1
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Alexandris D, Bobos M, Lallas A, Lazaridou E, Apalla Z. Clinical, dermatoscopic and histopathologic characteristics of tumoural melanosis: A case-series and literature review. J Eur Acad Dermatol Venereol 2024; 38:e428-e433. [PMID: 38059544 DOI: 10.1111/jdv.19657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023]
Affiliation(s)
- D Alexandris
- Department of Oncology, Evaggelismos General Hospital, Athens, Greece
| | - M Bobos
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - A Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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2
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Salijuma E, Maskalane J, Lallas K, Papageorgiou C, Gkentsidi T, Manoli SM, Eftychidou P, Sakellaropoulou S, Nikolaidou C, Vakirlis E, Sotiriou E, Apalla Z, Lallas A. Poor correlation between diameter and Breslow thickness of melanoma. J Eur Acad Dermatol Venereol 2024; 38:e56-e58. [PMID: 37595962 DOI: 10.1111/jdv.19431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/11/2023] [Indexed: 08/20/2023]
Affiliation(s)
- E Salijuma
- Dermatology Clinic: Prof. J. Kisis & Asst. Prof. Rone-Kupfere, Riga, Latvia
| | - J Maskalane
- Dr. Maurins Laser Medical Clinic, Riga, Latvia
| | - K Lallas
- Department of Medical Oncology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - C Papageorgiou
- Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - T Gkentsidi
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - S M Manoli
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - P Eftychidou
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - S Sakellaropoulou
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - C Nikolaidou
- Department of Histopathology, Ippokrateio General Hospital, Thessaloniki, Greece
| | - E Vakirlis
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - E Sotiriou
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Z Apalla
- Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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Dixon A, Steinman HK, Kyrgidis A, Smith H, Sladden M, Zouboulis C, Argenziano G, Apalla Z, Lallas A, Longo C, Nirenberg A, Popescu C, Tzellos T, Cleaver L, Zachary C, Anderson S, Thomas JM. Online prediction tools for melanoma survival: A comparison. J Eur Acad Dermatol Venereol 2023; 37:1999-2003. [PMID: 37210649 DOI: 10.1111/jdv.19219] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Breslow thickness, patient age and ulceration are the three most valuable clinical and pathological predictors of melanoma survival. A readily available reliable online tool that accurately considers these and other predictors could be valuable for clinicians managing melanoma patients. OBJECTIVE To compare online melanoma survival prediction tools that request user input on clinical and pathological features. METHODS Search engines were used to identify available predictive nomograms. For each, clinical and pathological predictors were compared. RESULTS Three tools were identified. The American Joint Committee on Cancer tool inappropriately rated thin tumours as higher risk than intermediate tumours. The University of Louisville tool was found to have six shortcomings: a requirement for sentinel node biopsy, unavailable input of thin melanoma or patients over 70 years of age and less reliable hazard ratio calculations for age, ulceration and tumour thickness. The LifeMath.net tool was found to appropriately consider tumour thickness, ulceration, age, sex, site and tumour subtype in predicting survival. LIMITATIONS The authors did not have access to the base data used to compile various prediction tools. CONCLUSION The LifeMath.net prediction tool is the most reliable for clinicians in counselling patients with newly diagnosed primary cutaneous melanoma regarding their survival prospects.
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Affiliation(s)
- A Dixon
- Australasian College of Cutaneous Oncology, Victoria, Melbourne, Australia
| | - H K Steinman
- Campbell University, Buies Creek, North Carolina, USA
| | - A Kyrgidis
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - H Smith
- Oxford Dermatology, Western Australia, Perth, Australia
| | - M Sladden
- University of Tasmania, Tasmania, Launceston, Australia
| | - C Zouboulis
- Staedtisches Klinikum Dessau, Brandenburg Medical School, Dessau, Germany
| | - G Argenziano
- Dermatology, University of Campania, Naples, Italy
| | - Z Apalla
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Longo
- University of Modena and Reggio Emilia, Modena, Italy
- Azienda Unita Sanitaria Locale, IRCCS di Reggio Emilia, Skin Cancer Center, Regio Emilia, Italy
| | - A Nirenberg
- Australasian College of Cutaneous Oncology, Victoria, Melbourne, Australia
| | - C Popescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - T Tzellos
- Arctic University of Norway, Tromsø, Norway
| | - L Cleaver
- AT Still University, Missouri, Kirksville, USA
| | - C Zachary
- University of California Irvine, California, Irvine, USA
| | - S Anderson
- Australasian College of Cutaneous Oncology, Victoria, Melbourne, Australia
| | - J M Thomas
- Formerly of Royal Marsden Hospital, Chelsea, London, UK
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4
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Dixon AJ, Steinman HK, Kyrgidis A, Smith H, Sladden M, Zouboulis C, Argenziano G, Apalla Z, Lallas A, Longo C, Nirenberg A, Popescu C, Dixon JB, Tzellos T, Zachary C, Cleaver L, Anderson S, Zagarella S, Thomas JM. Improved methodology in determining melanoma mortality and selecting patients for immunotherapy. J Eur Acad Dermatol Venereol 2023. [PMID: 36785984 DOI: 10.1111/jdv.18951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/08/2023] [Indexed: 02/15/2023]
Affiliation(s)
- A J Dixon
- Australasian College of Cutaneous Oncology, Melbourne, Victoria, Australia
| | - H K Steinman
- Campbell University, Buies Creek, North Carolina, USA
| | - A Kyrgidis
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - H Smith
- Oxford Dermatology, Perth, Western Australia, Australia
| | - M Sladden
- University of Tasmania, Launceston, Tasmania, Australia
| | - C Zouboulis
- Dessau Medical Center, Brandenburg Medical School, Dessau, Germany
| | | | - Z Apalla
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Longo
- University of Modena and Reggio Emilia, Modena, Italy
| | - A Nirenberg
- Australasian College of Cutaneous Oncology, Melbourne, Victoria, Australia
| | - C Popescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - J B Dixon
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - T Tzellos
- Arctic University of Norway, Tromsø, Norway
| | - C Zachary
- University of California, Irvine, California, USA
| | - L Cleaver
- A.T. Still University, Kirksville, Missouri, USA
| | - S Anderson
- Australasian College of Cutaneous Oncology, Melbourne, Victoria, Australia
| | - S Zagarella
- University of Sydney, Sydney, New South Wales, Australia
| | - J M Thomas
- Formerly of Royal Marsden Hospital, London, UK
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5
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Ingen-Housz-Oro S, Milpied B, Badrignans M, Carrera C, Elshot YS, Bensaid B, Segura S, Apalla Z, Markova A, Staumont-Sallé D, Marti-Marti I, Giavedoni P, Chua SL, Darrigade AS, Dezoteux F, Starace M, Torre AC, Riganti J, de Prost N, Lebrun-Vignes B, Bauvin O, Walsh S, Ortonne N, French LE, Sibaud V. Severe blistering eruptions induced by immune checkpoint inhibitors: a multicentre international study of 32 cases. Melanoma Res 2022; 32:205-210. [PMID: 35377864 PMCID: PMC9377568 DOI: 10.1097/cmr.0000000000000819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Among dermatologic adverse events induced by immune checkpoint inhibitors (ICI), bullous life-threatening reactions are rare. To better define the clinical and histological features, treatment, and prognosis of ICI-related severe blistering cutaneous eruptions. This retrospective case series was conducted between 2014/05/15 and 2021/04/15 by the dermatology departments of four international registries involved in drug reactions. Inclusion criteria were age ≥18 years old, skin eruption with blisters with detachment covering ≥1% body surface area and at least one mucous membrane involved, available pictures, and ICI as suspect drug. Autoimmune bullous disorders were excluded. Each participant medical team gave his own diagnosis conclusion: epidermal necrolysis (EN), severe lichenoid dermatosis (LD), or unclassified dermatosis (UD). After a standardized review of pictures, cases were reclassified by four experts in EN or LD/UD. Skin biopsies were blindly reviewed. Thirty-two patients were included. Median time to onset was 52 days (3-420 days). Cases were originally diagnosed as EN in 21 cases and LD/UD in 11 cases. After review by experts, 10/21 EN were reclassified as LD/UD. The following manifestations were more frequent or severe in EN: fever, purpuric macules, blisters, ocular involvement, and maximal detachment. Most patients were treated with topical with or without systemic corticosteroids. Eight patients (25%) died in the acute phase. The culprit ICI was not resumed in 92% of cases. In three patients, another ICI was given with a good tolerance. Histology did not reveal significant differences between groups. Severe blistering cutaneous drug reactions induced by ICI are often overdiagnosed as EN. Consensus for management is pending.
