. Moscarella
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - A. Kyrgidis
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - I. Sperduti
- Biostatistical Unit; Regina Elena National Cancer Institute; Rome Italy
| | - A. Abramavicus
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - G. Argenziano
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - C. Cota
- Dermatopathology Unit; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - L. Eibenschutz
- Oncologic Dermatology; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - P. De Simone
- Oncologic Dermatology; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - C. Longo
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
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34
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Malvehy J, Hauschild A, Curiel-Lewandrowski C, Mohr P, Hofmann-Wellenhof R, Motley R, Berking C, Grossman D, Paoli J, Loquai C, Olah J, Reinhold U, Wenger H, Dirschka T, Davis S, Henderson C, Rabinovitz H, Welzel J, Schadendorf D, Birgersson U. Clinical performance of the Nevisense system in cutaneous melanoma detection: an international, multicentre, prospective and blinded clinical trial on efficacy and safety. Br J Dermatol 2014; 171:1099-107. [PMID: 24841846 PMCID: PMC4257502 DOI: 10.1111/bjd.13121] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Even though progress has been made, the detection of melanoma still poses a challenge. In light of this situation, the Nevisense electrical impedance spectroscopy (EIS) system (SciBase AB, Stockholm, Sweden) was designed and shown to have the potential to be used as an adjunct diagnostic tool for melanoma detection. OBJECTIVES To assess the effectiveness and safety of the Nevisense system in the distinction of benign lesions of the skin from melanoma with electrical impedance spectroscopy. METHODS This multicentre, prospective, and blinded clinical study was conducted at five American and 17 European investigational sites. All eligible skin lesions in the study were examined with the EIS-based Nevisense system, photographed, removed by excisional biopsy and subjected to histopathological evaluation. A postprocedure clinical follow-up was conducted at 7 ± 3 days from the initial measurement. A total of 1951 patients with 2416 lesions were enrolled into the study; 1943 lesions were eligible and evaluable for the primary efficacy end point, including 265 melanomas - 112 in situ and 153 invasive melanomas with a median Breslow thickness of 0·57 mm [48 basal cell carcinomas (BCCs) and seven squamous cell carcinomas (SCCs)]. RESULTS The observed sensitivity of Nevisense was 96·6% (256 of 265 melanomas) with an exact one-sided 95% lower confidence bound estimated at 94·2% and an observed specificity of 34·4%, and an exact two-sided 95% confidence bound estimated at 32·0-36·9%. The positive and negative predictive values of Nevisense were 21·1% and 98·2%, respectively. The observed sensitivity for nonmelanoma skin cancer was 100% (55 of 48 BCCs and seven SCCs) with an exact two-sided 95% confidence bound estimated at 93·5-100·0%. CONCLUSIONS Nevisense is an accurate and safe device to support clinicians in the detection of cutaneous melanoma.
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Affiliation(s)
- J Malvehy
- Department of Dermatology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
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Frühauf J, Kröck S, Quehenberger F, Kopera D, Fink-Puches R, Komericki P, Pucher S, Arzberger E, Hofmann-Wellenhof R. Mobile teledermatology helping patients control high-need acne: a randomized controlled trial. J Eur Acad Dermatol Venereol 2014; 29:919-24. [PMID: 25258175 DOI: 10.1111/jdv.12723] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 07/28/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acne is an important health issue with a major psychological impact in addition to the physical problems it causes. OBJECTIVES To investigate the superiority of mobile teledermatology in the care of patients with high-need facial acne in comparison to outpatient services with particular attention to treatment efficacy, safety, and patient compliance. Further, patient satisfaction with remote care was evaluated. METHODS Sixty-nine consecutive patients (f: 25, m: 44, median age: 19 years, range: 13-37 years) were randomly allocated to either the teleconsultation (TCA) or the outpatient consultation (OCA) arm of the trial to receive isotretinoin treatment in weight and severity-dependent dosages over 24 weeks. Acne grading was performed by one examiner using the Global Acne Severity Scale (GEA) and the total lesion counting (TLC). RESULTS Due to noncompliance issues, 17 of 69 (24.6%) patients were excluded from the study, of who 10 had been assigned to the TCA (10/34; 29.4%) and 7 to the OCA (7/35; 20%). Both, in the TCA (GEA-score: ∆ = 2.25; TLC: ∆ = 89.08) and in the OCA (GEA-score: ∆ = 2.0; TLC: ∆ = 91.21) excellent and almost equivalent therapeutic outcomes were achieved. In the TCA, however, less patients experienced adverse reactions (P = 0.55). Even though additional live supervision would have been appreciated in some teledermatology cases, patients were satisfied with the mobile service and no consultation request was created. CONCLUSION Mobile teledermatology is an efficient, safe and well-accepted tool among patients with high-need acne constituting at least a valuable adjunct to outpatient care services. Further larger studies would be useful to confirm our findings.
