1
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Álvarez-Salafranca M, Zaballos P. Dermoscopy of Squamous Cell Carcinoma: From Actinic Keratosis to Invasive Forms. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00270-9. [PMID: 38556203 DOI: 10.1016/j.ad.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024] Open
Affiliation(s)
- M Álvarez-Salafranca
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - P Zaballos
- Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla, Tarragona, España
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2
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Perino F, Suarez R, Perez-Anker J, Carrera C, Rezze GG, Primiero CA, Alos LL, Díaz A, Barreiro A, Puig S, Peris K, Malvehy J. Concordance of in vivo reflectance confocal microscopy and horizontal-sectioning histology in skin tumours. J Eur Acad Dermatol Venereol 2024; 38:124-135. [PMID: 37669864 DOI: 10.1111/jdv.19491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/19/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND In vivo reflectance confocal microscopy (RCM) enables the study of architectural and cytological aspects in horizontal sections, which closely correlate with histologic features. However, traditional histopathological vertical sections cannot totally reproduce the image of the in vivo RCM horizontal section. OBJECTIVE To evaluate the concordance between in vivo RCM and histopathologic transverse sections for melanocytic lesions, basal cell carcinoma and seborrheic keratoses. METHODS Prospectively collected benign melanocytic and non-melanocytic tumours diagnosed by dermoscopy were evaluated for common RCM features and compared to histopathology in horizontal sections with haematoxylin and eosin staining. RESULTS A total of 44 skin tumours including 19 melanocytic lesions (nine compound, five junctional and five intradermal nevi), 12 basal cell carcinomas and 13 seborrheic keratoses were collected in the Department of Dermatology of Hospital Clinic of Barcelona. The RCM features that had statistically significant agreement with the histopathological horizontal sections were the preserved and visible honeycomb pattern, well defined DEJ, small bright particles, dermal nests, tumour islands and dark silhouettes, clefting, collagen bundles, thickened collagen bundles and cytologic atypia. CONCLUSIONS Histopathology evaluation of horizontal sections of skin tumours can be correlated with main RCM findings. The results of this study have improved the understanding and interpretation of RCM features in relation to skin tumours, thus reinforcing the utility of RCM as a diagnostic tool.
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Affiliation(s)
- F Perino
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - R Suarez
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - J Perez-Anker
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
| | - C Carrera
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salut Carlos III, Barcelona, Spain
| | - G G Rezze
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - C A Primiero
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Dermatology Research Centre, The University of Queensland Frazer Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - L L Alos
- Medicine Department, University of Barcelona, Barcelona, Spain
- Pathology Department, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Díaz
- Medicine Department, University of Barcelona, Barcelona, Spain
- Pathology Department, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Barreiro
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - S Puig
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salut Carlos III, Barcelona, Spain
| | - K Peris
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - J Malvehy
- Dermatology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salut Carlos III, Barcelona, Spain
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3
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Mazur E, Reich A. Photodynamic Therapy is an Effective Treatment of Facial Pigmented Actinic Keratosis. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00924-0. [PMID: 37162710 DOI: 10.1007/s13555-023-00924-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Actinic keratosis (AK), or solar keratosis, is a precancerous condition of the skin, mainly caused by excessive and chronic exposure to ultraviolet radiation. Pigmented AK (pAK) is a rare variant of AK. Photodynamic therapy (PDT) is widely used to treat the classical variant of AK, but very limited data are available on the use of PDT in patients with pAK. The objective of this study was to assess the usefulness of PDT in the treatment of pAK. METHODS The study included 16 patients with 20 pAK lesions treated with PDT. All skin lesions were clinically and dermatoscopically assessed for typical features characteristic of pAK. Reflectance confocal microscopy (RCM) was also used to assess keratinocyte atypia, confirm pAK diagnosis, and rule out other disease entities. RESULTS After three PDT sessions, the complete resolution of all clinical features of pAK was observed in 80% of the studied lesions. Dermatoscopically, 65% of the lesions achieved 100% response and no cellular atypia was seen in the follow-up RCM images of 85% of lesions. CONCLUSIONS Photodynamic therapy is an effective treatment modality for pAK in fair-skinned individuals.
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Affiliation(s)
- Ewelina Mazur
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
- Doctoral School of the University of Rzeszow, University of Rzeszow, Rzeszow, Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland.