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Affiliation(s)
- Saskia Ingen-Housz-Oro
- Dermatology department, AP-HP, Henri Mondor hospital, Créteil, France
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- Univ Paris est Créteil EpidermE, Créteil, France
- European Task Force “Dermatology for cancer patients” of EADV
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
| | - Brigitte Milpied
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- European Task Force “Dermatology for cancer patients” of EADV
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Dermatology department, CHU Bordeaux, Bordeaux, France
| | - Marine Badrignans
- Pathology department, AP-HP, Henri Mondor hospital, Créteil, France
- Université Paris Est Créteil Val de Marne UPEC, Créteil, France
| | - Cristina Carrera
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
- CIBERER Centro de investigaciones Biomedicas en Red de Enfermedades Raras Insituto de Salud Carlos III, Spain
- Pharmacovigilance Technical Committee Hospital Clinic Barcelona, Spain
| | - Yannick S. Elshot
- European Task Force “Dermatology for cancer patients” of EADV
- Department of Dermatology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Dermatology, Amsterdam UMC, Univ. of Amsterdam, The Netherlands
| | - Benoit Bensaid
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- Dermatology department, CHU Edouard Herriot, Lyon, France
| | - Sonia Segura
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Zoé Apalla
- European Task Force “Dermatology for cancer patients” of EADV
- Second Dermatology Department, Medical School, Aristotle University of Thessaloniki, Greece
| | - Alina Markova
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Dermatology, Weill Cornell Medical College, New York, NY, USA
| | - Delphine Staumont-Sallé
- FISARD group, Paris, France
- Dermatology Department, CHU Lille, University Lille, INFINITE U1286 Inserm, Lille, France
| | - Ignasi Marti-Marti
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Priscila Giavedoni
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Ser-Ling Chua
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Department of Dermatology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Anne-Sophie Darrigade
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- Dermatology department, CHU Bordeaux, Bordeaux, France
| | - Frédéric Dezoteux
- FISARD group, Paris, France
- Dermatology Department, CHU Lille, University Lille, INFINITE U1286 Inserm, Lille, France
| | - Michela Starace
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology -IRCCS Policlinico di Sant’Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Italy
| | - Ana Clara Torre
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Julia Riganti
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Nicolas de Prost
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- Intensive care unit, AP-HP, Henri Mondor hospital, Créteil, France
| | - Bénédicte Lebrun-Vignes
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Regional Pharmacovigilance Center, AP-HP, Pitié-Salpêtrière hospital, Paris, France
| | - Olivia Bauvin
- FISARD group, Paris, France
- Dermatology department, CHU Charles Nicolle, Rouen, France
| | - Sarah Walsh
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Department of Dermatology, King’s College Hospital, London, United Kingdom
| | - Nicolas Ortonne
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- Pathology department, AP-HP, Henri Mondor hospital, Créteil, France
- Université Paris Est Créteil Val de Marne UPEC, Créteil, France
| | - Lars E. French
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilan University (LMU) Munich, Munich, Germany
- Dr. Philip Frost, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Vincent Sibaud
- European Task Force “Dermatology for cancer patients” of EADV
- Department of Oncodermatology, Claudius Regaud Institute and University Cancer Institute Toulouse Oncopole, Toulouse, France
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6
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Spyridis I, Papageorgiou C, Apalla Z, Manoli SM, Eftychidoy P, Gkentsidi T, Bobos M, Boutis A, Vakirlis E, Sotiriou E, Ioannides D, Lallas A. The peculiar dermatoscopic pattern of scalp melanoma. J Eur Acad Dermatol Venereol 2022; 36:1564-1567. [DOI: 10.1111/jdv.18145] [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] [Received: 01/25/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 11/27/2022]
Affiliation(s)
- I Spyridis
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - C Papageorgiou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - Z Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - SM Manoli
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - P Eftychidoy
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - T Gkentsidi
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - M Bobos
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
- Department of Biomedical Science School of Health Sciences International Hellenic University, Alexandrian Campus Thessaloniki Greece
| | - A Boutis
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
- First Department of Medical Oncology, Theageneio Cancer Hospital Thessaloniki Greece
| | - E Vakirlis
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - E Sotiriou
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - D Ioannides
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - A Lallas
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
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7
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Apalla Z, Nikolaou V, Fattore D, Fabbrocini G, Freites-Martinez A, Sollena P, Lacouture M, Kraehenbuehl L, Stratigos A, Peris K, Lazaridou E, Richert B, Vigarios E, Riganti J, Baroudjian B, Filoni A, Dodiuk-Gad R, Lebbé C, Sibaud V. European recommendations for management of immune checkpoint inhibitors-derived dermatologic adverse events. The EADV task force 'Dermatology for cancer patients' position statement. J Eur Acad Dermatol Venereol 2021; 36:332-350. [PMID: 34910332 DOI: 10.1111/jdv.17855] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 12/14/2022]
Abstract
The introduction of immune checkpoint inhibitors (ICIs) opened a new era in oncologic therapy. The favourable profile of ICIs in terms of efficacy and safety can be overshadowed by the development of immune-related adverse events (irAEs). Dermatologic irAEs (dirAEs) appear in about 40% of patients undergoing immunotherapy and mainly include maculopapular, psoriasiform, lichenoid and eczematous rashes, auto-immune bullous disorders, pigmentary disorders, pruritus, oral mucosal lesions, hair and nail changes, as well as a few rare and potentially life-threatening toxicities. The EADV task force Dermatology for Cancer Patients merged the clinical experience of the so-far published data, incorporated the quantitative and qualitative characteristics of each specific dirAEs, and released dermatology-derived, phenotype-specific treatment recommendations for cutaneous toxicities (including levels of evidence and grades of recommendation). The basic principle of management is that the interventions should be tailored to serve the equilibrium between patients' relief from the symptoms and signs of skin toxicity and the preservation of an unimpeded oncologic treatment.
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Affiliation(s)
- Z Apalla
- Second Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Nikolaou
- First Department of Dermatology, "Andreas Sygros" Hospital for Skin Diseases, National and Kapodestrian University of Athens, Medical School, Athens, Greece
| | - D Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - A Freites-Martinez
- Servicio de Dermatología, Hospital Ruber Juan Bravo y Universidad Europea, Madrid, España
| | - P Sollena
- Dipartimento di Scienze Mediche e Chirurgiche, Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Lacouture
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - L Kraehenbuehl
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Parker Institute for Cancer Immunotherapy, Ludwig Collaborative and Swim Across America Laboratory, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - A Stratigos
- First Department of Dermatology, "Andreas Sygros" Hospital for Skin Diseases, National and Kapodestrian University of Athens, Medical School, Athens, Greece
| | - K Peris
- Dipartimento di Scienze Mediche e Chirurgiche, Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Lazaridou
- Second Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B Richert
- Department of Dermatology, Brugmann & Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - E Vigarios
- Department of Oral Medicine, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France
| | - J Riganti
- Hospital Italiano of Buenos Aires, Buenos Aires, Argentina
| | - B Baroudjian
- Dermatology Department, Saint Louis Hospital, Université de Paris, AP-HP, INSERM U976, Paris, France
| | - A Filoni
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - R Dodiuk-Gad
- Dermatology Department, Emek Medical Center, Afula, Israel
| | - C Lebbé
- Dermatology Department, Saint Louis Hospital, Université de Paris, AP-HP, INSERM U976, Paris, France
| | - V Sibaud
- Oncodermatology Department, Cancer University Institute, Toulouse Oncopole, Toulouse, France
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8
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Comont T, Dion J, Baroudjian B, Ezine E, Careira C, Anderle A, Apalla Z, Freites-Martinez A, Meyer N, Sibaud V. Sarcoïdose induite par les inhibiteurs de BRAF-MEK : série rétrospective européenne. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Lallas A, Martínez G, Arceu M, Kyrgidis A, Liopyris K, Brancaccio G, Longo C, Errichetti E, Sgouros D, Papageorgiou C, Fotiadou C, Siskou S, Manoli SM, Sotiriou E, Ioannides D, Katoulis A, Lazaridou E, Todorovska V, Argenziano G, Apalla Z. Clinical and dermatoscopic predictors of squamous cell carcinoma of the lips: a case-control, multicentric study. J Eur Acad Dermatol Venereol 2021; 36:222-227. [PMID: 34743367 DOI: 10.1111/jdv.17790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/29/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Squamous cell carcinoma of the lip accounts for 20% of all oral carcinomas. Its diagnosis may be challenging because it clinically resembles actinic cheilitis and inflammatory lesions of the lips. OBJECTIVES To determine clinical and dermatoscopic predictors of squamous cell carcinoma of the lip vs. other lip lesions. METHODS Multicentre retrospective morphological study, including histologically confirmed cases of squamous cell carcinoma of the lip and controls consisting of actinic cheilitis and inflammatory lesions of the lips. Clinical and dermatoscopic images were evaluated for the presence of predefined criteria. Crude and adjusted odds ratios and corresponding 95% confidence intervals were calculated by univariate and multivariate logistic regression respectively. RESULTS A total of 177 lip lesions were evaluated, 107 (60.5%) were squamous cell carcinomas and 70 (39.5%) were controls. The most frequent dermatoscopic criteria of lip squamous cell carcinoma were scales (100%), white halos (87.3%) and ulceration (79.4%). The majority of squamous cell carcinomas displayed polymorphic vessels (60.8%), with linear (68.6%) and hairpin (67.6%) being the most frequent types. Multivariate logistic regression analysis showed that clinical predictors of lip squamous cell carcinoma were exophytic appearance and clinical hyperkeratosis, with 43-fold and 6-fold higher probability respectively. White clods and ulceration in dermoscopy presented a 6-fold and 4-fold increased risk for squamous cell carcinoma respectively. CONCLUSIONS A scaly lesion with exophytic growth, dermatoscopically displaying white clods, ulceration and linear and hairpin vessels is very likely a squamous cell carcinoma of the lip.
