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D’Arino A, Caputo S, Eibenschutz L, Piemonte P, Buccini P, Frascione P, Bellei B. Skin Cancer Microenvironment: What We Can Learn from Skin Aging? Int J Mol Sci 2023; 24:14043. [PMID: 37762344 PMCID: PMC10531546 DOI: 10.3390/ijms241814043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 08/04/2023] [Revised: 08/30/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Aging is a natural intrinsic process associated with the loss of fibrous tissue, a slower cell turnover, and a reduction in immune system competence. In the skin, the continuous exposition of environmental factors superimposes extrinsic damage, mainly due to ultraviolet radiation causing photoaging. Although not usually considered a pathogenic event, photoaging affects cutaneous biology, increasing the risk of skin carcinogenesis. At the cellular level, aging is typified by the rise of senescence cells a condition characterized by reduced or absent capacity to proliferate and aberrant hyper-secretory activity. Senescence has a double-edged sword in cancer biology given that senescence prevents the uncontrolled proliferation of damaged cells and favors their clearance by paracrine secretion. Nevertheless, the cumulative insults and the poor clearance of injured cells in the elderly increase cancer incidence. However, there are not conclusive data proving that aged skin represents a permissive milieu for tumor onset. On the other hand, tumor cells are capable of activating resident fibroblasts onto a pro-tumorigenic phenotype resembling those of senescent fibroblasts suggesting that aged fibroblasts might facilitate cancer progression. This review discusses changes that occur during aging that can prime neoplasm or increase the aggressiveness of melanoma and non-melanoma skin cancer.
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Affiliation(s)
- Andrea D’Arino
- Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, 00141 Rome, Italy
| | - Silvia Caputo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, 00141 Rome, Italy
| | - Laura Eibenschutz
- Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, 00141 Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, 00141 Rome, Italy
| | - Pierluigi Buccini
- Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, 00141 Rome, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, 00141 Rome, Italy
| | - Barbara Bellei
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, 00141 Rome, Italy
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Carbone A, Silipo V, Eibenschutz L, Piemonte P, Ferrari A, Buccini P, Iorio A, Frascione P. Actinic keratoses: when and how to treat a single lesion. GIORN ITAL DERMAT V 2020; 155:527-528. [DOI: 10.23736/s0392-0488.18.06082-0] [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: 11/08/2022]
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Persechino F, Franceschini C, Iorio A, Carbone A, Ferrari A, Buccini P, Piemonte P, Eibenschutz L, Sperduti I, Cota C, Frascione P, Ardigo M. Clinical management of very small pigmented lesions: Improved clinical outcome through dermoscopy and reflectance confocal microscopy combination. Skin Res Technol 2020; 26:718-726. [PMID: 32207544 DOI: 10.1111/srt.12863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/27/2019] [Accepted: 02/29/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Small-sized pigmented lesions (SSPL) <3 mm in diameter are common pitfall in the daily dermatology practice. Dermoscopy alone is hampered by the lack of specific features inversely proportional to the diameter of the lesions and its performance is highly operator-dependent. Reflectance confocal microscopy (RCM) has been demonstrated to be effective in the diagnosis of several difficult lesions where dermoscopy lacks to provide conclusive information. MATERIALS AND METHODS A total of 179 lesions with uncertain or equivocal clinical and dermoscopy appearance were selected. Dermoscopist has been requested to express a diagnostic suspect when possible. Equivocal lesions underwent RCM performed by expert for second-level evaluation before surgical excision for histological diagnosis. Results have been later statistically analysed. RESULTS Dermoscopy was not diagnostic in large number of lesions with low concordance histology (39.1%) instead of a much high concordance when combined with RCM (93.9%). CONCLUSIONS Small-sized pigmented lesions were more likely to be located on the face area. Diagnosis of pigmented BCC was relatively easy on dermoscopy and also in the case of small lesions showing typical signs of BCC. LM and MM have been seen to be particularly difficult to be diagnosed using only dermoscopy. The combination of digital dermoscopy and RCM represents the correct approach of SSPL.