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4
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Dermoscopic and histopathological correlation in macular hyperpigmented facial lesions. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.996688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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5
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Polesie S, Zaar O. Frequency of Publication of Dermoscopic Images in Inter-observer Studies: A Systematic Review. Acta Derm Venereol 2021; 101:adv00621. [PMID: 34853864 PMCID: PMC9472090 DOI: 10.2340/actadv.v101.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Research interest in dermoscopy is increasing, but the complete dermoscopic image sets used in inter-observer studies of skin tumours are not often shared in research publications. The aim of this systematic review was to analyse what proportion of images depicting skin tumours are published in studies investigating inter-observer variations in the assessment of dermoscopic features and/or patterns. Embase, MEDLINE and Scopus databases were screened for eligible studies published from inception to 2 July 2020. For included studies the proportion of lesion images presented in the papers and/or supplements was extracted. A total of 61 studies (53 original studies and 8 shorter reports (i.e. research letters or concise reports)). published in the period 1997 to 2020 were included. These studies combined included 14,124 skin tumours, of which 373 (3%) images were published. This systematic review highlights that the vast majority of images included in dermoscopy research are not published. Data sharing should be a requirement for future studies, and must be enabled and standardized by the dermatology research community and editorial offices.
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Affiliation(s)
- Sam Polesie
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna stråket 16, SE-413 45 Gothenburg, Sweden.
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6
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Pigmented lesion on the face: which is the chance of being melanoma using reflectance confocal microscopy features? Arch Dermatol Res 2021; 314:563-571. [PMID: 34152481 DOI: 10.1007/s00403-021-02263-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/30/2021] [Accepted: 06/11/2021] [Indexed: 10/21/2022]
Abstract
Facial melanoma presents itself as a brownish macula, being difficult to differentiate it from benign pigmented lesions of the face on clinical examination. Reflectance confocal microscopy (RCM) assists in diagnosing facial lesions in which dermoscopy has limitations, allowing to increase the diagnostic accuracy. The study aimed to analyze the RCM features of pigmented isolated lesions of the face for diagnosing melanoma. Also, we sought to establish the chance of a pigmented lesion on the face being a melanoma using RCM criteria. In this retrospective and prospective study, 105 clinical pigmented lesions on the face underwent RCM, and cytoarchitectural features in the epidermis, the dermo-epidermal junction (DEJ), and dermis were described. For statistical analysis, the exact chi-square test was applied to the RCM criteria. The odds ratio was estimated using univariate logistic regression. Finally, we used the multiple logistic regression method for creating a nomogram to predict the chance of a lesion being a melanoma. After univariate and multivariate logistic regression, atypical round nucleated cells within the epidermis, pagetoid spread, and follicular dendritic cells presented as statistically significant features. Then, a complex nomogram was created to give the chance of a pigmented lesion on the face being a melanoma. The presence of these three features resulted in a 98% probability for melanoma. This study allowed to estimate the diagnosis of melanoma on the face, using RCM, practicable and feasible in the daily routine, through the presence of some RCM nomogram criteria.
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7
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Dika E, Lambertini M, Patrizi A, Misciali C, Scarfì F, Pellacani G, Mandel VD, Tullio FD, Stanganelli I, Chester J, Kaleci S, Massi D, De Giorgi V, Cinotti E, Rubegni P, Perrot JL, Farnetani F. Follikulotropismus bei Lentigo maligna und Lentigo‐maligna‐Melanom im Kopf‐Hals‐Bereich. J Dtsch Dermatol Ges 2021; 19:223-230. [PMID: 33586901 DOI: 10.1111/ddg.14311_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Emi Dika
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Martina Lambertini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Federica Scarfì
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Giovanni Pellacani
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Victor Desmond Mandel
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy.,Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Francesca Di Tullio
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy.,Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Johanna Chester
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniela Massi
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Vincenzo De Giorgi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Jean Luc Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint-Etienne, France
| | - Francesca Farnetani
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
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8
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De Carvalho N, Fagundes Sortino AM, Martinez Zugaib Abdalla B, Martinez Zugaib Abdalla C. How can reflectance confocal microscopy help in the diagnosis of pigmented facial macules: A series of 3 cases. Australas J Dermatol 2021; 62:e244-e248. [PMID: 33527349 DOI: 10.1111/ajd.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/29/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Nathalie De Carvalho
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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9