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Affiliation(s)
- J Frühauf
- JF Private Dermatology Practice, Maria Enzersdorf, Lower Austria, Austria; Department of Dermatology, Medical University of Graz, Graz, Austria
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Blum A, Thunemann D, Hofmann-Wellenhof R. [Comedo or basal cell carcinoma?]. Hautarzt 2014; 65:835-7. [PMID: 25115982 DOI: 10.1007/s00105-014-2828-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A Blum
- Hautarztpraxis Konstanz, Seestr. 3a, 78464, Konstanz, Deutschland,
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37
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Woltsche N, Woltsche-Kahr I, Hofmann-Wellenhof R. [Skin-colored nodules on back of 47-year-old woman and breast of 56-year-old man: twins?]. Hautarzt 2014; 65:651-2. [PMID: 25005114 DOI: 10.1007/s00105-014-2816-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- N Woltsche
- Univ. Klinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
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38
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Massone C, Noll P, Hofmann-Wellenhof R. Multiple, bilateral periorbital blue macules. Clin Exp Dermatol 2014; 39:423-4. [PMID: 24635095 DOI: 10.1111/ced.12284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2013] [Indexed: 11/27/2022]
Affiliation(s)
- C Massone
- Department of Dermatology, Medical University of Graz, Graz, Austria
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39
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Richtig G, Richtig E, Massone C, Hofmann-Wellenhof R. Analysis of clinical, dermoscopic and histopathological features of primary melanomas of patients with metastatic disease--a retrospective study at the Department of Dermatology, Medical University of Graz, 2000-2010. J Eur Acad Dermatol Venereol 2014; 28:1776-81. [PMID: 24576192 DOI: 10.1111/jdv.12413] [Citation(s) in RCA: 8] [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: 11/23/2013] [Accepted: 01/25/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Incidence rates of malignant melanoma have been increasing worldwide and metastatic melanoma is still a significant problem despite widespread prevention programmes. OBJECTIVES We made a systemic review of all metastasized melanoma patients treated at the Department of Dermatology, Medical University of Graz in the years 2000-2010 and looked at the kind of melanoma type, e.g. if it has been slowly growing superficial spreading melanoma (SSM) or fast growing nodular melanoma (NM). METHODS Histological slides and clinical images of patients treated at our department between 2000 and 2010, who received chemotherapy because of proven metastatic disease were analysed with regard to growth type of their primary tumours. RESULTS A total of 88 patients met the inclusion criteria. Mean age of all patients was 57 years (median 59 years, SD ± 15 years). Of these 88 patients 51 patients (58%) (28 male patients and 23 female patients) had SSM; mean age 58 years (median 58 years, SD ± 14 years) and 37 patients (42%) (18 male patients and 19 female patients) had NM; mean age 56 years (median 61 years, SD ± 17 years). Mean Breslow thickness in the SSM group was 2.26 mm (median: 1.6 mm, SD ± 2.11 mm). In the NM group, mean Breslow thickness was 4.59 mm (median: 3.50 mm, SD ± 4.07 mm). When separated by gender, 46 melanomas were seen in the male group (28 SSM and 18 NM) and 42 melanomas in the female group (23 SSM and 19 NM). CONCLUSIONS Our results showed that more than half of the patients with metastatic disease had SSMs and not, as suspected, NMs. As SSMs are growing over a longer period to become invasive and potentially metastatic, there might be a chance to focus primary and secondary prevention programmes not only on fast growing tumours but also on slowly changes of tumours.