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Affiliation(s)
- A Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Martínez
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - M Arceu
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece
| | - K Liopyris
- First Department of Dermatology, Andreas Syggros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - G Brancaccio
- Dermatology Department, University of Campania, Naples, Italy
| | - C Longo
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - D Sgouros
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - C Papageorgiou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Fotiadou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Siskou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S M Manoli
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sotiriou
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Katoulis
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - G Argenziano
- Dermatology Department, University of Campania, Naples, Italy
| | - Z Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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10
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Kyrmanidou E, Koletsa T, Sotiriou E, Ioannides D, Fotiadou C, Chatzopoulos S, Apalla Z, Hytiroglou P, Lazaridou E. Immunohistochemical evidence implicating plasmacytoid dendric cells in the early stages of AA and its clinical impact. J Eur Acad Dermatol Venereol 2021; 36:e104-e106. [PMID: 34487410 DOI: 10.1111/jdv.17643] [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] [Received: 12/14/2020] [Accepted: 08/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- E Kyrmanidou
- 2nd Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Koletsa
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sotiriou
- 1st Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- 1st Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Fotiadou
- 2nd Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Chatzopoulos
- School of Statistics and Insurance Science, University of Western Macedonia, Kozani, Greece
| | - Z Apalla
- 2nd Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P Hytiroglou
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- 2nd Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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11
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Lallas A, Moscarella E, Kittler H, Longo C, Thomas L, Zalaudek I, Kyrgidis A, Manoli SM, di Meo N, Papageorgiou C, Apalla Z, Argenziano G. Real-world experience of off-label use of imiquimod 5% as an adjuvant therapy after surgery or as a monotherapy for lentigo maligna. Br J Dermatol 2021; 185:675-677. [PMID: 33894006 DOI: 10.1111/bjd.20407] [Citation(s) in RCA: 12] [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: 02/09/2021] [Revised: 04/17/2021] [Accepted: 04/22/2021] [Indexed: 01/17/2023]
Affiliation(s)
- A Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,DERMOMEDICA Dermatology Unit, Thessaloniki, Greece
| | - E Moscarella
- Dermatology Unit, University of Campania, Naples, Italy
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unita Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - L Thomas
- Department of Dermatology, Hospital Lyon Sud, France.,Lyon 1 University, Lyon, France.,Lyons cancer research center INSERM U1052-CNRS UMR5286, France
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Italy
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, Greece
| | - S M Manoli
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,DERMOMEDICA Dermatology Unit, Thessaloniki, Greece
| | - N di Meo
- Department of Dermatology, University of Trieste, Italy
| | - C Papageorgiou
- DERMOMEDICA Dermatology Unit, Thessaloniki, Greece.,Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Z Apalla
- DERMOMEDICA Dermatology Unit, Thessaloniki, Greece.,Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
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12
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Siskou S, Lallas A, Theodoropoulos K, Sgouros D, Trakatelli M, Patsatsi A, Trigoni A, Manoli M, Papageorgiou C, Liopyris K, Katoulis A, Stratigos A, Ioannides D, Lazaridou E, Apalla Z. Diagnostic and management challenges of erosive pustular dermatosis of the scalp: a retrospective study in Greek population. J Eur Acad Dermatol Venereol 2021; 35:e776-e779. [PMID: 34143550 DOI: 10.1111/jdv.17455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S Siskou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - A Lallas
- Dermomedica, Dermatology Unit, Thessaloniki, Greece.,First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Theodoropoulos
- Second Dermatology Department, Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - D Sgouros
- Second Dermatology Department, Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - M Trakatelli
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Patsatsi
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Trigoni
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Manoli
- Dermomedica, Dermatology Unit, Thessaloniki, Greece.,First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Papageorgiou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Dermomedica, Dermatology Unit, Thessaloniki, Greece
| | - K Liopyris
- First Dermatology Department, Kapodistrian University of Athens, A. Syggros Hospital, Athens, Greece
| | - A Katoulis
- Second Dermatology Department, Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - A Stratigos
- First Dermatology Department, Kapodistrian University of Athens, A. Syggros Hospital, Athens, Greece
| | - D Ioannides
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Dermomedica, Dermatology Unit, Thessaloniki, Greece
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13
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Starace M, Iorizzo M, Mandel VD, Bruni F, Misciali C, Apalla Z, Silyuk T, Pellacani G, Patrizi A, Piraccini BM, Alessandrini A. Scalp dysaesthesia and lichen simplex chronicus: diagnostic and therapeutic update with literature review. Clin Exp Dermatol 2021; 47:3-8. [PMID: 34137059 PMCID: PMC9290567 DOI: 10.1111/ced.14808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/28/2022]
Abstract
Scalp dysaesthesia, considered a variant of the cutaneous dysaesthesia syndrome, is characterized by chronic sensory symptoms, including pruritus, pain, burning and stinging in a well‐defined location, without objective findings. Its aetiology is not well elucidated and treatment options are limited, thus it can be challenging and frustrating for both patient and physician. It can be associated with lichen simplex chronicus. In this paper, we review the literature on the pathogenetic factors, diagnostic methods and therapeutic options in the management of scalp dysaesthesia. Dissociation, cervical spine disease and muscle tension seem to be the most important pathogenetic factors. Trichoscopy, reflectance confocal microscopy and biopsy are all helpful for the diagnosis of the disease. Therapies include high‐potency topical or intralesional corticosteroids, capsaicin and topical anaesthetics, sedative antihistamines, tricyclic antidepressants, transcutaneous electric nerve stimulation, botulinum toxin and vitamin B12.
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Affiliation(s)
- M Starace
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - M Iorizzo
- Private Dermatology Practice, Lugano and Bellinzona, Switzerland
| | - V D Mandel
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - F Bruni
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - C Misciali
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - Z Apalla
- Dermatology Department, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - T Silyuk
- Private Dermatology Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russia
| | - G Pellacani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - A Patrizi
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - B M Piraccini
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - A Alessandrini
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
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14
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Lazaridou E, Fotiadou C, Apalla Z. Melanocytic lesions with peripheral globules: still a pitfall in the differential diagnosis of melanoma. J Eur Acad Dermatol Venereol 2021; 35:1040. [PMID: 33885195 DOI: 10.1111/jdv.17239] [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] [Received: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- E Lazaridou
- Second Department of Dermatology-Venereology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Fotiadou
- Second Department of Dermatology-Venereology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- Second Department of Dermatology-Venereology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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15
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Starace M, Mandel V, Francesca B, Alessandrini A, Misciali C, Apalla Z, Iorizzo M, Pellacani G, Silyuk T, Patrizi A, Piraccini B. Lichen simplex chronicus of the scalp: dermoscopy and reflectance confocal microscopy features. J Eur Acad Dermatol Venereol 2021; 35:e450-e452. [DOI: 10.1111/jdv.17206] [Citation(s) in RCA: 1] [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: 11/26/2020] [Revised: 02/02/2021] [Accepted: 02/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- M. Starace
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - V.D. Mandel
- Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
- Dermatology Unit Department of Clinical and Experimental Medicine University of Parma Parma Italy
| | - B. Francesca
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - A. Alessandrini
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - C. Misciali
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - Z. Apalla
- State Dermatology Department Hippokratio Hospital of Thessaloniki Thessaloniki Greece
| | - M. Iorizzo
- Private Dermatology Practice Lugano and Bellinzona Switzerland
| | - G. Pellacani
- Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - T. Silyuk
- Dermatology Private Practice Hair Treatment and Transplantation Center Saint Petersburg Russia
| | - A. Patrizi
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - B.M. Piraccini
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
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16
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Marghoob N, Liopyris K, Navarrete‐Dechent C, Dusza S, Balais G, Megaris A, Papageorgiou C, Apalla Z, Lallas A. ‘Inverse association between the total naevus count and melanoma thickness’. J Eur Acad Dermatol Venereol 2020; 34:2303-2307. [DOI: 10.1111/jdv.16367] [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] [Received: 10/31/2019] [Accepted: 02/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- N.G. Marghoob
- OMSIII New York Institute of Technology College of Osteopathic Medicine New York NY USA
- Department of Dermatology Mount Sinai New York NY USA
| | - K. Liopyris
- Dermatology Service Department of Medicine Memorial Sloan‐Kettering Cancer Center New York NY USA
- Department of Dermatology Andreas Sygros Hospital University of Athens Athens Greece
| | - C. Navarrete‐Dechent
- Dermatology Service Department of Medicine Memorial Sloan‐Kettering Cancer Center New York NY USA
- Department of Dermatology Escuela de Medicina Pontificia Universidad Católica de Chile Santiago Chile
| | - S.W. Dusza
- Dermatology Service Department of Medicine Memorial Sloan‐Kettering Cancer Center New York NY USA
| | - G. Balais
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | | | - C. Papageorgiou
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - Z. Apalla
- State Clinic of Dermatology Hospital for Skin and Venereal Diseases Thessaloniki Greece
| | - A. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
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17
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Sgouros D, Lallas A, Kittler H, Zarras A, Kyrgidis A, Papageorgiou C, Puig S, Scope A, Argenziano G, Zalaudek I, Pizzichetta MA, Marghoob A, Liopyris K, Malvehy J, Oikonomou C, Flórez A, Braun R, Cabo H, Nazzaro G, Lanssens S, Menzies S, Paoli J, Kaminska-Winciorek G, Longo C, Katoulis A, Apalla Z, Ioannides D, Thomas L, Tromme I, Ogata D, Desinioti C, Geller A, Stratigos A. Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2020; 34:2541-2547. [PMID: 32654237 DOI: 10.1111/jdv.16815] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Thin nodular melanoma (NM) often lacks conspicuous melanoma-specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour. OBJECTIVE To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours. METHODS Retrospective, morphological case-control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed. RESULTS Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non-melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4-fold), white shiny streaks (2.9-fold) and irregular blue structureless area (2.4-fold) were predictors for thinner NM compared to non-melanoma nodular tumours. Overall, irregular blue structureless area (3.4-fold), dotted vessels (4.6-fold) and serpentine vessels (1.9-fold) were predictors of all NM compared to non-melanoma nodular lesions. LIMITATIONS Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community. CONCLUSIONS Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non-melanoma nodular tumours.