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Dika E, Lambertini M, Patrizi A, Misciali C, Scarfì F, Pellacani G, Mandel VD, Di Tullio F, Stanganelli I, Chester J, Kaleci S, Massi D, De Giorgi V, Cinotti E, Rubegni P, Perrot JL, Farnetani F. Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma. J Dtsch Dermatol Ges 2020; 19:223-229. [PMID: 33166059 DOI: 10.1111/ddg.14311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/15/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Lentigo maligna (LM) and lentigo maligna-melanoma (LMM) are histotypes of melanoma arising in skin with cumulative solar radiation damage. The extension of atypical melanocytes to the hair follicle (folliculotropism) is a histopathological feature of LM/LMM. Its role has not been totally clarified, but it may be correlated to treatment response in LM or to progression in LMM. OBJECTIVE This retrospective, multicentric study aims to identify dermatoscopic features associated with folliculotropism in LMs/LMMs. PATIENTS AND METHODS We analyzed cases of head and neck LMs/LMMs diagnosed between 2005-2014 at Melanoma Units, University of Bologna/Modena/Florence/Siena (Italy), Nice (France): 25 LMs and 73 LMMs were included. RESULTS Grey circles (44 %) indicated an isthmic/bulb level of involvement, which were completely absent in the infundibular LM lesions (P = 0.041). In the group of LMMs, light/dark brown pseudonetwork and light brown structureless areas were an indicator of diffuse distribution of malignant melanocytes in the follicular units (P < 0.001 and P = 0.001, respectively), while grey circles indicated focal or diffuse distribution (P < 0.001). CONCLUSIONS A better understanding of the extension of malignant melanocytes is helpful, aiding clinicians in their decision to perform a radical excision or obtaining a biopsy in the most invasive area of the lesion, which includes potential folliculotropism.
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Affiliation(s)
- Emi Dika
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Martina Lambertini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Federica Scarfì
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Laboratory of Bioengineering, University of Bologna, Bologna, Italy
| | - Giovanni Pellacani
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Victor Desmond Mandel
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy.,Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Francesca Di Tullio
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy.,Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Johanna Chester
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniela Massi
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Vincenzo De Giorgi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Jean Luc Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint-Etienne, France
| | - Francesca Farnetani
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy
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10
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Lallas A, Lallas K, Tschandl P, Kittler H, Apalla Z, Longo C, Argenziano G. The dermoscopic inverse approach significantly improves the accuracy of human readers for lentigo maligna diagnosis. J Am Acad Dermatol 2020; 84:381-389. [PMID: 32592885 DOI: 10.1016/j.jaad.2020.06.085] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND A recently introduced dermoscopic method for the diagnosis of early lentigo maligna (LM) is based on the absence of prevalent patterns of pigmented actinic keratosis and solar lentigo/flat seborrheic keratosis. We term this the inverse approach. OBJECTIVE To determine whether training on the inverse approach increases the diagnostic accuracy of readers compared to classic pattern analysis. METHODS We used clinical and dermoscopic images of histopathologically diagnosed LMs, pigmented actinic keratoses, and solar lentigo/flat seborrheic keratoses. Participants in a dermoscopy masterclass classified the lesions at baseline and after training on pattern analysis and the inverse approach. We compared their diagnostic performance among the 3 timepoints and to that of a trained convolutional neural network. RESULTS The mean sensitivity for LM without training was 51.5%; after training on pattern analysis, it increased to 56.7%; and after learning the inverse approach, it increased to 83.6%. The mean proportions of correct answers at the 3 timepoints were 62.1%, 65.5, and 78.5%. The percentages of readers outperforming the convolutional neural network were 6.4%, 15.4%, and 53.9%, respectively. LIMITATIONS The experimental setting and the inclusion of histopathologically diagnosed lesions only. CONCLUSIONS The inverse approach, added to the classic pattern analysis, significantly improves the sensitivity of human readers for early LM diagnosis.
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Affiliation(s)
- Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece.
| | | | - Philipp Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Harald Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Zoe Apalla
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy; Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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11
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Reinehr CPH, Bakos RM. Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects. An Bras Dermatol 2019; 94:637-657. [PMID: 31789244 PMCID: PMC6939186 DOI: 10.1016/j.abd.2019.10.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Actinic keratoses are dysplastic proliferations of keratinocytes with potential for malignant transformation. Clinically, actinic keratoses present as macules, papules, or hyperkeratotic plaques with an erythematous background that occur on photoexposed areas. At initial stages, they may be better identified by palpation rather than by visual inspection. They may also be pigmented and show variable degrees of infiltration; when multiple they then constitute the so-called field cancerization. Their prevalence ranges from 11% to 60% in Caucasian individuals above 40 years. Ultraviolet radiation is the main factor involved in pathogenesis, but individual factors also play a role in the predisposing to lesions appearance. Diagnosis of lesions is based on clinical and dermoscopic examination, but in some situations histopathological analysis may be necessary. The risk of transformation into squamous cell carcinoma is the major concern regarding actinic keratoses. Therapeutic modalities for actinic keratoses include topical medications, and ablative and surgical methods; the best treatment option should always be individualized according to the patient.