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Affiliation(s)
- G Richtig
- Department of Dermatology, Medical University of Graz, Graz, Austria
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40
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Massone C, Maak D, Hofmann-Wellenhof R, Soyer H, Frühauf J. Teledermatology for skin cancer prevention: an experience on 690 Austrian patients. J Eur Acad Dermatol Venereol 2013; 28:1103-8. [DOI: 10.1111/jdv.12351] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- C. Massone
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - D. Maak
- Department of Dermatology; Medical University of Graz; Graz Austria
| | | | - H.P. Soyer
- Dermatology Research Centre; The University of Queensland; School of Medicine; Princess Alexandra Hospital; Brisbane Qld Australia
| | - J. Frühauf
- Department of Dermatology; Medical University of Graz; Graz Austria
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Koller S, Inzinger M, Rothmund M, Ahlgrimm-Siess V, Massone C, Arzberger E, Wolf P, Hofmann-Wellenhof R. UV-induced alterations of the skin evaluated over time by reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2013; 28:1061-8. [DOI: 10.1111/jdv.12284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/16/2013] [Indexed: 11/26/2022]
Affiliation(s)
- S. Koller
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - M. Inzinger
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - M. Rothmund
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - V. Ahlgrimm-Siess
- Department of Dermatology; Paracelsus Medical University of Salzburg; Salzburg Austria
| | - C. Massone
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - E. Arzberger
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - P. Wolf
- Department of Dermatology; Medical University of Graz; Graz Austria
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42
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Blum A, Kittler H, Zalaudek I, Simionescu O, Marghoob AA, Hofmann-Wellenhof R, Argenziano G, Soyer HP. [Unclear clinical change on the glans penis leads to different dermoscopic diagnoses]. Hautarzt 2013; 64:768-9. [PMID: 24071999 DOI: 10.1007/s00105-013-2664-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- A Blum
- Hautarztpraxis Konstanz, Seestr. 3a, 78464, Konstanz, Deutschland,
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43
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Di Stefani A, Massone C, Soyer H, Zalaudek I, Argenziano G, Arzberger E, Lozzi G, Chimenti S, Hofmann-Wellenhof R. Benign dermoscopic features in melanoma. J Eur Acad Dermatol Venereol 2013; 28:799-804. [DOI: 10.1111/jdv.12192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 05/06/2013] [Indexed: 11/27/2022]
Affiliation(s)
- A. Di Stefani
- Department of Dermatology; University of Rome Tor Vergata; Rome Italy
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - C. Massone
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - H.P. Soyer
- Dermatology Research Centre, The University of Queensland; School of Medicine, Translational Research Institute; Brisbane Australia
| | - I. Zalaudek
- Department of Dermatology; Medical University of Graz; Graz Austria
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - G. Argenziano
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - E. Arzberger
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - G.P. Lozzi
- Department of Dermatology; Medical University of Graz; Graz Austria
- Dermatology Service; University of Rome “Foro Italico” and Villa Stuart; Rome Italy
| | - S. Chimenti
- Department of Dermatology; University of Rome Tor Vergata; Rome Italy
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44
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Suppa M, Argenziano G, Moscarella E, Hofmann-Wellenhof R, Thomas L, Catricalà C, Gutiérrez-González E, Fargnoli M, Peris K, Zalaudek I. Selective sunscreen application on nevi: frequency and determinants of a wrong sun-protective behaviour. J Eur Acad Dermatol Venereol 2013; 28:348-54. [DOI: 10.1111/jdv.12108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 01/10/2013] [Indexed: 10/27/2022]
Affiliation(s)
- M. Suppa
- Department of Dermatology; University of L'Aquila; L'Aquila Italy
| | - G. Argenziano
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova - IRCCS; Reggio Emilia Italy
| | - E. Moscarella
- Dermatology and Skin Cancer Unit; Arcispedale Santa Maria Nuova - IRCCS; Reggio Emilia Italy
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | | | - L. Thomas
- Department of Dermatology; Centre Hospitalier Lyon Sud; Université Claude Bernard Lyon 1; Lyon France
| | - C. Catricalà
- Department of Oncologic Dermatology; San Gallicano Dermatological Institute; Rome Italy
| | | | - M.C. Fargnoli
- Department of Dermatology; University of L'Aquila; L'Aquila Italy
| | - K. Peris
- Department of Dermatology; University of L'Aquila; L'Aquila Italy
| | - I. Zalaudek
- Department of Dermatology; University of Graz; Graz Austria
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45
