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Ceder H, Backman E, Marghoob A, Navarrete-Dechent C, Polesie S, Reiter O, Paoli J. Importance of Both Clinical and Dermoscopic Findings in Predicting High-Risk Histopathological Subtype in Facial Basal Cell Carcinomas. Dermatol Pract Concept 2024:dpc.1403a212. [PMID: 38934710 DOI: 10.5826/dpc.1403a212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Being able to recognize high-risk facial basal cell carcinoma (BCC) may lead to fewer incomplete excisions and inappropriate treatments. OBJECTIVES We sought to investigate clinical and dermoscopic criteria for predicting facial BCC subtypes, analyze the interobserver agreement between readers, and develop a diagnostic algorithm to predict high-risk histopathological subtype. METHODS In this single-center, retrospective investigation, 6 independent readers evaluated predefined clinical and dermoscopic criteria in images of histopathologically verified primary facial BCCs including: topography, border demarcation, vessels, ulceration, white porcelain areas, shiny white blotches and strands, and pigmented structures and vessels within ulceration. RESULTS Overall, 297 clinical and dermoscopic image pairs were analyzed. The strongest associations with high-risk subtype were: "bumpy" topography (OR 3.8, 95% CI, 3.1-4.7), ill-defined borders (OR 3.4, 95% CI 3.1-4.7), white porcelain area (OR 3.5, 95% CI 2.8-4.5), and vessels within ulceration (OR 3.1, 95% CI 2.4-4.1). Predominantly focused vessels were a positive diagnostic criterium for either nodular (OR 1.7, 95% CI 1.3-2.2) or high-risk (OR 2.0, 95% CI 1.6-2.5) subtypes and a strong negative diagnostic criterium for superficial BCC (OR 14.0, 95% CI 9.6-20.8). Interobserver agreement ranged from fair to substantial (κ=0.36 to 0.72). A diagnostic algorithm based on these findings demonstrated a sensitivity of 81.4% (95% CI, 78.9-83.7%) and a specificity of 53.3% (95% CI, 49.7-56.9%) for predicting high-risk BCC subtype. CONCLUSIONS Integration of both clinical and dermoscopic features (including novel features such as topography and vessels within ulceration) are essential to improve subtype prediction of facial BCCs and management decisions.
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Affiliation(s)
- Hannah Ceder
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Backman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ashfaq Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, Hauppague, New York
| | - Cristián Navarrete-Dechent
- Melanoma and Skin Cancer Unit, Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sam Polesie
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ofer Reiter
- Dermatology Division, Rabin Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Barbarossa L, D’Onghia M, Cartocci A, Suppa M, Tognetti L, Cappilli S, Peris K, Perez-Anker J, Malvehy J, Baldino G, Militello C, Perrot JL, Rubegni P, Cinotti E. Understanding the Dermoscopic Patterns of Basal Cell Carcinoma Using Line-Field Confocal Tomography. Tomography 2024; 10:826-838. [PMID: 38921940 PMCID: PMC11209319 DOI: 10.3390/tomography10060063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Basal cell carcinoma (BCC) is the most frequent malignancy in the general population. To date, dermoscopy is considered a key tool for the diagnosis of BCC; nevertheless, line-field confocal optical coherence tomography (LC-OCT), a new non-invasive optical technique, has become increasingly important in clinical practice, allowing for in vivo imaging at cellular resolution. The present study aimed to investigate the possible correlation between the dermoscopic features of BCC and their LC-OCT counterparts. In total, 100 histopathologically confirmed BCC cases were collected at the Dermatologic Clinic of the University of Siena, Italy. Predefined dermoscopic and LC-OCT criteria were retrospectively evaluated, and their frequencies were calculated. The mean (SD) age of our cohort was 65.46 (13.36) years. Overall, BCC lesions were mainly located on the head (49%), and they were predominantly dermoscopically pigmented (59%). Interestingly, all dermoscopic features considered had a statistically significant agreement with the LC-OCT criteria (all p < 0.05). In conclusion, our results showed that dermoscopic patterns may be associated with LC-OCT findings, potentially increasing accuracy in BCC diagnosis. However, further studies are needed in this field.