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Affiliation(s)
| | - Renato Marchiori Bakos
- Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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12
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Navarrete-Dechent C, Liopyris K, Cordova M, Busam KJ, Marghoob AA, Chen CSJ. Reflectance Confocal Microscopic and En Face Histopathologic Correlation of the Dermoscopic "Circle Within a Circle" in Lentigo Maligna. JAMA Dermatol 2019; 154:1092-1094. [PMID: 30046812 DOI: 10.1001/jamadermatol.2018.2216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Cristian Navarrete-Dechent
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Miguel Cordova
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ashfaq A Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
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13
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Yélamos O, Braun RP, Liopyris K, Wolner ZJ, Kerl K, Gerami P, Marghoob AA. Dermoscopy and dermatopathology correlates of cutaneous neoplasms. J Am Acad Dermatol 2019; 80:341-363. [DOI: 10.1016/j.jaad.2018.07.073] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/01/2018] [Accepted: 07/04/2018] [Indexed: 12/21/2022]
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14
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Farnetani F, Manfredini M, Chester J, Ciardo S, Gonzalez S, Pellacani G. Reflectance confocal microscopy in the diagnosis of pigmented macules of the face: differential diagnosis and margin definition. Photochem Photobiol Sci 2019; 18:963-969. [DOI: 10.1039/c8pp00525g] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Here we review the state-of-the-art of RCM morphologic descriptors, standardized terminology, and diagnostic algorithms for the assessment of pigmented macules of the face, for their correct diagnosis and management.
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Affiliation(s)
- Francesca Farnetani
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | - Marco Manfredini
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | - Johanna Chester
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | - Silvana Ciardo
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
| | | | - Giovanni Pellacani
- Department of Surgical
- Medical
- Dental & Morphological Sciences with Interest Transplant
- Oncological & Regenerative Medicine
- Dermatology Unit
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15
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Dinnes J, Deeks JJ, Chuchu N, Saleh D, Bayliss SE, Takwoingi Y, Davenport C, Patel L, Matin RN, O'Sullivan C, Patalay R, Williams HC. Reflectance confocal microscopy for diagnosing keratinocyte skin cancers in adults. Cochrane Database Syst Rev 2018; 12:CD013191. [PMID: 30521687 PMCID: PMC6516892 DOI: 10.1002/14651858.cd013191] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Early accurate detection of all skin cancer types is important to guide appropriate management and improve morbidity and survival. Basal cell carcinoma (BCC) is usually a localised skin cancer but with potential to infiltrate and damage surrounding tissue, whereas cutaneous squamous cell carcinoma (cSCC) and melanoma are higher risk skin cancers with the potential to metastasise and ultimately lead to death. When used in conjunction with clinical or dermoscopic suspicion of malignancy, or both, reflectance confocal microscopy (RCM) may help to identify cancers eligible for non-surgical treatment without the need for a diagnostic biopsy, particularly in people with suspected BCC. Any potential benefit must be balanced against the risk of any misdiagnoses. OBJECTIVES To determine the diagnostic accuracy of RCM for the detection of BCC, cSCC, or any skin cancer in adults with any suspicious lesion and lesions that are difficult to diagnose (equivocal); and to compare its accuracy with that of usual practice (visual inspection or dermoscopy, or both). SEARCH METHODS We undertook a comprehensive search of the following databases from inception to August 2016: Cochrane Central Register of Controlled Trials; MEDLINE; Embase; CINAHL; CPCI; Zetoc; Science Citation Index; US National Institutes of Health Ongoing Trials Register; NIHR Clinical Research Network Portfolio Database; and the World Health Organization International Clinical Trials Registry Platform. We studied reference lists and published systematic review articles. SELECTION CRITERIA Studies of any design that evaluated the accuracy of RCM alone, or RCM in comparison to visual inspection or dermoscopy, or both, in adults with lesions suspicious for skin cancer compared with a reference standard of either histological confirmation or clinical follow-up, or both. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data using a standardised data extraction and quality assessment form (based on QUADAS-2). We contacted authors of included studies where information related to the target condition or diagnostic threshold were missing. We estimated summary sensitivities and specificities using the bivariate hierarchical model. For computation of likely numbers of true-positive, false-positive, false-negative, and true-negative findings in the 'Summary of findings' tables, we applied summary sensitivity and specificity estimates to lower quartile, median and upper quartiles of the prevalence observed in the study groups. We also investigated the impact of observer experience. MAIN RESULTS The review included 10 studies reporting on 11 study cohorts. All 11 cohorts reported data for the detection of BCC, including 2037 lesions (464 with BCC); and four cohorts reported data for the detection of cSCC, including 834 lesions (71 with cSCC). Only one study also reported data for the detection of BCC or cSCC using dermoscopy, limiting comparisons between RCM and dermoscopy. Studies were at high or unclear risk of bias across almost all methodological quality domains, and were of high or unclear concern regarding applicability of the evidence. Selective participant recruitment, unclear blinding of the reference test, and exclusions due to image quality or technical difficulties were observed. It was unclear whether studies were representative of populations eligible for testing with RCM, and test interpretation was often undertaken using images, remotely from the participant and the interpreter blinded to clinical information that would normally be available in practice.Meta-analysis found RCM to be more sensitive but less specific for the detection of BCC in studies of participants with equivocal lesions (sensitivity 94%, 95% confidence interval (CI) 79% to 98%; specificity 85%, 95% CI 72% to 92%; 3 studies) compared to studies that included any suspicious lesion (sensitivity 76%, 95% CI 45% to 92%; specificity 95%, 95% CI 66% to 99%; 4 studies), although CIs were wide. At the median prevalence of disease of 12.5% observed in studies including any suspicious lesion, applying these results to a hypothetical population of 1000 lesions results in 30 BCCs missed with 44 false-positive results (lesions misdiagnosed as BCCs). At the median prevalence of disease of 15% observed in studies of equivocal lesions, nine BCCs would be missed with 128 false-positive results in a population of 1000 lesions. Across both sets of studies, up to 15% of these false-positive lesions were observed to be melanomas mistaken for BCCs. There was some suggestion of higher sensitivities in studies with more experienced observers. Summary sensitivity and specificity could not be estimated for the detection of cSCC due to paucity of data. AUTHORS' CONCLUSIONS There is insufficient evidence for the use of RCM for the diagnosis of BCC or cSCC in either population group. A possible role for RCM in clinical practice is as a tool to avoid diagnostic biopsies in lesions with a relatively high clinical suspicion of BCC. The potential for, and consequences of, misclassification of other skin cancers such as melanoma as BCCs requires further research. Importantly, data are lacking that compare RCM to standard clinical practice (with or without dermoscopy).
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Affiliation(s)
- Jacqueline Dinnes
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Jonathan J Deeks
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Naomi Chuchu
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Daniel Saleh
- Newcastle Hospitals NHS Trust, Royal Victoria InfirmaryNewcastle HospitalsNewcastleUK
- The University of Queensland, PA‐Southside Clinical UnitSchool of Clinical MedicineBrisbaneQueenslandAustralia
| | - Susan E Bayliss
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Yemisi Takwoingi
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Clare Davenport
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Lopa Patel
- Royal Stoke HospitalPlastic SurgeryStoke‐on‐TrentStaffordshireUKST4 6QG
| | - Rubeta N Matin
- Churchill HospitalDepartment of DermatologyOld RoadHeadingtonOxfordUKOX3 7LE
| | | | - Rakesh Patalay
- Guy's and St Thomas' NHS Foundation TrustDepartment of DermatologyDSLU, Cancer CentreGreat Maze PondLondonUKSE1 9RT
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
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Persechino F, De Carvalho N, Ciardo S, De Pace B, Casari A, Chester J, Kaleci S, Stanganelli I, Longo C, Farnetani F, Pellacani G. Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy. Exp Dermatol 2018; 27:227-232. [DOI: 10.1111/exd.13487] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Flavia Persechino
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | - Nathalie De Carvalho
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