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Affiliation(s)
- D Sgouros
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Lallas
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Zarras
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Kyrgidis
- Department of Clinical Pharmacology, Aristotle University, Thessaloniki, Greece
| | - C Papageorgiou
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salut de Carlos III, Barcelona, Spain
| | - A Scope
- Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Argenziano
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - M A Pizzichetta
- Department of Dermatology, University of Trieste, Trieste, Italy.,Division of Medical Oncology - Preventive Oncology, National Cancer Institute, Aviano, Italy
| | - A Marghoob
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, USA
| | - K Liopyris
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.,Memorial Sloan Kettering Cancer Center, Hauppauge, NY, USA
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salut de Carlos III, Barcelona, Spain
| | - C Oikonomou
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Flórez
- Department of Dermatology, Pontevedra University Hospital, Pontevedra, Spain
| | - R Braun
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - H Cabo
- Dermatology Institute of Medical Reserch, University of Buenos Aires, Buenos Aires, Argentina
| | - G Nazzaro
- Dermatology Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - S Lanssens
- Private practice Dermatology Maldegem, Maldegem, Belgium
| | - S Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - J Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G Kaminska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Skłodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Gliwice, Poland
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Katoulis
- 2nd Department of Dermatology-Venereology, "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Z Apalla
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - D Ioannides
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - L Thomas
- Department of Dermatology, Lyon University, Lyon, France
| | - I Tromme
- Department of Dermatology, King Albert II Institute, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - D Ogata
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - C Desinioti
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Geller
- Department of Social and Behavioral Sciences, Harvard TH School of Public Health, Boston, MA, USA
| | - A Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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18
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Lekkas D, Ioannides D, Lazaridou E, Lallas A, Apalla Z, Vakirlis E, Sotiriou E. Dermatoscopy in tinea capitis: can it provide clues for the responsible fungi? J Eur Acad Dermatol Venereol 2020; 35:e85-e87. [PMID: 32725704 DOI: 10.1111/jdv.16825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- D Lekkas
- 1st Dermatology Department, Aristotle University, Thessaloniki, Greece
| | - D Ioannides
- 1st Dermatology Department, Aristotle University, Thessaloniki, Greece
| | - E Lazaridou
- 2nd Dermatology Department, Aristotle University, Thessaloniki, Greece
| | - A Lallas
- 1st Dermatology Department, Aristotle University, Thessaloniki, Greece
| | - Z Apalla
- 2nd Dermatology Department, Aristotle University, Thessaloniki, Greece
| | - E Vakirlis
- 1st Dermatology Department, Aristotle University, Thessaloniki, Greece
| | - E Sotiriou
- 1st Dermatology Department, Aristotle University, Thessaloniki, Greece
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Lekkas D, Ioannides D, Lazaridou E, Lallas A, Apalla Z, Vakirlis E, Johr R, Errichetti E, Kyrgidis A, Sotiriou E. Dermatoscopy of tinea corporis. J Eur Acad Dermatol Venereol 2020; 34:e278-e280. [DOI: 10.1111/jdv.16277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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)
- D. Lekkas
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - D. Ioannides
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - E. Lazaridou
- 2nd Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Lallas
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - Z. Apalla
- State Clinic of Dermatology Hippokration General Hospital Thessaloniki Greece
| | - E. Vakirlis
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - R. Johr
- University of Miami Miller School of Medicine Miami FL USA
| | - E. Errichetti
- Institute of Dermatology “Santa Maria della Misericordia” University Hospital Udine Italy
| | - A. Kyrgidis
- Department of Clinical Pharmacology Aristotle University Thessaloniki Greece
| | - E. Sotiriou
- 1st Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
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Neagu N, Lallas K, Maskalane J, Salijuma E, Papageorgiou C, Gkentsidi T, Spyridis I, Morariu S, Apalla Z, Lallas A. Minimizing the dermatoscopic morphologic overlap between basal and squamous cell carcinoma: a retrospective analysis of initially misclassified tumours. J Eur Acad Dermatol Venereol 2020; 34:1999-2003. [DOI: 10.1111/jdv.16207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/31/2019] [Indexed: 01/05/2023]
Affiliation(s)
- N. Neagu
- State Clinic of Dermatology Mureș County Hospital Tîrgu Mureș Romania
| | - K. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - J. Maskalane
- Postgraduate Study Program in Dermatology, Venereology University of Latvia Riga Latvia
| | - E. Salijuma
- Postgraduate Study Program in Dermatology, Venereology RigaStradiņš University Riga Latvia
| | - C. Papageorgiou
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - T. Gkentsidi
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - I. Spyridis
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - S.‐H. Morariu
- State Clinic of Dermatology Mureș County Hospital Tîrgu Mureș Romania
| | - Z. Apalla
- State Clinic of Dermatology Hippokration Hospital Thessaloniki Greece
| | - A. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
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Errichetti E, Zalaudek I, Kittler H, Apalla Z, Argenziano G, Bakos R, Blum A, Braun R, 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 R, 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. 定义在非癌症皮肤疾病的皮肤镜检查研究中应使用的术语和参数. Br J Dermatol 2020. [DOI: 10.1111/bjd.18768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Errichetti E, Zalaudek I, Kittler H, Apalla Z, Argenziano G, Bakos R, Blum A, Braun R, 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 R, 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. Defining the terminology and parameters that should be used in studies into dermoscopy for non‐cancer skin diseases. Br J Dermatol 2020. [DOI: 10.1111/bjd.18753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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23
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Errichetti E, Lallas A, De Marchi G, Apalla Z, Zabotti A, De Vita S, Stinco G. Dermoscopy in the differential diagnosis between malar rash of systemic lupus erythematosus and erythematotelangiectatic rosacea: an observational study. Lupus 2019; 28:1583-1588. [DOI: 10.1177/0961203319882493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Malar rash is one of the three cutaneous diagnostic criteria of systemic lupus erythematosus (SLE). Although its clinical recognition is often straightforward, the differential diagnosis with erythematotelangiectatic rosacea may sometimes be challenging. Objective To describe dermoscopic features of SLE malar rash and investigate the accuracy of dermoscopy for the differential diagnosis with erythematotelangiectatic rosacea. Methods A representative dermoscopic image of target areas was evaluated for the presence of specific features. Fisher’s test was used to compare their prevalence between the two cohorts, and accuracy parameters (specificity, sensitivity, and positive and negative predictive values) were evaluated. Results Twenty-eight patients were included in the analysis, of which 13 had SLE malar rash and 15 erythematotelangiectatic rosacea. The main dermoscopic features of malar rash were reddish/salmon-coloured follicular dots surrounded by white halos (‘inverse strawberry’ pattern), being present in 53.9% of the cases, while network-like vessels (vascular polygons) turned out to be the main feature of erythematotelangiectatic rosacea, with a prevalence of 93.3%. The comparative analysis showed that the ‘inverse strawberry’ pattern was significantly more common in SLE malar rash, with a specificity of 86.7%, while vascular polygons were significantly more frequent in rosacea, with a specificity of 92.3%. Conclusion Dermoscopy may be a useful support to distinguish SLE malar rash and erythematotelangiectatic rosacea by showing peculiar features.
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Affiliation(s)
- E Errichetti
- Institute of Dermatology, ‘Santa Maria della Misericordia’ University Hospital, Udine, Italy
| | - A Lallas
- Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G De Marchi
- Rheumatology Clinic, ‘Santa Maria della Misericordia’ University Hospital, Udine, Italy
| | - Z Apalla
- Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A Zabotti
- Rheumatology Clinic, ‘Santa Maria della Misericordia’ University Hospital, Udine, Italy
| | - S De Vita
- Rheumatology Clinic, ‘Santa Maria della Misericordia’ University Hospital, Udine, Italy
| | - G Stinco
- Institute of Dermatology, ‘Santa Maria della Misericordia’ University Hospital, Udine, Italy
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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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Apalla Z, Errichetti E, Kyrgidis A, Stolz W, Puig S, Malvehy J, Zalaudek I, Moscarella E, Longo C, Blum A, Lanssens S, Savoia F, Tschandl P, Kittler H, Sinz C, Stinco G, Argenziano G, Lazaridou E, Lallas A. Dermoscopic features of mammary Paget’s disease: a retrospective case‐control study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2019; 33:1892-1898. [DOI: 10.1111/jdv.15732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Z. Apalla
- State Dermatology Department Hippokratio General Hospital Thessaloniki Greece
| | - E. Errichetti
- Institute of Dermatology ‘Santa Maria della Misericordia’ University Hospital Udine Italy
| | - A. Kyrgidis
- Department of Clinical Pharmacology Aristotle University of Thessaloniki Thessaloniki Greece
| | - W. Stolz
- Clinic of Dermatology II Munich Hospital Munich Germany
| | - S. Puig
- Department of Dermatology Hospital Clinic Barcelona Spain
| | - J. Malvehy
- Department of Dermatology Hospital Clinic Barcelona Spain
| | - I. Zalaudek
- Department of Dermatology University of Trieste Trieste Italy
| | - E. Moscarella
- Dermatology Unit University of Campania Naples Italy
| | - 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
| | - A. Blum
- Public, Private and Teaching Practice of Dermatology Konstanz Germany
| | | | - F. Savoia
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola‐Malpighi Hospital University of Bologna Bologna Italy
| | - P. Tschandl
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - H. Kittler
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - C. Sinz
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - G. Stinco
- Institute of Dermatology ‘Santa Maria della Misericordia’ University Hospital Udine Italy
| | - G. Argenziano
- Dermatology Unit University of Campania Naples Italy
| | - E. Lazaridou
- Second Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
| | - A. Lallas
- First Dermatology Department Aristotle University of Thessaloniki Thessaloniki Greece
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Russo T, Pampena R, Piccolo V, Alfano R, Papageorgiou C, Apalla Z, Longo C, Lallas A, Argenziano G. The prevalent dermoscopic criterion to distinguish between benign and suspicious pink tumours. J Eur Acad Dermatol Venereol 2019; 33:1886-1891. [PMID: 31125473 DOI: 10.1111/jdv.15707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/08/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pink skin tumours are difficult to differentiate, clinically and dermoscopically. In previous studies, mainly focused on pigmented lesions, pattern analysis provided the best sensitivity and specificity values, as compared to other algorithms. These findings suggest that the global dermoscopic appearance, based on the evaluation of prevalent features, could represent a valuable and practical approach even when dealing with pink lesions. OBJECTIVE In this study, we aimed to evaluate the diagnostic accuracy of a new dermoscopic approach for pink tumours based on the prevalent criterion, as compared to a standard diagnostic method (Menzies algorithm). METHODS The databases of two referral centres were retrospectively evaluated to retrieve dermoscopic images of amelanotic/hypomelanotic skin lesions. Two experts in dermoscopy, blinded for the final diagnosis and for clinical and demographic information, evaluated separately dermoscopic pictures of 1000 lesions according to the Menzies score and to the prevalent criterion method. RESULTS According to the high sensitivity model of the Menzies score, 129 (12.9%) lesions were considered as non-suspicious (of which 16 were false negative) and 871 (87.1%) as suspicious (of which 212 were false positive), with 97.6% sensitivity and 34.8% specificity. According to the high specificity model, 370 (37%) lesions were evaluated as non-suspicious (of which 105 were false negative) and 630 (63%) as suspicious (of which 60 were false positive), with 84.4% sensitivity and 81.5% specificity. Concerning the prevalent criterion method, 316 (31.6%) lesions were evaluated as non-suspicious (of which 46 were false negative) and 684 (68.4) as suspicious (of which 55 were false positive), with 93.2% sensitivity and 83.1% specificity. CONCLUSIONS This study demonstrated that focusing on the prevalent dermoscopic features could allow to detect malignant pink tumours with similar sensitivity but higher specificity than using the conventional Menzies scoring system.