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Affiliation(s)
- Flavia Persechino
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Chiara Franceschini
- Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Alessandra Iorio
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Anna Carbone
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Angela Ferrari
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Pierluigi Buccini
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Laura Eibenschutz
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Isabella Sperduti
- Biostatistical Unit, Scientific Direction, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Carlo Cota
- Dermatopathology Laboratory, San Gallicano Dermatological Institute, Rome, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Marco Ardigo
- Clinical Dermatology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
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Carbone A, Persechino F, Paolino G, Cota C, Piemonte P, Franceschini C, Eibenschutz L, Ferrari A, Buccini P, Frascione P, Calvieri S, Ardigò M. Enlarging melanocytic lesions with peripheral globular pattern: a dermoscopic and confocal microscopy study. Ital J Dermatol Venerol 2019. [PMID: 31760729 DOI: 10.23736/s0392-0488.19.06471-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Enlarging melanocytic lesions with peripheral globular pattern (EMLPGP) are a pitfall in dermoscopy. Our aim was to evaluate the meaning of EMLPGP and to assess the use of dermoscopy and reflectance confocal microscopy (RCM) in order to improve the clinical management of this subtype of melanocytic lesions. METHODS A total of 135 EMLPGP were recruited and, accordingly to the dermoscopy features, were removed; later, an expert dermoscopist reviewed the lesions blinded to histology. Moreover, a subgroup of 63 lesions who underwent also to RCM, were reviewed by an expert confocalist. RESULTS Patients had a median age of 41 years old and a female prevalence (61.5%). The main anatomic site was the trunk (86%). Histology of the 135 excised EMLPGP disclosed 116 nevi (86%; P<0.0001) and 19 melanomas (14%). On dermoscopy, statistical significance was detected for small globules that were observed in 106 cases (78.5%; P<0.0001), while globules distribution and color did not impact the diagnosis prediction, as well as age, sex or any other patient profile. Considering the RCM, atypical cytology and irregular architecture were detected in 100% of melanomas (P<0.0001). CONCLUSIONS Our study shows that EMLPGPs are detectable in every age and can be a pitfall in especially in high risk patients with an over-excision of lesions. The presence of peripheral globules should be evaluated considering the overall dermoscopic features. RCM can contribute significantly in the management of lesions trough the detection of cyto-architectural atypia. Therefore, RCM in combination with dermoscopy can optimize the reduction of harmless lesions.
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Affiliation(s)
- Anna Carbone
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy -
| | - Flavia Persechino
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giovanni Paolino
- Department of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy.,Dermatology Clinic, Sapienza University, Rome, Italy
| | - Carlo Cota
- Dermatopathology Research Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Chiara Franceschini
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Laura Eibenschutz
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Angela Ferrari
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pierluigi Buccini
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | - Marco Ardigò
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Carbone A, Persechino F, Paolino G, Cota C, Piemonte P, Franceschini C, Eibenschutz L, Ferrari A, Buccini P, Frascione P, Calvieri S, Ardigò M. Enlarging melanocytic lesions with peripheral globular pattern: a dermoscopic and confocal microscopy study. Ital J Dermatol Venerol 2019; 156:467-472. [PMID: 31760729 DOI: 10.23736/s2784-8671.19.06471-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Enlarging melanocytic lesions with peripheral globular pattern (EMLPGP) are a pitfall in dermoscopy. Our aim was to evaluate the meaning of EMLPGP and to assess the use of dermoscopy and reflectance confocal microscopy (RCM) in order to improve the clinical management of this subtype of melanocytic lesions. METHODS A total of 135 EMLPGP were recruited and, accordingly to the dermoscopy features, were removed; later, an expert dermoscopist reviewed the lesions blinded to histology. Moreover, a subgroup of 63 lesions who underwent also to RCM, were reviewed by an expert confocalist. RESULTS Patients had a median age of 41 years old and a female prevalence (61.5%). The main anatomic site was the trunk (86%). Histology of the 135 excised EMLPGP disclosed 116 nevi (86%; P<0.0001) and 19 melanomas (14%). On dermoscopy, statistical significance was detected for small globules that were observed in 106 cases (78.5%; P<0.0001), while globules distribution and color did not impact the diagnosis prediction, as well as age, sex or any other patient profile. Considering the RCM, atypical cytology and irregular architecture were detected in 100% of melanomas (P<0.0001). CONCLUSIONS Our study shows that EMLPGPs are detectable in every age and can be a pitfall in especially in high risk patients with an over-excision of lesions. The presence of peripheral globules should be evaluated considering the overall dermoscopic features. RCM can contribute significantly in the management of lesions trough the detection of cyto-architectural atypia. Therefore, RCM in combination with dermoscopy can optimize the reduction of harmless lesions.