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Affiliation(s)
- Lorenzo Barbarossa
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Martina D’Onghia
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Alessandra Cartocci
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Simone Cappilli
- Department of Dermatology, Sacred Heart Catholic University, 00168 Rome, Italy; (S.C.)
| | - Ketty Peris
- Department of Dermatology, Sacred Heart Catholic University, 00168 Rome, Italy; (S.C.)
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Gennaro Baldino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
| | - Caterina Militello
- Department of Pathological Anatomy, University of Siena, 53100 Siena, Italy
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
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Barten AHJ, Beyers CP, Vondenhoff MFR, Stergioulas L, Kukutsch NA. The effect of a dermoscopy training programme on diagnostic accuracy and management decisions regarding pigmented skin lesions: a comparison between dermal therapists and general practitioners. Clin Exp Dermatol 2024; 49:591-598. [PMID: 38214576 DOI: 10.1093/ced/llad441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/31/2023] [Accepted: 12/04/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. OBJECTIVES This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. METHODS In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. RESULTS Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30-90) for GPs and 63% (range 27-80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor > 100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. CONCLUSIONS The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed.
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Affiliation(s)
| | - Cornelis P Beyers
- Data Science Research Group, The Hague University of Applied Sciences, The Hague, the Netherlands
- The Centre of Expertise Wellbeing Economy and New Entrepreneurship, Avans University of Applied Sciences, Breda, the Netherlands
| | - Mark F R Vondenhoff
- Oncological Care Research Group
- Data Science Research Group, The Hague University of Applied Sciences, The Hague, the Netherlands
| | - Lampros Stergioulas
- Data Science Research Group, The Hague University of Applied Sciences, The Hague, the Netherlands
| | - Nicole A Kukutsch
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
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Longo C, Guida S, Mirra M, Pampena R, Ciardo S, Bassoli S, Casari A, Rongioletti F, Spadafora M, Chester J, Kaleci S, Lai M, Magi S, Mazzoni L, Farnetani F, Stanganelli I, Pellacani G. Dermatoscopy and reflectance confocal microscopy for basal cell carcinoma diagnosis and diagnosis prediction score: A prospective and multicenter study on 1005 lesions. J Am Acad Dermatol 2024; 90:994-1001. [PMID: 38296197 DOI: 10.1016/j.jaad.2024.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/25/2023] [Accepted: 01/05/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is usually diagnosed by clinical and dermatoscopy examination, but diagnostic accuracy may be suboptimal. Reflectance confocal microscopy (RCM) imaging increases skin cancer diagnostic accuracy. OBJECTIVE To evaluate additional benefit in diagnostic accuracy of handheld RCM in a prospective controlled clinical setting. METHODS A prospective, multicenter study in 3 skin cancer reference centers in Italy enrolling consecutive lesions with clinical-dermatoscopic suspicion of BCC (ClinicalTrials.gov: NCT04789421). RESULTS A total of 1005 lesions were included, of which 474 histopathologically confirmed versus 531 diagnosed by clinical-dermatoscopic-RCM correlation, confirmed with 2 years of follow-up. Specifically, 740 were confirmed BCCs. Sensitivity and specificity for dermatoscopy alone was 93.2% (95% CI, 91.2-94.9) and 51.7% (95% CI, 45.5-57.9); positive predictive value was 84.4 (95% CI, 81.7-86.8) and negative predictive value 73.3 (95% CI, 66.3-79.5). Adjunctive RCM reported higher rates: 97.8 (95% CI, 96.5-98.8) sensitivity and 86.8 (95% CI, 82.1-90.6) specificity, with positive predictive value of 95.4 (95% CI, 93.6-96.8) and negative predictive value 93.5 (95% CI, 89.7-96.2). LIMITATIONS Study conducted in a single country. CONCLUSIONS Adjunctive handheld RCM assessment of lesions clinically suspicious for BCC permits higher diagnostic accuracy with minimal false negative lesions.