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Affiliation(s)
- T Russo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - V Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Alfano
- Department of Anesthesiology, Surgery and Emergency, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - C Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Dermatology Department, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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Marghoob N, Navarrete-Dechent C, Liopyris K, Apalla Z, Lallas A, Marghoob AA. Dermoscopic features of benign vascular lesions presenting on volar skin: a case series and literature review. J Eur Acad Dermatol Venereol 2019; 33:e444-e445. [PMID: 31233635 DOI: 10.1111/jdv.15758] [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: 11/30/2022]
Affiliation(s)
- N Marghoob
- New York Institute of Technology College of Osteopathic Medicine, New York, NY, USA.,Department of Dermatology, Mount Sinai, New York, NY, USA
| | - C Navarrete-Dechent
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - K Liopyris
- Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Dermatology, Andreas Sygros Hospital, University of Athens, Athens, Greece
| | - Z Apalla
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A A Marghoob
- Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Errichetti E, Lallas A, Di Stefani A, Apalla Z, Kyrgidis A, Lacarrubba F, Micali G, Galvan A, Piaserico S, Stinco G. Accuracy of dermoscopy in distinguishing erythroplasia of Queyrat from common forms of chronic balanitis: results from a multicentric observational study. J Eur Acad Dermatol Venereol 2018; 33:966-972. [DOI: 10.1111/jdv.15359] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- E. Errichetti
- Department of Medical Area Institute of Dermatology University of Udine Udine Italy
| | - A. Lallas
- Department of Dermatology Aristotle University Thessaloniki Greece
| | - A. Di Stefani
- Division of Dermatology Catholic University of the Sacred Heart Rome Italy
| | - Z. Apalla
- Department of Dermatology Aristotle University Thessaloniki Greece
| | - A. Kyrgidis
- Skin Cancer Unit Arcispedale Santa Maria Nuova IRCCS Reggio Emilia Italy
| | - F. Lacarrubba
- Dermatology Clinic University of Catania Catania Italy
| | - G. Micali
- Dermatology Clinic University of Catania Catania Italy
| | | | - S. Piaserico
- Dermatology Unit Department of Medicine Padua University Padua Italy
| | - G. Stinco
- Department of Medical Area Institute of Dermatology University of Udine Udine Italy
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Papageorgiou C, Apalla Z, Variaah G, Matiaki FC, Sotiriou E, Vakirlis E, Lazaridou E, Ioannides D, Lallas A. Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen's disease. J Eur Acad Dermatol Venereol 2018; 32:1914-1919. [PMID: 29633377 DOI: 10.1111/jdv.14995] [Citation(s) in RCA: 16] [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: 01/23/2018] [Accepted: 03/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The dermoscopic features of superficial basal cell carcinoma (sBCC) and Bowen's disease (BD) have been extensively investigated, and dermoscopy was shown to significantly improve their recognition. However, incorrectly diagnosed cases still exist, with a considerable number of sBCCs dermoscopically interpreted as BD. Our aim was to investigate the dermoscopic variability in sBCC and BD on different anatomic sites, to identify potent dermoscopic predictors for each diagnosis and to investigate the potential source of the inaccurate clinico-dermoscopic diagnosis of some sBCCs. METHODS Dermoscopic images of histopathologically diagnosed sBCC and BD were evaluated by three independent investigators for the presence of predefined criteria. Subsequently, three independent investigators with expertise in dermoscopy classified the tumours as sBCC or BD based on the dermoscopic image. Diagnostic accuracy scores were calculated and crude and adjusted odds ratios, and 95% confidence intervals were calculated by univariate and conditional multivariate logistic regression, respectively. RESULTS A total of 283 lesions were included in the study (194 sBCCs and 89 BD). The main dermoscopic predictors of BD were dotted vessels (7.5-fold) and glomerular vessels (12.7-fold). The presence of leaf-like areas/spoke-wheel areas/concentric structures (OR = 0.027) and arborizing vessels (OR = 0.065) has predicted sBCC. Multivariate risk factors for sBCC misclassification were the location on lower extremities (OR = 5.5), the presence of dotted vessels (OR = 59.5) and the presence of large ulceration (OR = 6.4). In contrast, the presence of brown-coloured pigmentation was a protective predictor for misdiagnosis (OR = 0.007). Finally, a subgroup analysis of lesions located on lower extremities revealed two additional potent predictors of sBCC: superficial fine telangiectasia (SFT) and whity shiny blotches/strands. CONCLUSIONS Dotted and glomerular vessels are strong predictors of BD. When located on the lower extremities, sBCC may also display dotted vessels, rendering its recognition problematic. On the latter anatomic site, clinicians should consider SFT and whity shiny blotches/strands as additional sBCC predictors.
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Affiliation(s)
- C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G Variaah
- Department of Dermatology & Venereology, Medical University, Pleven, Bulgaria
| | - F C Matiaki
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Vakirlis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Lazaridou
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Vrani F, Sotiriou E, Lazaridou E, Vakirlis E, Sideris N, Kirmanidou E, Apalla Z, Lallas A, Ioannides D. Short incubation fractional CO
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laser‐assisted photodynamic therapy vs. conventional photodynamic therapy in field‐cancerized skin: 12‐month follow‐up results of a randomized intraindividual comparison study. J Eur Acad Dermatol Venereol 2018; 33:79-83. [DOI: 10.1111/jdv.15109] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/28/2018] [Indexed: 01/01/2023]
Affiliation(s)
- F. Vrani
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - E. Sotiriou
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - E. Lazaridou
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - E. Vakirlis
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - N. Sideris
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - E. Kirmanidou
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - Z. Apalla
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - A. Lallas
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
| | - D. Ioannides
- First Dermatology Department Aristotle University Thessaloniki Thessaloniki Greece
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Papakonstantinou A, Ioannides D, Vakirlis E, Savvoulidis C, Lallas A, Apalla Z, Sotiriou E, Lazaridou E. Dermoscopic features of melanocytic skin lesions in Greek children and adolescents and their association with environmental factors and skin types. J Eur Acad Dermatol Venereol 2018; 32:2142-2148. [PMID: 29633380 DOI: 10.1111/jdv.14996] [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] [Received: 01/07/2018] [Accepted: 03/15/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acquired naevi often present in childhood and increase in number and size during early and middle life. As naevi represent potential mimickers of melanoma, the knowledge of their epidemiologic and morphologic characteristics is essential. OBJECTIVE In this study, we intend to determine the prevalence of dermoscopic patterns of naevi, as well their association with environmental and constitutional factors. METHODS Cross-sectional data derived from a population-based cohort of children and adolescents aged 6-18 years, from 12 different schools in Thessaloniki, Greece. For each participant, a consent form and a questionnaire were completed, which included data on age, sex, phototype, sun sensitivity, sun exposure, sunscreen use and previous sunburn history. All naevi, their body distribution, and their dermoscopic patterns were recorded. RESULTS Two thousand and five hundred and five (2505) subjects were enrolled into the study (47.8% males and 52.2% females). The mean number of MN counted in a single person was 29.11 (SD = ±23.863). TNC increased continuously with higher age. Males were found to have a significantly increased number on the trunk (11.7 ± 11.2 and 10.0 ± 8.7, respectively, P < 0.001) and face and neck (6.2 ± 5.3 and 5.1 ± 4.3, respectively, P < 0.001) while females on the upper (10.3 ± 10.1 and 9.3 ± 9.4, respectively, P = 0.008) and lower extremities (2.8 ± 3.4 and 2.5 ± 3.2, respectively, P = 0.008). Globular pattern was the most frequent dominant pattern in lower age groups, and its percentage fell as age increased. On the contrary, the reticular pattern was more often documented in individuals in adolescence. CONCLUSION This first study of MN in our young population aims to be the basis of further investigation for the MM preventive policy of our state.