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Affiliation(s)
- Anna Carbone
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy -
| | - Flavia Persechino
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giovanni Paolino
- Department of Dermatology and Cosmetology, IRCCS San Raffaele Hospital, Milan, Italy.,Dermatology Clinic, Sapienza University, Rome, Italy
| | - Carlo Cota
- Dermatopathology Research Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Paolo Piemonte
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Chiara Franceschini
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Laura Eibenschutz
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Angela Ferrari
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pierluigi Buccini
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | - Marco Ardigò
- Rare Disease Unit, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Paolino G, Muscardin LM, Buccini P, Didona D, Donati M, Mercuri SR, Panetta C, Donati P. Angiomatoid melanoma: a dermoscopic and pathologic challenge. GIORN ITAL DERMAT V 2018; 154:718-719. [PMID: 29417796 DOI: 10.23736/s0392-0488.18.05828-5] [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: 11/08/2022]
Affiliation(s)
- Giovanni Paolino
- Dermatologic Clinic, Sapienza University, Rome, Italy.,Unit of Dermatology and Cosmetology, Vita-Salute San Raffaele University, Milan, Italy
| | - Luca M Muscardin
- Dermatopathological Laboratory, San Gallicano Institute, Rome, Italy
| | - Pierluigi Buccini
- Department of Oncologic and Prevention Dermatology, San Gallicano Institute, Rome, Italy
| | - Dario Didona
- Clinic for Dermatology and Allergology, University Clinic of Marburg, Marburg, Germany -
| | | | - Santo R Mercuri
- Unit of Dermatology and Cosmetology, Vita-Salute San Raffaele University, Milan, Italy
| | - Chiara Panetta
- Dermatopathological Laboratory, San Gallicano Institute, Rome, Italy
| | - Pietro Donati
- Dermatopathological Laboratory, San Gallicano Institute, Rome, Italy
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Carbone A, Sperduti I, De Simone P, Piemonte P, Ferrari A, Buccini P, Silipo V, Iorio A, Frascione P, Eibenschutz L. Daylight photodynamic therapy: experience in the treatment of actinic keratosis in the San Gallicano Institute (Rome) and a review of literature. GIORN ITAL DERMAT V 2018; 155:312-319. [PMID: 29368865 DOI: 10.23736/s0392-0488.18.05880-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Actinic keratosis (AK) is a photo-induced skin lesion. It has been considered by several authors as in-situ squamous cell carcinoma (SCC), that can evolve to invasive SCC (iSCC). Given the malignant potential and because it is impossible predict which AK will evolve in iSCC, it is necessary to treat each lesion. Multiple therapeutic approaches have been described to treat AKs. In addition to the topical drugs, photodynamic therapy (PDT) has become an established therapeutic modality for grade I and II of AKs of face and scalp. Recently the daylight photo-dynamic therapy (DL-PDT) has found extensive use in the care of the AK and in the field cancerization. METHODS The study included 101 patients, 90 males and 11 females, mean age 71, phototype I-II, with multiple AK I and II of the face and the scalp, treated with DL-PDT. Patients were clinically evaluated for 3 months. The aim of this study was to show our experience in Daylight Photodynamic Therapy, to confirm the validity in term of efficacy and safety of DL-PDT for I and II AK of face and scalp and to underline the patient's higher satisfaction for this type of treatment and his availability to be retreated with the DL-PDT. RESULTS The efficacy was complete in 16 patients (15.8%), in 71 patients (70.3%) was much improved or improved and only in 14 (13.9%) subjects were minimal, while nobody had worsened or changed. The majority of patients (84.2%) patients were satisfied of the efficacy as well of the cosmetic results, only 15 (14.9%) were low satisfied and one patient was not satisfied. CONCLUSIONS This study confirms that the DL-PDT is a good alternative to c-PDT for the treatment of grade I and II AK of the face and scalp and in Rome, as in Southern Europe, it is possible to perform the DL-PDT in almost every month of year.
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Affiliation(s)
- Anna Carbone
- San Gallicano Dermatological Institute IRCCS, Rome, Italy -
| | - Isabella Sperduti
- Department of Bio-Statistics, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Paolo Piemonte
- San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Angela Ferrari
- San Gallicano Dermatological Institute IRCCS, Rome, Italy
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Carbone A, Ferrari A, Paolino G, Buccini P, De Simone P, Eibenschutz L, Piemonte P, Silipo V, Sperduti I, Catricalà C, Frascione P. Lentigo maligna of the face: A quantitative simple method to identify individual patient risk probability on dermoscopy. Australas J Dermatol 2017; 58:286-291. [PMID: 28589538 DOI: 10.1111/ajd.12595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/27/2016] [Accepted: 11/01/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES The clinical and dermoscopic differential diagnosis of flat pigmented facial lesions represents a great challenge for the clinicians. Our aim was to report a quantitative method based on dermoscopic features to better classify pigmented facial lesions. METHODS This is a retrospective case-series study that analysed the dermoscopic features of 582 pigmented facial lesions. RESULTS The individual patient probability of lentigo maligna (LM) was predicted by a multivariate model, with an accuracy of 0.72. According to the odds ratio at the multivariate analysis, an individual scoring index was assigned to each criterion, and a value of 4.56 was identified as optimal cut-off point. Up to a score of 2.5, the probability that a lesion is an LM is 0. The probability increases from 10 to 50% for a score ranging between 4.5 and 6. It is about 90% for a score of 7. CONCLUSION The optimal cut-off point obtained and the curve that identifies the probability of a patient having a LM could improve the classification and the management strategies of equivocal pigmented facial lesions.