- Skin Cancer Unit Scientific Institute of Romagna for The study and Treatment of Cancer; IRCSS; IRST; Meldola Italy
| | - Silvana Ciardo
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | - Barbara De Pace
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | - Alice Casari
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | - Johanna Chester
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | - Shaniko Kaleci
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit Scientific Institute of Romagna for The study and Treatment of Cancer; IRCSS; IRST; Meldola Italy
| | - Caterina Longo
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
- Skin Cancer Unit; IRCCS Santa Maria Nuova; Reggio Emilia Italy
| | - Francesca Farnetani
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
| | - Giovanni Pellacani
- Dermatology Department; University of Modena and Reggio Emilia; Modena Italy
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17
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Kelati A, Baybay H, Moscarella E, Argenziano G, Gallouj S, Mernissi F. Dermoscopy of Pigmented Actinic Keratosis of the Face: A Study of 232 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Dermoscopy of Pigmented Actinic Keratosis of the Face: A Study of 232 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:844-851. [DOI: 10.1016/j.ad.2017.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/04/2017] [Accepted: 05/07/2017] [Indexed: 11/22/2022] Open
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19
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Dermatoscopic Patterns of Nonfacial Actinic Keratosis: Characterization of Pigmented and Nonpigmented Lesions. Dermatol Surg 2017; 43:1385-1391. [DOI: 10.1097/dss.0000000000001210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Lentigo Maligna, Macules of the Face, and Lesions on Sun-Damaged Skin: Confocal Makes the Difference. Dermatol Clin 2017; 34:421-429. [PMID: 27692448 DOI: 10.1016/j.det.2016.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Distinguishing lentigo maligna (LM) and lentigo maligna melanoma (LMM) from background pigmented non-melanoma lesions is challenging. The field of solar damage can obscure clinical assessment, and diagnostic ambiguities are created due to the overlap of the clinical features of LM with other benign lesions. Moreover, margin assessment on histology is limited by the resemblance between melanocytic hyperplasia of actinically damaged skin and scattered atypical melanocytes of LM/LMM. Dermoscopy has made a significant contribution but is often not sufficient for diagnosis and margin assessment. Confocal microscopy has become an important complementary tool in enhancing the management of these complex lesions.
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21
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Khlebnikova AN, Obydenova KV, Sedova TG, Andrukhina VV. Diagnosis of actinic keratosis by dermatoscopy. VESTNIK DERMATOLOGII I VENEROLOGII 2017. [DOI: 10.25208/0042-4609-2017-93-2-45-52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Actinic keratosis (AK) is a local introepidermal atypia of keratinocytes, formed as a result of intense and prolonged exposure to sunlight. AK lesions located on exposed areas of skin, mostly on the face, in this regard, a more relevant non-invasive diagnostic techniques, primarily dermatoscopy. Material and methods: We examined 35 patients and revealed they have 204 hearth. Results: Of the 204 lesions erythematous form was found in 160 (78, 4%) cases, keratotic - 24 (11,8%), pigmental (9.8 %). Patients with AK most private dermatoscopic signs were erythema (90,2%), vascular structures (67,65%), keratin scales (51,47%), pseudonetwork (23,04%). Discussion: Analyzing dermoscopic picture of the most common forms of AK met the characteristics for each shape. A detailed study of vascular structures allows for the differential diagnosis of cancer in situ. While AK watched point and the glomerular vessels of not more than 10% of cases, which helped to differentiate AK from cancer in situ, in which such vessels were found in 40%. Glomerular vessels are not met in our study and the points were only 2.45% of the cases. Keratotic AK was characterized in 100% of cases the presence of keratin scales. In pigment form, we revealed the dark brown streaks (80%), dark brown points (50%), brown globules (30%), dark brown blots (10%) and slate-grey dots (10%). But the gold standard for the differential diagnosis with maligna lentigo is a morphological study. Conclusion: AK has specific characteristics in treatment research, which helps to differentiate it from other benign and malignant tumors of the skin, and to diagnose it in its earliest stages without resorting to invasive procedures. Effective diagnosis of AK reduces the risk of malignant transformation and contribute to the selection of adequate and necessary treatment tactics.