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Affiliation(s)
- A Papakonstantinou
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - E Vakirlis
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - C Savvoulidis
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - Z Apalla
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - E Sotiriou
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - E Lazaridou
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
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Papageorgiou V, Apalla Z, Sotiriou E, Papageorgiou C, Lazaridou E, Vakirlis S, Ioannides D, Lallas A. The limitations of dermoscopy: false-positive and false-negative tumours. J Eur Acad Dermatol Venereol 2018; 32:879-888. [PMID: 29314288 DOI: 10.1111/jdv.14782] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/13/2017] [Indexed: 12/25/2022]
Abstract
Dermoscopy has been documented to increase the diagnostic accuracy of clinicians evaluating skin tumours, improving their ability to detect skin cancer and better recognize benign moles. However, dermoscopically 'false-positive' and 'false-negative' tumours do exist. False-positive diagnosis usually leads to unnecessary excisions. False-negative diagnosis is much more dangerous, as it might result in overlooking a cancer, with severe undesirable consequences for the patient and the physician. Therefore, management strategies should mainly focus on addressing the risk of dermoscopically false-negative tumours. The most frequent benign tumours that might acquire dermatoscopic characteristics suggestive of malignancy are seborrhoeic keratosis (SK), including solar lentigo, melanoacanthoma, irritated, clonal and regressive SK, angioma (mainly thrombosed angioma and angiokeratoma), dermatofibroma, benign adnexal tumours and naevi (Clark, Spitz, recurrent, combined, sclerosing). The most useful clues to recognize these tumours are the following: solar lentigo - broad network; melanoacanthoma - sharp border; irritated SK - regularly distributed white perivascular halos; clonal SK - classic SK criteria; regressive SK - remnants of SK; targetoid haemosiderotic haemangioma - dark centre and reddish periphery; thrombosed angioma - sharp demarcation; angiokeratoma - dark lacunae; atypical dermatofibromas - palpation; follicular tumours - white colour; sebaceous tumours - yellow colour; Clark naevi - clinical context; Spitz/Reed naevi - age; combined naevi - blue central area; recurrent naevi - pigmentation within the scar; sclerosing naevi - age and location on the upper back; blue naevi - history. Malignant tumours that might mimic benign ones and escape detection are melanoma (in situ, nevoid, spitzoid, verrucous, regressive, amelanotic), squamous cell carcinoma (mainly well-differentiated variants) and rarely basal cell carcinoma (non-pigmented variants). The most useful clues to recognize the peculiar melanoma subtypes are as follows: melanoma in situ - irregular hyperpigmented areas; nevoid melanoma - history of growth; spitzoid melanoma - age; verrucous melanoma - blue-black sign; regressive melanoma - peppering or scar-like depigmentation; amelanotic melanoma - pink colour, linear irregular vessels, dotted vessels. In this article, we summarized the most frequent dermoscopic variations of common skin tumours that are often misinterpreted, aiming to assist clinicians to reduce the number of false diagnoses.
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Affiliation(s)
- V Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece.,Cosmetic Derma Medicine Medical Group, Athens, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Lazaridou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - S Vakirlis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Pampena R, Benati E, Borsari S, Bombonato C, Lombardi M, Raucci M, Mirra M, Lallas A, Apalla Z, Papadimitriou I, Moscarella E, Kyrgidis A, Argenziano G, Pellacani G, Longo C. Tracking actinic keratosis of face and scalp treated with 0.015% ingenol mebutate to identify clinical and dermoscopic predictors of treatment response. J Eur Acad Dermatol Venereol 2018; 32:1461-1468. [PMID: 29356164 DOI: 10.1111/jdv.14803] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ingenol mebutate (IngMeb) 0.015% gel is an approved field treatment option for non-hyperkeratotic non-hypertrophic actinic keratosis (AK) of face and scalp. Efficacy of IngMeb has been assessed only on a clinical ground, in the majority of studies. Dermoscopy is a pivotal tool for the diagnosis of AK, while its role in evaluating the response to non-surgical therapies for AK has not been fully defined. OBJECTIVES Our study aims to determine whether some dermoscopic features of AK of the face and scalp areas may independently predict the response to IngMeb therapy. METHODS Clinical and dermoscopic responses, 1 month after 0.015% IngMeb therapy, were retrospectively evaluated using a per-patient and per-lesion approach. Safety was evaluated through local skin reaction composite score calculation. Demographic, clinical and dermoscopic factors were then evaluated via univariate and multivariate logistic regression analysis to assess independent predictors of response. RESULTS Fifty-five patients with 245 AKs were enrolled. Clinically, per-patient response evaluation identified 25 (45.4%) poor/partial and 30 (54.5%) complete responders, corresponding on a per-lesion approach to 66 (26.9%) and 179 (73.1%) AKs, respectively. Dermoscopy reclassified 14 patients in the per-patient and 48 AKs in the per-lesion analysis from complete to poor/partial responders. Multivariate logistic regression analysis showed that AKs dermoscopically characterized by red pseudonetwork and located on the face were independently associated with a complete dermoscopic response to 0.015% IngMeb therapy, while microerosions were negative predictors. CONCLUSION Specific dermoscopic features of AK may predict the response to 0.015% IngMeb therapy, together with the location on the face.
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Affiliation(s)
- R Pampena
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - E Benati
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - S Borsari
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - C Bombonato
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - M Lombardi
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - M Raucci
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - M Mirra
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - A Lallas
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Papadimitriou
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Moscarella
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - A Kyrgidis
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
| | - G Pellacani
- Dermatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - C Longo
- Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.,Dermatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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34
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Lekkas D, Ioannides D, Apalla Z, Lallas A, Lazaridou E, Sotiriou E. Dermoscopy for discriminating between Trichophyton and Microsporum infections in tinea capitis. J Eur Acad Dermatol Venereol 2017; 32:e234-e235. [PMID: 29237094 DOI: 10.1111/jdv.14755] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- D Lekkas
- First Dermatology-Venereology Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Dermatology-Venereology Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- First Dermatology-Venereology Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- First Dermatology-Venereology Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- First Dermatology-Venereology Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sotiriou
- First Dermatology-Venereology Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
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35
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Sotiriou E, Evangelou G, Papadavid E, Apalla Z, Vrani F, Vakirlis E, Panagiotou M, Stefanidou M, Pombou T, Krasagakis K, Rigopoulos D, Ioannides D. Conventional vs. daylight photodynamic therapy for patients with actinic keratosis on face and scalp: 12-month follow-up results of a randomized, intra-individual comparative analysis. J Eur Acad Dermatol Venereol 2017; 32:595-600. [DOI: 10.1111/jdv.14613] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 09/20/2017] [Indexed: 01/05/2023]
Affiliation(s)
- E. Sotiriou
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - G. Evangelou
- Dermatology Department; University Hospital of Crete; Crete Greece
| | - E. Papadavid
- Second Dermatology Department; National and Kapodistrian University of Athens; Athens Greece
| | - Z. Apalla
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - F. Vrani
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - E. Vakirlis
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - M. Panagiotou
- Second Dermatology Department; National and Kapodistrian University of Athens; Athens Greece
| | - M. Stefanidou
- Dermatology Department; University Hospital of Crete; Crete Greece
| | - T. Pombou
- Dermatology Department; University Hospital of Crete; Crete Greece
| | - K. Krasagakis
- Dermatology Department; University Hospital of Crete; Crete Greece
| | - D. Rigopoulos
- Second Dermatology Department; National and Kapodistrian University of Athens; Athens Greece
| | - D. Ioannides
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
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36
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Chaidemenos G, Apalla Z, Sidiropoulos T. Morbihan disease: successful treatment with slow-releasing doxycycline monohydrate. J Eur Acad Dermatol Venereol 2017; 32:e68-e69. [DOI: 10.1111/jdv.14521] [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: 01/08/2023]
Affiliation(s)
| | - Z. Apalla
- First Dermatology Clinic; Hospital of skin and Venereal Diseases; “Aristoteles University”; Thessaloniki Greece
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37
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Lallas A, Apalla Z, Ioannides D, Lazaridou E, Kyrgidis A, Broganelli P, Alfano R, Zalaudek I, Argenziano G. Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society. Br J Dermatol 2017; 177:645-655. [PMID: 28118479 DOI: 10.1111/bjd.15339] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 01/23/2023]
Abstract
Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical recognition, biological behaviour and management strategies. Although Spitz naevi are considered benign tumours, their clinical and dermoscopic morphological overlap with spitzoid melanoma renders the management of spitzoid lesions particularly difficult. The controversy deepens because of the existence of tumours that cannot be safely histopathologically diagnosed as naevi or melanomas (atypical Spitz tumours). The dual objective of the present study was to provide an updated classification on dermoscopy of Spitz naevi, and management recommendations of spitzoid-looking lesions based on a consensus among experts in the field. After a detailed search of the literature for eligible studies, a data synthesis was performed from 15 studies on dermoscopy of Spitz naevi. Dermoscopically, Spitz naevi are typified by three main patterns: starburst pattern (51%), a pattern of regularly distributed dotted vessels (19%) and globular pattern with reticular depigmentation (17%). A consensus-based algorithm for the management of spitzoid lesions is proposed. According to it, dermoscopically asymmetric lesions with spitzoid features (both flat/raised and nodular) should be excised to rule out melanoma. Dermoscopically symmetric spitzoid nodules should also be excised or closely monitored, irrespective of age, to rule out atypical Spitz tumours. Dermoscopically symmetric, flat spitzoid lesions should be managed according to the age of the patient. Finally, the histopathological diagnosis of atypical Spitz tumour should warrant wide excision but not a sentinel lymph-node biopsy.