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Affiliation(s)
- Anna Carbone
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Angela Ferrari
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Giovanni Paolino
- Department of Dermatology, Clinica Dermatologica, La Sapienza University of Rome, Rome, Italy
| | - Pierluigi Buccini
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Paola De Simone
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Laura Eibenschutz
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Paolo Piemonte
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Vitaliano Silipo
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Isabella Sperduti
- Department of Biostatistics, Regina Elena National Cancer Institute, Rome, Italy
| | - Caterina Catricalà
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Pasquale Frascione
- Department of Oncological and Preventative Dermatological, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Agozzino M, Ferrari A, Cota C, Franceschini C, Buccini P, Eibenshutz L, Ardigò M. Reflectance confocal microscopy analysis of equivocal melanocytic lesions with severe regression. Skin Res Technol 2017; 24:9-15. [PMID: 28543606 DOI: 10.1111/srt.12382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The differential diagnosis between regressing nevi and melanoma might be challenging; regressing areas can represent a confounding factor for the diagnosis and the histology still remain mandatory to rule out melanoma. Reflectance confocal microscopy may add valuable information by revealing features suggestive of the nature of the melanocytic proliferation. OBJECTIVE To assess the impact of confocal microscopy in the management of regressive melanocytic lesions. METHODS The dermoscopic analysis of 92 melanocytic lesions showing that more than 30% of regressions have been retrospectively considered, among them, 32 melanocytic lesions with a 7 check point list ≥3 they were assessed at the rcm and subsequently excised. For each selected lesion, dermoscopic features of regression (white scar-like areas, blue areas, blue white areas), distribution of regressing areas (central, peripheral, or both) and the percentage of regression have been examined by an expert in dermoscopy, blinded to the histological and confocal diagnosis. Subsequently, two experts in confocal microscopy revaluated, blinded from histology, RCM images. RESULTS Of the 32 lesions analyzed, 23 (71.5%) were diagnosed histologically as nevi, and 9 (28.5%) as melanomas. 26 of 32 lesions (81.5%) exhibited regression >50% of the overall. On RCM, 11 lesions have been interpreted as malignant and 21 as benign. On RCM the majority of nevi exhibited regular architecture without cytological atypia. Epidermal disarray, pagetoid infiltration, disarranged dermo-epidermal junction architecture and atypical nests were considered as suspicious for malignancy. Good concordance between confocal readers has been detected. CONCLUSION A combined dermoscopic/confocal approach can be used for the management of lesions exhibiting dermoscopic features of regression in order to provide a more conclusive pre-histological diagnosis avoiding a high number of unnecessary excisions. Limits of this study were represented by the relatively small number of lesions and the retrospective approach. Further, prospective studies on a larger number of cases, will be necessary in order to compare the efficacy of dermoscopy alone versus dermoscopy in combination with RCM for the evaluation of regression, suspected pigmented lesions.
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Affiliation(s)
- M Agozzino
- Dermatology Unit, Second University of Naples, Naples, Italy
| | - A Ferrari
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - C Cota
- Dermatopathology Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - C Franceschini
- Dermatology Unit, University of Tor Vergata, Rome, Italy
| | - P Buccini
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - L Eibenshutz
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - M Ardigò
- Department of Dermatologic Clinic, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
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Paolino G, Donati P, Ferrari A, Panetta C, Buccini P, Donati M, Zalaudek I. Clinicopathological and dermoscopic features of angio-eccrine hyperplasia in clear cell acanthoma. J Am Acad Dermatol 2017; 74:1259-1261.e3. [PMID: 27185430 DOI: 10.1016/j.jaad.2015.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/24/2015] [Accepted: 12/02/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Giovanni Paolino
- Clinica Dermatologica, La Sapienza University of Rome, Rome, Italy.