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Affiliation(s)
- Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
| | - Stefania Guida
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Dermatology Clinic, IRCCS San Raffaele Hospital, Milan, Italy.
| | - Marica Mirra
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
| | - Riccardo Pampena
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Sara Bassoli
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alice Casari
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Franco Rongioletti
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Dermatology Clinic, IRCCS San Raffaele Hospital, Milan, Italy
| | - Marco Spadafora
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Michela Lai
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Serena Magi
- Dermatology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy; Skin Cancer Unit, IRCCS, Istituto Romagnolo per lo Studio dei Tumori (IRST), Meldola, Italy
| | - Laura Mazzoni
- Dermatology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy; Skin Cancer Unit, IRCCS, Istituto Romagnolo per lo Studio dei Tumori (IRST), Meldola, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Ignazio Stanganelli
- Dermatology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy; Skin Cancer Unit, IRCCS, Istituto Romagnolo per lo Studio dei Tumori (IRST), Meldola, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Cabo H, Salerni G, Sabban EC, Garlatti AB, Orendain N, Rodríguez-Saa S, Bakos RM, Pozzobon FC, González VM, Peralta R, Navarrete-Dechent C, Peirano D, Pérez-Fernández E, Puig S. Dermoscopic Features of Pigmented Bowen Disease: A Multicenter Study on Behalf of the Ibero-Latin American College of Dermatology (CILAD). Dermatol Pract Concept 2024; 14:dpc.1402a86. [PMID: 38810038 PMCID: PMC11135966 DOI: 10.5826/dpc.1402a86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series. OBJECTIVES To report dermoscopic findings in a large series of 147 pBD diagnosed in Ibero-Latin American population. METHODS We conducted a multicentric, retrospective study on 147 histologically proven pBD under the auspices of the Dermoscopy Chapter of the Ibero-Latin American College of Dermatology. RESULTS The study population consisted of 77 females (52%) and 70 males (48%) with a mean age of 68.6 years. 70.1% of patients had skin phototype 3, 15.6% to skin phototype 2, and 14.3% to skin phototype 4. On clinical examination, near 60% of pBD were flat, 70% presented with scales, and 90% were asymmetric. Under dermoscopy, structureless hypopigmented areas, dots brown and pink color were the most frequently observed. Regarding specific dermoscopic clues to pBD, the most prevalent were structureless hypopigmented areas, vessels arranged in linear fashion at the periphery, and pigmented lines or pigmented dots distributed in a linear fashion. Clustered, coiled, and dotted vessels were observed in 55.8%, 45.6%, and 45.6% of the cases, respectively. CONCLUSIONS We report a large series of cases of pBD in Latin American patients, with most patients being skin phototype 3 and 4. Distinctively in our study, the pigmented structures and the clues derived from the presence of melanin were much more frequent than in previous reports in fair skin.
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Affiliation(s)
- Horacio Cabo
- Head Professor of Dermatology, Universidad de Buenos Aires, Argentina
| | - Gabriel Salerni
- Dermatology Department, Hospital Provincial del Centenario de Rosario - Universidad Nacional de Rosario, Rosario, Argentina
| | - Emilia Cohen Sabban
- Head of Dermatology Service, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina
| | | | | | - Sonia Rodríguez-Saa
- Department of Dermatology, Hospital Nuestra Señora del Carmen, Obra Social de Empleados Públicos (OSEP), Godoy Cruz, Mendoza, Argentina
| | - Renato Marchiori Bakos
- Department of Dermatology, Hospital de Clınicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flavia Carolina Pozzobon
- Centro de Diagnostico Dermatológico, Bogotá, Colombia; Instituto Nacional de Cancerología, Bogotá, Colombia
| | | | - Rosario Peralta
- Dermatology Department, Instituto de Investigaciones Médicas “A. Lanari”, University of Buenos Aires, Buenos Aires, Argentina
| | - Cristian Navarrete-Dechent
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Dermatology Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Dominga Peirano
- Department of Dermatology Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Elia Pérez-Fernández
- Unidad de Investigación. Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Susana Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain. CIBER de enfermedades raras, Instituto de Salud Carlos III, Barcelona, Spain