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Affiliation(s)
- A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Lazaridou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - P Broganelli
- City of Health and Science University, Turin, Italy
| | - R Alfano
- Department of Anaesthesiology, Surgery and Emergency Medicine, Second University of Naples, Naples, Italy
| | - I Zalaudek
- Department of Dermatology and Venereology, Nonmelanoma Skin Cancer Unit, Medical University of Graz, Austria
| | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
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38
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Sotiriou E, Apalla Z, Vrani F, Lazaridou E, Vakirlis E, Lallas A, Ioannides D. Daylight photodynamic therapy vs. Conventional photodynamic therapy as skin cancer preventive treatment in patients with face and scalp cancerization: an intra-individual comparison study. J Eur Acad Dermatol Venereol 2017; 31:1303-1307. [DOI: 10.1111/jdv.14177] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 02/06/2017] [Indexed: 01/06/2023]
Affiliation(s)
- E. Sotiriou
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Z. Apalla
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - F. Vrani
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - E. Lazaridou
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - E. Vakirlis
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - A. Lallas
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - D. Ioannides
- First Dermatology Department; Medical School; Aristotle University of Thessaloniki; Thessaloniki Greece
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Fotiadou C, Lazaridou E, Sotiriou E, Kyrgidis A, Apalla Z, Ioannides D. Scalp psoriasis and biologic agents: a retrospective, comparative study from a tertiary psoriasis referral centre. J Eur Acad Dermatol Venereol 2016; 30:2091-2096. [DOI: 10.1111/jdv.13780] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 04/13/2016] [Indexed: 12/28/2022]
Affiliation(s)
- C. Fotiadou
- First Department of Dermatology-Venereology; Aristotle University Medical School; Thessaloniki Greece
| | - E. Lazaridou
- First Department of Dermatology-Venereology; Aristotle University Medical School; Thessaloniki Greece
| | - E. Sotiriou
- First Department of Dermatology-Venereology; Aristotle University Medical School; Thessaloniki Greece
| | - A. Kyrgidis
- Department of Oral Maxillofacial Surgery; Aristotle University Medical School; Thessaloniki Greece
| | - Z. Apalla
- First Department of Dermatology-Venereology; Aristotle University Medical School; Thessaloniki Greece
| | - D. Ioannides
- First Department of Dermatology-Venereology; Aristotle University Medical School; Thessaloniki Greece
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Apalla Z, Lallas A, Sotiriou E, Lazaridou E, Vakirlis E, Trakatelli M, Kyrgidis A, Ioannides D. Farmers develop more aggressive histologic subtypes of basal cell carcinoma. Experience from a Tertiary Hospital in Northern Greece. J Eur Acad Dermatol Venereol 2016; 30 Suppl 3:17-20. [DOI: 10.1111/jdv.13605] [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] [Accepted: 01/21/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Z. Apalla
- First Department of Dermatology; Aristotle University of Thessaloniki; Greece
| | - A. Lallas
- First Department of Dermatology; Aristotle University of Thessaloniki; Greece
| | - E. Sotiriou
- First Department of Dermatology; Aristotle University of Thessaloniki; Greece
| | - E. Lazaridou
- First Department of Dermatology; Aristotle University of Thessaloniki; Greece
| | - E. Vakirlis
- First Department of Dermatology; Aristotle University of Thessaloniki; Greece
| | - M. Trakatelli
- Second Department of Dermatology; Aristotle University of Thessaloniki; Greece
- Department of Dermatology; St.Pierre Hospital; Brussels Belgium
| | - A. Kyrgidis
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - D. Ioannides
- First Department of Dermatology; Aristotle University of Thessaloniki; Greece
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Apalla Z, Sotiriou E, Trigoni A, Ioannides D. Psoriatic Cheilitis: A Report of 2 Cases Treated Successfully With Topical Tacrolimus and a Review of the Literature. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2015.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Lallas A, Kyrgidis A, Koga H, Moscarella E, Tschandl P, Apalla Z, Di Stefani A, Ioannides D, Kittler H, Kobayashi K, Lazaridou E, Longo C, Phan A, Saida T, Tanaka M, Thomas L, Zalaudek I, Argenziano G. The BRAAFF checklist: a new dermoscopic algorithm for diagnosing acral melanoma. Br J Dermatol 2015. [PMID: 26211689 DOI: 10.1111/bjd.14045] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [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 The parallel ridge pattern (PRP) is considered the dermoscopic hallmark of acral melanoma (AM). However, it was recently shown that approximately one-third of AMs do not display a PRP dermoscopically, rendering their detection more troublesome. OBJECTIVES To investigate the diagnostic accuracy of dermoscopic criteria for the diagnosis of AM. METHODS Dermoscopic images of consecutive cases of histopathologically diagnosed AMs and acral naevi with histopathological diagnosis or with at least 1 year of follow-up were evaluated by three independent investigators for the presence of predefined criteria. Crude and adjusted odds ratios and their corresponding 95% confidence intervals were calculated by univariate and multivariate logistic regression, respectively. Receiver operating characteristic curves were used to choose among competing classification schemes. RESULTS In total 603 lesions (472 naevi and 131 AMs) were included in the study. A scoring system (named BRAAFF) composed of six variables was associated with optimal area under the curve and sensitivity for the diagnosis of AM. This method includes four positive (irregular blotches, ridge pattern, asymmetry of structures and asymmetry of colours) and two negative predictors (furrow pattern and fibrillar pattern). CONCLUSIONS The BRAAFF checklist significantly improves the diagnostic accuracy of dermoscopy for the diagnosis of AM.
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Affiliation(s)
- A Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - H Koga
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - E Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - P Tschandl
- Division of General Dermatology, Department of Dermatology, Medical University, Vienna, Austria
| | - Z Apalla
- First Department of Dermatology, Medical School, Aristotle University, Thessaloniki, Greece
| | - A Di Stefani
- Division of Dermatology, Complesso Integrato Columbus, Rome, Italy
| | - D Ioannides
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - H Kittler
- First Department of Dermatology, Medical School, Aristotle University, Thessaloniki, Greece
| | - K Kobayashi
- Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.,Kobayashi Clinic, Tokyo, Japan
| | - E Lazaridou
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - C Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - A Phan
- Department of Dermatology, Claude Bernard - Lyon 1 University, Centre Hospitalier Lyon-Sud, Pierre Bénite, France
| | - T Saida
- Division of General Dermatology, Department of Dermatology, Medical University, Vienna, Austria
| | - M Tanaka
- Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - L Thomas
- Department of Dermatology, Claude Bernard - Lyon 1 University, Centre Hospitalier Lyon-Sud, Pierre Bénite, France
| | - I Zalaudek
- Department of Dermatology and Venereology, Medical University, Graz, Austria
| | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
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Lallas A, Chellini P, Guimarães M, Cordeiro N, Apalla Z, Longo C, Moscarella E, Alfano R, Argenziano G. Eccrine poroma: the great dermoscopic imitator. J Eur Acad Dermatol Venereol 2015; 30:e61-e63. [DOI: 10.1111/jdv.13302] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Lallas
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - P.R. Chellini
- Instituto de Dermatologia Professor Rubem David Azulay; Santa Casa da Misericórdia do Rio de Janeiro; Rio de Janeiro Brazil
| | - M.G. Guimarães
- Instituto de Dermatologia Professor Rubem David Azulay; Santa Casa da Misericórdia do Rio de Janeiro; Rio de Janeiro Brazil
| | - N. Cordeiro
- Instituto de Dermatologia Professor Rubem David Azulay; Santa Casa da Misericórdia do Rio de Janeiro; Rio de Janeiro Brazil
| | - Z. Apalla
- First Department of Dermatology; Aristotle University; Thessaloniki Greece
| | - C. Longo
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - E. Moscarella
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - R. Alfano
- Department of Anesthesiology, Surgery and Emergency; Second University of Naples; Naples Italy
| | - G. Argenziano
- Dermatology Unit; Second University of Naples; Naples Italy
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Gualdi G, Monari P, Apalla Z, Lallas A. Surgical treatment of basal cell carcinoma and squamous cell carcinoma. GIORN ITAL DERMAT V 2015; 150:435-447. [PMID: 26140396] [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: 06/04/2023]
Abstract
Non melanoma skin cancers (NMSC) are the most common human neoplasms, encompassing basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), but also cutaneous lymphomas, adnexal tumors, merckel cell carcinoma and other rare tumors. The incidence of BCC and SCC varies significantly among different populations, and the overall incidence of both tumors has increased over the last decades. Although generally associated with a favorable prognosis, recent evidence suggests that the mortality rates of SCC might have been underestimated up-to-date.1 According to Medicare data, NMSC is the fifth most expensive cancer for health care systems. This increased economic burden is not associated with the cost of treating an individual patient, but with the large number of affected patients and the recurrence rates.2 Therefore, the adequate management of the primary tumor with a complete excision becomes a priority not only for the patient but also for the public health systems. Multiple treatment modalities are currently usedin clinicalpractice for the treatment of NMSC. While surgical excision (SE) remains the gold standard of care, non-surgical techniques have gained appreciation due to lower morbidity and better cosmetic results. The optimal management of treatment includes a complete tumor clearance, preservation of the normal tissue function, and the best possible cosmetic outcome.3 Surgery with a predefined excision margin is the treatment of choice for most NMSCs, with Mohs micrographic surgery being recommended for tumors considered to be at a higher recurrence risk or those developing on cosmetically sensitive areas.4, 5 Therefore, the surgical approach of a NMSC consists with three different and equally important steps. First the preoperative clinical assessment of the tumor margins, which can be facilitated by the use of dermoscopy. Second, the definition of the surgical margins depending on the tumor subtype and its biological behavior. Finally, the surgical procedure must be designed based on the anatomic site and the patient's charachteristics. This preoperative assessment requires specific skills and might be performed by a physician, the dermatosurgeon, two collaborating specialists, namely a dermatologist and a surgeon.