| | - Pietro Donati
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Angela Ferrari
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Chiara Panetta
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Pierluigi Buccini
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Michele Donati
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Iris Zalaudek
- Dermatology Department, Medical Univeristy of Graz, Graz, Austria
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Paolino G, Bekkenk MW, Didona D, Eibenschutz L, Richetta AG, Cantisani C, Viti G, Carbone A, Buccini P, De Simone P, Ferrari A, Scali E, Calvieri S, Silipo V, Cigna E, Viti GP, Bottoni U. Is the prognosis and course of acral melanoma related to site-specific clinicopathological features? Eur Rev Med Pharmacol Sci 2016; 20:842-848. [PMID: 27010139] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Acral melanoma is an uncommon type of melanoma in Caucasian patients. However, acral melanoma is the most common type of melanoma in African and Asian patients. Comparison analyses between hand-acral melanoma and foot-acral melanoma have been rarely reported in the literature. Acral melanoma is an uncommon melanocytic tumor characterized by an intrinsic aggressiveness, with specific histological and clinicopathological features. Acral melanoma involves the palms, soles and sub-ungueal sites. PATIENTS AND METHODS A total of 244 patients with acral melanoma were included in our analysis. The current study was performed in three different medical centers: Sapienza University of Rome, San Gallicano Institute of Rome and University of Magna Graecia (Italy). The Kaplan-Meier product was used to estimate survival curves for disease-free survival and overall survival. The log-rank test was used to evaluate differences between the survival curves. Assuming that the effects of the predictor variables are constant over time, the independent predictive factors were assessed by Spearman's test and subsequently data were analyzed performing Cox proportional-hazard regression. RESULTS In both univariate and multivariate analyses Breslow thickness (p < 0.0001) and ulceration (p = 0.003) remained the main predictors. General BRAF mutation was detected in 13.8% of cases. We found that median Breslow value and the percentage of recurrences were similar in hand-acral melanoma and foot-acral melanoma, as well as there were no differences in both short and long-term. CONCLUSIONS The absence of differences in survival between hand-acral melanoma and foot-acral melanoma shows that the aggressiveness of the disease is related to distinct mutational rate, as well as to anatomical site-specific features, rather than to the visibility of the primary lesion.
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Affiliation(s)
- G Paolino
- Dermatologic Clinic, "La Sapienza" University of Rome, Rome, Italy.
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12
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Agozzino M, Buccini P, Catricalà C, Covello R, Donadio C, Ferrari A, Franceschini C, Sperduti I, Ardigò M. Noninvasive assessment of benign pigmented genital lesions using reflectance confocal microscopy. Br J Dermatol 2015; 173:1312-5. [PMID: 26076369 DOI: 10.1111/bjd.13947] [Citation(s) in RCA: 6] [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: 11/29/2022]
Affiliation(s)
- M Agozzino
- Department of Oncologic Dermatology, San Gallicano Dermatologic Institute, IRCCS, Via Chianesi 53, 00144, Rome, Italy
| | - P Buccini
- Department of Oncologic Dermatology, San Gallicano Dermatologic Institute, IRCCS, Via Chianesi 53, 00144, Rome, Italy
| | - C Catricalà
- Department of Oncologic Dermatology, San Gallicano Dermatologic Institute, IRCCS, Via Chianesi 53, 00144, Rome, Italy
| | - R Covello
- Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy
| | - C Donadio
- Department of Biomorphological and Functional Sciences, Pathology Section, University of Naples 'Federico II', Naples, Italy
| | - A Ferrari
- Department of Oncologic Dermatology, San Gallicano Dermatologic Institute, IRCCS, Via Chianesi 53, 00144, Rome, Italy
| | - C Franceschini
- Dermatologic Unit, University of Tor Vergata, Rome, Italy
| | - I Sperduti
- Biostatistical Unit, Scientific Direction, San Gallicano Dermatologic Institute, IRCCS, Via Chianesi 53, 00144, Rome, Italy
| | - M Ardigò
- Department of Clinical Dermatology, San Gallicano Dermatologic Institute, IRCCS, Via Chianesi 53, 00144, Rome, Italy
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Pedace L, Cozzolino AM, Barboni L, De Bernardo C, Grammatico P, De Simone P, Buccini P, Ferrari A, Catricalà C, Colombo T, Donati P, Morrone A. A novel variant in the 3' untranslated region of the CDK4 gene: interference with microRNA target sites and role in increased risk of cutaneous melanoma. Cancer Genet 2014; 207:168-9. [PMID: 24797605 DOI: 10.1016/j.cancergen.2014.03.005] [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: 02/07/2014] [Revised: 03/10/2014] [Accepted: 03/12/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Lucia Pedace
- Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy.