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22
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Lentigo maligno. Claves en el diagnóstico dermatoscópico. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:489-97. [DOI: 10.1016/j.ad.2016.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/15/2015] [Accepted: 01/03/2016] [Indexed: 11/20/2022] Open
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23
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Bollea-Garlatti L, Galimberti G, Galimberti R. Lentigo Maligna: Keys to Dermoscopic Diagnosis. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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24
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Lallas A, Tschandl P, Kyrgidis A, Stolz W, Rabinovitz H, Cameron A, Gourhant J, Giacomel J, Kittler H, Muir J, Argenziano G, Hofmann-Wellenhof R, Zalaudek I. Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis. Br J Dermatol 2016; 174:1079-85. [DOI: 10.1111/bjd.14355] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 11/26/2022]
Affiliation(s)
- A. Lallas
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - P. Tschandl
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - A. Kyrgidis
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - W. Stolz
- Department of Dermatology, Allergology and Environmental Medicine II; Hospital Thalkirchner Straße; Städtisches Klinikum Munich Munich Germany
| | | | - A. Cameron
- School of Medicine; University of Queensland; Brisbane Qld Australia
| | | | - J. Giacomel
- Skin Spectrum Medical Services; Como WA Australia
| | - H. Kittler
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - J. Muir
- School of Medicine; The University of Queensland; Brisbane Qld Australia
| | - G. Argenziano
- Dermatology Unit; Second University of Naples; Naples Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Non-Melanoma Skin Cancer Unit; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venerology; Non-Melanoma Skin Cancer Unit; Medical University of Graz; Graz Austria
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25
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Dinnes J, Matin RN, Moreau JF, Patel L, Chan SA, Chuchu N, Bayliss SE, Grainge M, Takwoingi Y, Davenport C, Walter FM, Fleming C, Schofield J, Shroff N, Godfrey K, O'Sullivan C, Deeks JJ, Williams HC. Tests to assist in the diagnosis of cutaneous melanoma in adults: a generic protocol. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011902] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Jac Dinnes
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Rubeta N Matin
- Churchill Hospital; Department of Dermatology; Old Road Headington Oxford UK OX3 7LJ
| | - Jacqueline F Moreau
- University of Pittsburgh Medical Center; Internal Medicine; Department of Medicine, Office of Education UPMC Montefiore Hospital, N715 Pittsburgh USA PA, 15213
| | - Lopa Patel
- Royal Stoke Hospital; Plastic Surgery; Stoke-on-Trent Staffordshire UK ST4 6QG
| | - Sue Ann Chan
- NHS; Dermatology; 104 Times Square Avenue Brierley Hill Dudley UK DY5 1SX
| | - Naomi Chuchu
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Susan E Bayliss
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Matthew Grainge
- School of Community Health Sciences; Division of Epidemiology and Public Health; University of Nottingham Nottingham UK NG7 2UH
| | - Yemisi Takwoingi
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Clare Davenport
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Fiona M Walter
- University of Cambridge; Public Health & Primary Care; Strangeways Research Laboratory, Worts Causeway Cambridge UK CB1 8RN
| | - Colin Fleming
- NHS Tayside, Ninewells Hospital; Dermatology; Ninewells Drive Dundee UK DD1 9SY
| | - Julia Schofield
- United Lincolnshire Hospitals NHS Trust; Dermatology; Greetwell Street Lincoln UK LN2 5QY
| | - Neil Shroff
- Keyworth Medical Practice; Bunny Lane Keyworth Nottingham UK NG12 5JU
| | - Kathie Godfrey
- The University of Nottingham; c/o Cochrane Skin Group; Nottingham UK
| | | | - Jonathan J Deeks
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Hywel C Williams
- The University of Nottingham; Centre of Evidence Based Dermatology; Queen's Medical Centre Derby Road Nottingham UK NG7 2UH
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26
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Kasprzak JM, Xu YG. Diagnosis and management of lentigo maligna: a review. Drugs Context 2015; 4:212281. [PMID: 26082796 PMCID: PMC4453766 DOI: 10.7573/dic.212281] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 05/12/2015] [Indexed: 01/14/2023] Open
Abstract
Lentigo maligna is a melanocytic neoplasm occurring on sun-exposed skin, usually on the head and neck, of middle-aged and elderly patients. It is thought to represent the in situ phase of lentigo maligna melanoma. The ill-defined nature and potentially large size of lesions can pose significant diagnostic and treatment challenges. The goal of therapy is to cure the lesions in order to prevent development of invasive disease, and surgical excision is the treatment of choice to achieve clear histological margins. Nonsurgical treatment modalities have been reported; however, evidence is lacking to support their use. Age, general health, and comorbidities need to be taken into account when deciding the right treatment modality for each individual patient.
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Affiliation(s)
- Julia M Kasprzak
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Yaohui G Xu
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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