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Moscarella E, Zalaudek I, Cerroni L, Sperduti I, Catricalà C, Smolle J, Hofmann-Wellenhof R, Sgambato A, Pellacani G, Argenziano G. Excised melanocytic lesions in children and adolescents - a 10-year survey. Br J Dermatol 2012; 167:368-73. [PMID: 22428965 DOI: 10.1111/j.1365-2133.2012.10952.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early recognition and prompt excision is to date the only available strategy for reducing mortality from melanoma. Little is known about the accuracy of melanoma detection in children and adolescents. OBJECTIVES To assess the accuracy of melanoma detection in a paediatric population. METHODS From the Department of Dermatology, Medical University of Graz, Austria, we reviewed the dermatopathology reports of naevi and melanomas excised in patients younger than 20 years over a 10-year period (1998-2007). Patients were subdivided into four age groups: 0-4, 5-9, 10-14 and 15-19 years. RESULTS Accuracy in melanoma detection was tested using the number needed to excise (NNE) value that is obtained by dividing the total number of excised lesions by the number of melanomas. A total of 22564 lesions were reviewed, disclosing 22526 naevi and 38 melanomas, for an overall NNE value of 593.8. Five melanomas were excised in children aged 10-14 years (NNE 1141) and 33 in children aged 15-19 years (NNE 479.8), whereas no melanomas were found among 1026 lesions excised in children younger than 10 years. In children aged 0-4 years, congenital and Spitz/Reed naevi accounted for 34.5% and 20% of lesions, respectively. These percentages decreased progressively when moving to older age groups (P<0.0001). In contrast, the percentage of dermal and compound naevi rose in direct proportion with age, being 3.4% and 20.7%, respectively, in the youngest age group, and 36.7% and 31.9%, respectively, among the oldest patients (P<0.0001). CONCLUSIONS The overall NNE value in paediatric patients over the 10-year study period was 593.8, meaning that about 594 lesions were excised to find one melanoma. This value is 20 times higher than the rates found in adult patients.
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Affiliation(s)
- E Moscarella
- Department of Oncological Dermatology, Santa Maria and San Gallicano Dermatologic Institute, Rome, Italy
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46
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Luttrell MJ, McClenahan P, Hofmann-Wellenhof R, Fink-Puches R, Soyer HP. Laypersons’ sensitivity for melanoma identification is higher with dermoscopy images than clinical photographs. Br J Dermatol 2012; 167:1037-41. [PMID: 22762457 DOI: 10.1111/j.1365-2133.2012.11130.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- M J Luttrell
- Dermatology Research Centre, The University of Queensland, School of Medicine, Princess Alexandra Hospital, Brisbane, Australia
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47
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Rubegni P, Cevenini G, Nami N, Argenziano G, Saida T, Burroni M, Quaglino P, Bono R, Hofmann-Wellenhof R, Fimiani M. A simple scoring system for the diagnosis of palmo-plantar pigmented skin lesions by digital dermoscopy analysis. J Eur Acad Dermatol Venereol 2012; 27:e312-9. [PMID: 22817393 DOI: 10.1111/j.1468-3083.2012.04651.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many research groups have recently developed equipments and statistical methods enabling pattern classification of pigmented skin lesions. To differentiate between benign and malignant ones, the mathematical extraction of digital patterns together with the use of appropriate statistical approaches is a challenging task. OBJECTIVE To design a simple scoring model that provides accurate classification of benign and malignant palmo-plantar pigmented skin lesions, by evaluation of parameters obtained by digital dermoscopy analysis (DDA). PATIENTS AND METHODS In the present study we used a digital dermoscopy analyser to evaluate a series of 445 palmo-plantar melanocytic skin lesion images (25 melanomas 420 nevi). Area under the receiver operator curve, sensitivity and specificity were calculated to evaluate the diagnostic performance of our scoring model for the differentiation of benign and malignant palmo-plantar melanocytic lesions. RESULTS Model performance reached a very high value (0.983). The DDA parameters selected by the model that proved statistically significant were: area, peripheral dark regions, total imbalance of colours, entropy, dark area and red and blue multicomponent. When all seven model variables were used in a multivariate mode, setting sensitivity at 100% to avoid false negatives, we estimated a minimum specificity of about 80%. CONCLUSIONS Simplicity of use and effectiveness of implementation are important requirements for the success of quantitative methods in routine clinical practice. Scoring systems meet these requirements. Their outcomes are accessible in real time without the use of any data processing system, thus allowing decisions to be made quickly and effectively.