| | - Angela M Cozzolino
- Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Luana Barboni
- Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Carmelilia De Bernardo
- Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Paola Grammatico
- Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Paola De Simone
- Department of Dermatologic Oncology, San Gallicano Dermatologic Institute-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Pierluigi Buccini
- Department of Dermatologic Oncology, San Gallicano Dermatologic Institute-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Angela Ferrari
- Department of Dermatologic Oncology, San Gallicano Dermatologic Institute-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Caterina Catricalà
- Department of Dermatologic Oncology, San Gallicano Dermatologic Institute-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Teresa Colombo
- Institute for Computing Applications Mauro Picone, National Research Council, Rome, Italy
| | - Pietro Donati
- Dermatopathology Unit, San Gallicano IRCCS, Rome, Italy
| | - Aldo Morrone
- Healthcare Administration Dermatology, San Camillo-Forlanini Hospital, Rome, Italy
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Ferrari A, Argenziano G, Buccini P, Cota C, Sperduti I, De Simone P, Eibenschutz L, Silipo V, Zalaudek I, Catricalà C. Typical and atypical dermoscopic presentations of dermatofibroma. J Eur Acad Dermatol Venereol 2012; 27:1375-80. [PMID: 23176079 DOI: 10.1111/jdv.12019] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dermatofibroma is a common skin neoplasm that is usually easy to recognize, but in some cases its differentiation from melanoma and other tumours may be difficult. OBJECTIVE To describe the dermoscopic features of dermatofibromas, with special emphasis on the characteristics of atypical patterns, and to calculate pattern frequency according to the patients age and gender, anatomical site and histopathological subtype. METHODS Two groups of patients were consecutively seen, one with dermatofibromas that were surgically excised because of clinically and/or dermoscopically equivocal aspects or following patient request, and another with non-equivocal dermatofibromas. Each lesion was scored for previously reported global dermoscopic patterns and for additional features. RESULTS A typical pattern was observed in 92 of 130 (70.8%) lesions, whereas an atypical pattern, that we named the 'non Dermatofibroma (DF)-like' pattern, was seen in 38 of 130 (29.2%). Atypical dermatofibromas showed features reminiscent of different conditions, such as melanoma in 21(16.2%) cases, vascular tumour in six (4.6%), basal cell carcinoma in five (3.8%), collision tumour in three (2.3%) and psoriasis in three (2.3%). A significant association was found between the 'melanoma-like' pattern/'vascular tumour-like' pattern and males, whereas a trend was observed between the above-mentioned patterns and hemosiderotic/aneurysmal DFs. 'Peripheral pigment network and central white scar-like patch' pattern was found associated with females and classic histopathological variant of DF. CONCLUSION Dermatofibromas may display different morphological faces. The typical dermoscopic patterns allow a confident diagnosis, whereas a full surgical excision is always recommended in all doubtful cases.
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Affiliation(s)
- A Ferrari
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute, Rome, ItalyDermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, ItalyLaboratory of Pathology, San Gallicano Dermatologic Institute, Rome, ItalyUnit of Biostatistics, Regina Elena National Cancer Institute, Rome, Italy
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Moscarella E, Zalaudek I, Buccini P, Cota C, Catricalà C, Argenziano G. Dermoscopy and confocal microscopy of thrombosed hemangiomas. ACTA ACUST UNITED AC 2012; 148:410. [PMID: 22431796 DOI: 10.1001/archdermatol.2011.1027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Pedace L, De Simone P, Castori M, Sperduti I, Silipo V, Eibenschutz L, De Bernardo C, Buccini P, Moscarella E, Panetta C, Ferrari A, Grammatico P, Catricalà C. Clinical features predicting identification of CDKN2A mutations in Italian patients with familial cutaneous melanoma. Cancer Epidemiol 2011; 35:e116-20. [DOI: 10.1016/j.canep.2011.07.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 07/24/2011] [Accepted: 07/29/2011] [Indexed: 12/12/2022]
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Argenziano G, Catricalà C, Ardigo M, Buccini P, De Simone P, Eibenschutz L, Ferrari A, Mariani G, Silipo V, Sperduti I, Zalaudek I. Seven-point checklist of dermoscopy revisited. Br J Dermatol 2011; 164:785-90. [PMID: 21175563 DOI: 10.1111/j.1365-2133.2010.10194.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G Argenziano
- Dermatology Unit, 1st Medical Department, Arcispedale Santa Maria Nuova, 42100 Reggio Emilia, Italy.
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Argenziano G, Catricalà C, Ardigo M, Buccini P, De Simone P, Eibenschutz L, Ferrari A, Mariani G, Silipo V, Zalaudek I. Dermoscopy of patients with multiple nevi: Improved management recommendations using a comparative diagnostic approach. ACTA ACUST UNITED AC 2011; 147:46-9. [PMID: 21242392 DOI: 10.1001/archdermatol.2010.389] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess the outcome on management recommendations of a comparative approach vs a morphologic approach in evaluating dermoscopic images of lesions from a series of patients with multiple nevi. DESIGN In a 2-step study, 6 experienced dermoscopists were asked to provide management recommendations (excision or follow-up) for a series of lesions from patients with multiple nevi based on dermoscopic images of the lesions. In the first step, participating dermoscopists evaluated individual images of lesions based only on morphologic structure (morphologic approach). In the second step, the same lesions were grouped by patient, allowing the participants to evaluate the lesions in the context of other nevi from the same patient (comparative approach). SETTING Academic referral center. PATIENTS Seventeen patients with 190 lesions (184 monitored nevi, 4 excised nevi, and 2 excised melanomas). MAIN OUTCOME MEASURE Using pooled data from each step, excision recommendation rates for the comparative approach and the morphologic approach were calculated. RESULTS Using the morphologic approach, 55.1% of overall recommendations favored excision; using the comparative approach, the rate decreased to 14.1%. The 2 melanomas included in the study were correctly judged to merit excision by all participants in step 1 and in step 2. Conclusion Among patients with multiple nevi, evaluation of equivocal lesions in the context of a patient's other nevi results in a lower rate of excision recommendations compared with evaluation of individual lesions based on morphologic structure alone.