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Affiliation(s)
- G Gualdi
- Dermatologic Clinic Spedali Civili Brescia, Brescia, Italy -
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Apalla Z, Calzavara-Pinton P, Lallas A, Argenziano G, Kyrgidis A, Crotti S, Facchetti F, Monari P, Gualdi G. Histopathological study of perilesional skin in patients diagnosed with nonmelanoma skin cancer. Clin Exp Dermatol 2015; 41:21-5. [PMID: 26189480 DOI: 10.1111/ced.12713] [Citation(s) in RCA: 7] [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] [Accepted: 02/10/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Epidemiological and clinical data suggest that actinic damage to the skin is an important predictor of skin carcinogenesis. AIM To investigate the association of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with sun-damage alterations seen by histopathology. METHOD In the current prospective study, perilesional skin of SCC or BCC lesions was evaluated for presence of alterations associated with chronic photodamage. Presence of scarring, perineural/perivascular invasion, haemorrhage/haemorrhagic crust, ulceration/erosion and margin involvement were also assessed. RESULT Of 6038 included lesions, 4523 (74.9%) were BCCs and 1515 (25.1%) were SCCs. Presence of actinic damage was five times more frequent in SCC than in BCC (OR = 5.29, 95% CI 4.44-6.00, P < 0.001), and diagnosis of SCC was twice as common in photo-exposed than nonphoto-exposed body sites (OR = 2.34, 95% CI 2.03-2.70, P < 0.001). There were twofold higher odds for actinic damage in SCC compared with Bowen disease (OR = 2.015, 95% CI 1.55-2.61, P < 0.001). Assessing the different BCC histological subtypes, we found that nodular BCC had at least twofold higher odds (OR = 2.63, 95% CI 2.09-3.32), infiltrative BCC had 48% higher odds (OR = 1.487, 95% CI 1.18-1.87) and basosquamous BCC had fourfold higher odds (OR = 4.10, 95% CI 3.01-5.57) of having actinic damage compared with superficial BCC. CONCLUSIONS Histological verification of ultraviolet-associated alterations in the perilesional skin in patients with NMSC in our study confirms the aetiopathogenic link between sun exposure and epithelial carcinogenesis on a histopathological basis. This correlation was stronger for SCCs than for BCCs.
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Affiliation(s)
- Z Apalla
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - A Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - G Argenziano
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - S Crotti
- Department of Dermatology, Spedali Civili Brescia, Brescia, Italy
| | - F Facchetti
- Department of Pathology 1-2, Spedali Civili Brescia, Brescia, Italy
| | - P Monari
- Department of Dermatology, Spedali Civili Brescia, Brescia, Italy
| | - G Gualdi
- Department of Dermatology, Spedali Civili Brescia, Brescia, Italy
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Apalla Z, Sotiriou E, Trigoni A, Ioannides D. Psoriatic cheilitis: a report of 2 cases treated successfully with topical tacrolimus and a review of the literature. Actas Dermosifiliogr 2015; 106:687-9. [PMID: 26164836 DOI: 10.1016/j.ad.2015.01.016] [Citation(s) in RCA: 2] [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] [Received: 09/09/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Z Apalla
- First Dermatology Department, Aristotle University of Thessaloniki, Greece
| | - E Sotiriou
- First Dermatology Department, Aristotle University of Thessaloniki, Greece.
| | - A Trigoni
- State Clinic, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece
| | - D Ioannides
- First Dermatology Department, Aristotle University of Thessaloniki, Greece
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Sotiriou E, Apalla Z, Vrani F, Lallas A, Chovarda E, Ioannides D. Photodynamic therapy vs. imiquimod 5% cream as skin cancer preventive strategies in patients with field changes: a randomized intraindividual comparison study. J Eur Acad Dermatol Venereol 2014; 29:325-329. [PMID: 24754529 DOI: 10.1111/jdv.12538] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 03/28/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Actinic damage is responsible for the development of multiple, recurrent non-melanoma skin cancers (NMSCs), including actinic keratoses (AKs). Photodynamic therapy (PDT) and imiquimod cream (IMIQ) 5% are recommended as field-directed treatment options. OBJECTIVES To compare efficacy and safety of methyl aminolevulinate (MAL)-PDT vs. IMIQ 5% in the prevention of new NMSCs development patients with field changes. METHODS Patients with field cancerization of the face or scalp were randomized to receive MAL-PDT on one side, and IMIQ 5% on the mirror field. The primary endpoint was the number of new lesions on the treated fields during a 12-month follow-up period. Secondary assessments included adverse events and patient preference. RESULTS Forty-four patients completed the study. MAL-PDT and IMIQ did not differ concerning the primary endpoint, as there was no statistically significant difference in terms of development of new NMSCs at any point of follow-up. Both treatment regimens were safe and well tolerated. Patients' preference based on the procedure, response rates and future choice favoured MAL-PDT. CONCLUSIONS MAL-PDT and IMIQ 5% are safe and well-tolerated treatments that equally prevent development of new AKs in patients suffering from field changes. MAL-PDT treatment appears to be superior in terms of patients' preference.
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Affiliation(s)
- E Sotiriou
- First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - F Vrani
- First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - A Lallas
- First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - E Chovarda
- First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Dermatology Department, Medical Schoool, Aristotle University Thessaloniki, Thessaloniki, Greece
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Apalla Z, Lallas A, Tzellos T, Sidiropoulos T, Lefaki I, Trakatelli M, Sotiriou E, Lazaridou E, Evangelou G, Patsatsi A, Kyrgidis A, Stratigos A, Zalaudek I, Argenziano G, Ioannides D. Applicability of dermoscopy for evaluation of patients' response to nonablative therapies for the treatment of superficial basal cell carcinoma. Br J Dermatol 2014; 170:809-15. [DOI: 10.1111/bjd.12749] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Z. Apalla
- State Clinic of Dermatology; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
| | - A. Lallas
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - T. Tzellos
- State Clinic of Dermatology; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
| | - T. Sidiropoulos
- State Clinic of Dermatology; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
| | - I. Lefaki
- State Clinic of Dermatology; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
| | - M. Trakatelli
- Second Department of Dermatology; School of Medicine; Aristotle University; Papageorgiou Hospital; Thessaloniki Greece
| | - E. Sotiriou
- First Department of Dermatology; School of Medicine; Aristotle University; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
| | - E. Lazaridou
- First Department of Dermatology; School of Medicine; Aristotle University; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
| | - G. Evangelou
- Department of Dermatology; University Hospital of Heraklion; Heraklion Greece
| | - A. Patsatsi
- Second Department of Dermatology; School of Medicine; Aristotle University; Papageorgiou Hospital; Thessaloniki Greece
| | - A. Kyrgidis
- First Department of Otorhinolaryngology - Head and Neck Surgery; School of Medicine; Aristotle University; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
| | - A. Stratigos
- First Department of Dermatology; School of Medicine; University of Athens; ‘Andreas Sygros’ Hospital for Skin and Venereal Diseases; Athens Greece
| | - I. Zalaudek
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - G. Argenziano
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Reggio Emilia Italy
| | - D. Ioannides
- First Department of Dermatology; School of Medicine; Aristotle University; Hospital of Skin and Venereal Diseases; Thessaloniki Greece
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Giacomel J, Lallas A, Argenziano G, Reggiani C, Piana S, Apalla Z, Ferrara G, Moscarella E, Longo C, Zalaudek I. Dermoscopy of basosquamous carcinoma. Br J Dermatol 2014; 169:358-64. [PMID: 23607676 DOI: 10.1111/bjd.12394] [Citation(s) in RCA: 33] [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] [Accepted: 04/09/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Basosquamous carcinoma (BSC) is a rare and potentially aggressive tumour, characterized by clinical and pathological features of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). It is reported to have a nonspecific clinical presentation, which makes naked-eye diagnosis a challenge. OBJECTIVES To describe the dermoscopic patterns of BSC, which may facilitate early diagnosis and accurate management. METHODS This was a retrospective evaluation of clinical and dermoscopic images of histopathologically proven BSC, collected from skin cancer centres in Australia (Perth), Greece (Thessaloniki) and Italy (Naples, Reggio Emilia). RESULTS Twenty-two tumours were included in the study. Our analysis revealed that the dermoscopic pattern of BSC comprises BCC-related criteria, as well as features that are known to characterize invasive SCC. The most frequently detected criteria were: unfocused (peripheral) arborizing vessels (73%), keratin masses (73%), white structureless areas (73%), superficial scale (68%), ulceration or blood crusts (68%), white structures (64%), blue-grey blotches (59%) and blood spots in keratin masses (55%). Notably, all but one of the tumours exhibited at least one BCC-related plus one SCC-related dermoscopic feature. CONCLUSIONS BSC appears to have overlapping dermoscopic features of BCC and invasive SCC, and detection of at least one dermoscopic criterion of both BCC and SCC should raise suspicion for the tumour. Appreciation of the dermoscopic patterns of BSC might assist in the timely and accurate diagnosis and subsequent optimal management of this unusual and potentially metastatic skin tumour.
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Affiliation(s)
- J Giacomel
- Skin Spectrum Medical Services, Como, WA, Australia
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Lallas A, Argenziano G, Kyrgidis A, Apalla Z, Moscarella E, Longo C, Ferrara G, Piana S, Benati E, Zendri E, Sotiriou E, Zalaudek I. Dermoscopy uncovers clinically undetectable pigmentation in basal cell carcinoma. Br J Dermatol 2014; 170:192-5. [DOI: 10.1111/bjd.12634] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2013] [Indexed: 12/23/2022]
Affiliation(s)
- A. Lallas
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - G. Argenziano
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - A. Kyrgidis
- Pathology Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - Z. Apalla
- Department of Otolaryngology Head & Neck Surgery; Medical School; Aristotle University; Thessaloniki Greece
| | - E. Moscarella
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - C. Longo
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - G. Ferrara
- First Department of Dermatology; Medical School; Aristotle University; Thessaloniki Greece
| | - S. Piana
- State Clinic of Dermatology; Hospital of Venereal and Skin Diseases; Thessaloniki Greece
| | - E. Benati
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - E. Zendri
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - E. Sotiriou
- Anatomic Pathology Unit; Department of Oncology; Gaetano Rummo General Hospital; Benevento Italy
| | - I. Zalaudek
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
- Department of Dermatology; Medical University of Graz; Graz Austria
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