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Affiliation(s)
- P Rubegni
- Department of Clinical Medicine and Immunological Sciences; Dermatology Section, University of Siena, Siena, Italy Department of Surgery and Bioengineering, University of Siena, Siena, Italy Dermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division, University of Turin, Italy Department of Immuno-oncodermatology, Istituto Dermopatico dell'Immacolata, Rome, Italy Department of Dermatology, Medical University Graz, Graz, Austria
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48
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Braun RP, Gutkowicz-Krusin D, Rabinovitz H, Cognetta A, Hofmann-Wellenhof R, Ahlgrimm-Siess V, Polsky D, Oliviero M, Kolm I, Googe P, King R, Prieto VG, French L, Marghoob A, Mihm M. Agreement of dermatopathologists in the evaluation of clinically difficult melanocytic lesions: how golden is the 'gold standard'? Dermatology 2012; 224:51-8. [PMID: 22433231 DOI: 10.1159/000336886] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 01/23/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The 'gold standard' for the diagnosis of melanocytic lesions is dermatopathology. Although most of the diagnostic criteria are clearly defined, the interpretation of histopathology slides may be subject to interobserver variability. OBJECTIVES The aim of this study was to determine the variability among dermatopathologists in the interpretation of clinically difficult melanocytic lesions. METHODS This study used the database of MelaFind®, a computer-vision system for the diagnosis of melanoma. All lesions were surgically removed and sent for independent evaluation by four dermatopathologists. Agreement was calculated using kappa statistics. RESULTS A total of 1,249 pigmented melanocytic lesions were included. There was a substantial agreement among expert dermatopathologists: two-category kappa was 0.80 (melanoma vs. non-melanoma) and three-category kappa was 0.62 (malignant vs. borderline vs. benign melanocytic lesions). The agreement was significantly greater for patients ≥40 years (three-category kappa = 0.67) than for younger patients (kappa = 0.49). In addition, the agreement was significantly lower for patients with atypical mole syndrome (AMS) (kappa = 0.31) than for patients without AMS (kappa = 0.76). LIMITATIONS The data were limited by the inclusion/exclusion criteria of the MelaFind® study. This might represent a selection bias. The agreement was evaluated using kappa statistics. This is a standard method for evaluating agreement among pathologists, but might be considered controversial by some statisticians. CONCLUSIONS Expert dermatopathologists have a high level of agreement when diagnosing clinically difficult melanocytic lesions. However, even among expert dermatopathologists, the current 'gold standard' is not perfect. Our results indicate that lesions from younger patients and patients with AMS may be more problematic for the dermatopathologists, suggesting that improved diagnostic criteria are needed for such patients.
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Affiliation(s)
- R P Braun
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland.
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49
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Kainz JT, Hofmann-Wellenhof R. [Trivial injury to the sole of the foot]. Hautarzt 2011; 62:943-6. [PMID: 22160227 DOI: 10.1007/s00105-011-2272-0] [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: 10/14/2022]
Abstract
A 67-year-old male patient noticed a foreign body sensation following a trivial trauma to the sole of the left foot approximately 4 months before presentation. The existing skin alteration had been self-treated with pumice stone and an unidentifiable wart tincture. The examination revealed an approximately 2 cm in diameter macula on the left heel with a zonal construction. The periphery was formed by a polycyclic dark brown ring which enclosed a reddish skin colored macula with several minute erosions. Dermatoscopy revealed an unspecific pattern with polymorphic vessels in the center. The peripheral ring showed radially running streaks as well as a parallel track-like pattern in one region. Histology revealed this to be an acral melanoma. A melanoma should always be included in the differential diagnostic considerations of atypical acral lesions. A biopsy should always be carried by unclear clinical and light microscopical findings out to enable a final diagnosis.
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Affiliation(s)
- J T Kainz
- Hautarztpraxis Dr. Kainz, Leibnitz, Österreich
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50
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Nami N, Rubegni P, Massone C, Fimiani M, Hofmann-Wellenhof R. New trends in dermoscopy. GIORN ITAL DERMAT V 2011; 146:333-339. [PMID: 21956270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The dermatologists, in their educational training, learn to observe, recognize and classify lesions in order to obtain those stereotypes that allow them to make the diagnosis. For this reason, they have not felt the need to develop means to flank examination. For some years, however, this sort of prejudice is disappearing and also dermatology has begun to make use of semiotics instrumental. Among the most tried and tested equipment in clinical practice, worth remembering the dermoscopy and digital dermoscopic analysis. The recent availability of digital cameras and phones equipped with the latest generation of optical systems capable of capturing images of pigmented lesions in epiluminescence, has further expanded the range of tools at our disposal.
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Affiliation(s)
- N Nami
- Department of Clinical Medicine and Immunological Science, University of Siena, Siena, Italy.
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