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Affiliation(s)
- Giuseppe Argenziano
- Pigmented Lesions Clinic, Department of Dermatology, Second University of Naples, Italy.
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Ferrari A, Zalaudek I, Argenziano G, Buccini P, De Simone P, Silipo V, Eibenschutz L, Mariani G, Covello R, Sperduti I, Mariani L, Catricalà C. Dermoscopy of pigmented lesions of the vulva: a retrospective morphological study. Dermatology 2011; 222:157-66. [PMID: 21311169 DOI: 10.1159/000323409] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 12/01/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The dermoscopic patterns of pigmented skin tumors are influenced by the body site. OBJECTIVE To evaluate the clinical and dermoscopic features associated with pigmented vulvar lesions. METHODS Retrospective analysis of clinical and dermoscopic images of vulvar lesions. The χ² test was used to test the association between clinical data and histopathological diagnosis. RESULTS A total of 42 (32.8%) melanocytic and 86 (67.2%) nonmelanocytic vulvar lesions were analyzed. Nevi significantly prevailed in younger women compared with melanomas and melanosis and exhibited most commonly a globular/cobblestone (51.3%) and a mixed (21.6%) pattern. Dermoscopically all melanomas showed a multicomponent pattern. Melanotic macules showed clinical overlapping features with melanoma, but their dermoscopic patterns differed significantly from those observed in melanomas. CONCLUSION The diagnosis and management of pigmented vulvar lesions should be based on a good clinicodermoscopic correlation. Dermoscopy may be helpful in the differentiation of solitary melanotic macules from early melanoma.
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Affiliation(s)
- Angela Ferrari
- Department of Oncologic Dermatology, Santa Maria and San Gallicano Institute of Rome, Rome, Italy
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Ferrari A, Buccini P, Silipo V, De Simone P, Mariani G, Marenda S, Hagman JH, Amantea A, Panetta C, Catricalà C. Eccrine poroma: a clinical-dermoscopic study of seven cases. Acta Derm Venereol 2009; 89:160-4. [PMID: 19326001 DOI: 10.2340/00015555-0608] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Eccrine poroma can mimic benign and malignant melanocytic and non-melanocytic lesions. To date, little is known about the dermoscopic features of this condition. Seven histopathologically proven cases of eccrine poroma were examined using dermoscopy by three independent dermatologists. Both glomerular and hairpin vessels were observed in 71% of cases, whereas linear irregular vessels were observed in 43% of cases. A white-to-pink halo surrounding the vessels and multiple pink-white structureless areas were also frequently found (in 86% and 71% of cases, respectively). Three dermoscopic "profiles" were identified, all characterized by the presence of a white-to-pink halo surrounding the vessels, as well as by the association of two additional different features, namely: glomerular vessels and pink-white structureless areas, glomerular and linear irregular vessels, hairpin vessels and linear irregular vessels. However, due to the small number of lesions studied so far, we suggest that these profiles should be considered as likely, but not definitely pathognomonic signs of eccrine poroma.
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Affiliation(s)
- Angela Ferrari
- Department of Dermatologic Oncology, Santa Maria and San Gallicano Dermatologic Institute - IFO of Rome, Italy.
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Ferrari A, Buccini P, Covello R, De Simone P, Silipo V, Mariani G, Eibenschutz L, Mariani L, Catricalà C. The ringlike pattern in vulvar melanosis: a new dermoscopic clue for diagnosis. ACTA ACUST UNITED AC 2008; 144:1030-4. [PMID: 18711077 DOI: 10.1001/archderm.144.8.1030] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Vulvar melanosis is a benign pigmented lesion that may clinically mimic melanoma. Whereas the dermoscopic features of other pigmented skin lesions have been extensively described, little is known about vulvar melanosis. OBSERVATIONS A retrospective dermoscopic study was conducted on 87 lesions with histopathologically proved melanosis. We describe and define, for the first time to our knowledge, a ringlike pattern, found in 28 of 87 melanotic lesions (32%), characterized by multiple round to oval structures, white to tan, with dark brown, well-defined regular borders. The structureless and globularlike patterns were observed in 18 of 87 lesions (21%), the parallel pattern in 15 (17%), and the cobblestonelike and reticularlike patterns in 4 (5%). A significant association was found between the distribution of multifocal lesions showing a ringlike vs a nonringlike pattern (82% vs 52%; P = .008), whereas a weak association was found between anatomical site and the different patterns (P = .55). The ringlike pattern was frequently combined with multifocality and simultaneous occurrence at the labia majora and the labia minora. CONCLUSION Dermoscopy can be useful for the clinical detection of vulvar melanosis, and the ringlike pattern may represent a new dermoscopic clue for the diagnosis of this lesion.
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Affiliation(s)
- Angela Ferrari
- Department of Dermatologic Oncology, Santa Maria and San Gallicano Dermatologic Institute, IFO of Rome, Via Elio Chianesi 53, 00144 Rome, Italy.
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Abstract
The occurrence of cancer in pregnant women is not a common phenomenon and the real incidence of malignant melanoma during this period is unknown. Many authors reported a poor prognosis in pregnant women with melanoma compared with non-pregnant women's tumour. Several retrospective reviews reported a worsened prognosis in pregnant women with melanoma and found that progesterone and oestrogen receptors can be detected in melanoma tissue. Other data are in conflict with these opinions; several studies demonstrated that the timing of the disease diagnosis during pregnancy did not appear to influence the risk of mortality. In our report, we reviewed data on women with malignant melanoma who were diagnosed during pregnancy in our institute from 1991 to 2000. We have considered the following parameters: age at diagnosis, histological type and tumour thickness, stage of disease and surgical management and we have compared the clinical and biological behaviour of these melanomas with melanoma in non-pregnant women observed in the same period and in a follow-up of 5 years. In our study, there is no significant difference in outcome and survival rate between pregnant and non-pregnant women with melanoma. During pregnancy, melanocytic skin lesions show a transient modification of dermoscopic pattern; consequently, a close follow-up of pigmented lesions, both clinical and instrumental, is very important during pregnancy and care must be taken in revealing the presence of other risk factors for melanoma.
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Affiliation(s)
- Vitaliano Silipo
- Department of Dermatology-Oncology, S Gallicano Dermatological Institute, Via Elio Chianesi, Rome, Italy
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Seidenari S, Pellacani G, Martella A, Giusti F, Argenziano G, Buccini P, Carli P, Catricalà C, De Giorgi V, Ferrari A, Ingordo V, Manganoni AM, Peris K, Piccolo D, Pizzichetta MA. Instrument-, age- and site-dependent variations of dermoscopic patterns of congenital melanocytic naevi: a multicentre study. Br J Dermatol 2006; 155:56-61. [PMID: 16792752 DOI: 10.1111/j.1365-2133.2006.07182.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recently, we identified and described dermoscopic aspects, present with a higher frequency in congenital melanocytic lesions with respect to acquired naevi. We also classified small- and medium-sized congenital naevi (CN) into nine subtypes according to their macroscopic and dermoscopic aspects. OBJECTIVES Because the recognition of dermoscopic features may be instrument dependent, in this study, we wanted to check whether dermoscopic patterns specific for CN can be identified in digital images acquired by means of different instruments. We also wanted to check the validity of our previously proposed classification and assess possible age- and site-dependent variations of dermoscopic patterns and naevus subtypes. PATIENTS/METHODS Images corresponding to 384 small- or medium-sized CN were collected in eight different centres employing four different instruments. Lesion images were evaluated and checked for the presence of specific dermoscopic criteria, classified, and compared with a database of 350 acquired naevi. RESULTS Specific and unspecific dermoscopic features were identifiable in images acquired by means of all four instrument types. The mean number of identified features per lesion did not vary according to the instrument employed for the acquisition of the images; however, it was lower for lesions recorded employing low magnifications. The previously proposed classification was easily applied to the whole image database. The variegated naevus type was identified as a highly specific clinical/dermoscopic pattern. Dermoscopic features varied according to age and location. The globular type prevailed in subjects under 11 years of age and on the trunk, whereas the majority of reticular lesions were located on the limbs. CONCLUSIONS Because definite clinical and histological criteria for the diagnosis of the congenital nature of naevi are lacking, the use of dermoscopy can be of great help in identifying those lesions where the presence of specific dermoscopic features makes the diagnosis of CN more likely. Moreover, dermoscopy can be useful both for the classification of lesions already identified as congenital according to definite clinical and anamnestic data and for a possible correlation of naevus phenotype and dermoscopic patterns to the risk of developing a malignant melanoma in prospective studies.
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Affiliation(s)
- S Seidenari
- Department of Dermatology, University of Modena and Reggio Emilia, and Department of Dermatology, Italian Navy Main Hospital, Taranto, Italy.
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