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Marsden H, Kemos P, Venzi M, Noy M, Maheswaran S, Francis N, Hyde C, Mullarkey D, Kalsi D, Thomas L. Accuracy of an artificial intelligence as a medical device as part of a UK-based skin cancer teledermatology service. Front Med (Lausanne) 2024; 11:1302363. [PMID: 38585154 PMCID: PMC10996444 DOI: 10.3389/fmed.2024.1302363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction An artificial intelligence as a medical device (AIaMD), built on convolutional neural networks, has demonstrated high sensitivity for melanoma. To be of clinical value, it needs to safely reduce referral rates. The primary objective of this study was to demonstrate that the AIaMD had a higher rate of correctly classifying lesions that did not need to be referred for biopsy or urgent face-to-face dermatologist review, compared to teledermatology standard of care (SoC), while achieving the same sensitivity to detect malignancy. Secondary endpoints included the sensitivity, specificity, positive and negative predictive values, and number needed to biopsy to identify one case of melanoma or squamous cell carcinoma (SCC) by both the AIaMD and SoC. Methods This prospective, single-centre, single-arm, masked, non-inferiority, adaptive, group sequential design trial recruited patients referred to a teledermatology cancer pathway (clinicaltrials.gov NCT04123678). Additional dermoscopic images of each suspicious lesion were taken using a smartphone with a dermoscopic lens attachment. The images were assessed independently by a consultant dermatologist and the AIaMD. The outputs were compared with the final histological or clinical diagnosis. Results A total of 700 patients with 867 lesions were recruited, of which 622 participants with 789 lesions were included in the per-protocol (PP) population. In total, 63.3% of PP participants were female; 89.0% identified as white, and the median age was 51 (range 18-95); and all Fitzpatrick skin types were represented including 25/622 (4.0%) type IV-VI skin. A total of 67 malignant lesions were identified, including 8 diagnosed as melanoma. The AIaMD sensitivity was set at 91 and 92.5%, to match the literature-defined clinician sensitivity (91.46%) as closely as possible. In both settings, the AIaMD identified had a significantly higher rate of identifying lesions that did not need a biopsy or urgent referral compared to SoC (p-value = 0.001) with comparable sensitivity for skin cancer. Discussion The AIaMD identified significantly more lesions that did not need to be referred for biopsy or urgent face-to-face dermatologist review, compared to teledermatologists. This has the potential to reduce the burden of unnecessary referrals when used as part of a teledermatology service.
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Affiliation(s)
| | - Polychronis Kemos
- Blizard Institute, The Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | - Mariana Noy
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Shameera Maheswaran
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Nicholas Francis
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, United Kingdom
| | - Christopher Hyde
- Exeter Test Group, Department of Health and Community Sciences, University of Exeter Medical School, Exeter, United Kingdom
| | | | | | - Lucy Thomas
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
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Manca R, Dattolo A, Valenzano F, Castriota M, Martella A, Galdo G, Argenziano G, Abeni D, Fania L. Proposal of a new dermoscopic criterion for pigmented basal cell carcinoma: a multicentre retrospective study. Dermatol Reports 2024; 16:9691. [PMID: 38623374 PMCID: PMC11017719 DOI: 10.4081/dr.2023.9691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 02/24/2023] [Indexed: 04/17/2024] Open
Abstract
Dermoscopy is widely used for the diagnosis of skin cancer and it increases the accuracy of basal cell carcinoma (BCC) detection. BCC dermoscopic criteria have been updated and divided into vascular, pigment-related, and non-vascular/non-pigment-related. Our multicenter retrospective study tested a new dermoscopic pigment-related characteristic to detect pigmented BCC (pBCC) [brown homogeneous blotches (BHB)]. Cases of pBCC were collected from the databases of IDI-IRCCS of Rome and from three Italian private dermatology centers. BHB are confined patches of brown uniform pigmentation without dermoscopic features (net, fat fingers, etc.) or other internal dermoscopic structures, except for occasional vascular ones like arborizing vessels or globules/dots. Melanocytic and non-melanocytic controls were used. We reviewed photos of 270 pigmented lesions (female 145; 51.8%), including 90 histopathologically verified pBCC and 180 control cases (90 melanocytic and 90 non-melanocytic). BHB were found in 61 cases of 90 pBCC patients. The results showed a 67.8 sensitivity, 93.3 specificity, 83.6 positive and 85.3 negative predictive values, posLR 10.2, negLR 0.3, odds ratio 29.4, p<0.001. Our multicentre retrospective analysis suggested the BHB may be a novel dermoscopic pBCC diagnosis criterion.
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Affiliation(s)
| | - Anna Dattolo
- IDI-IRCCS, Dermatological Research Hospital, Rome
| | | | | | | | | | | | | | - Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Rome
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García Ruiz R, Mateu Puchades A, Alegre de Miquel V. Basal Cell Carcinoma: Incidence and Trends in Valencia, Spain. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00186-8. [PMID: 38452894 DOI: 10.1016/j.ad.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/14/2024] [Accepted: 02/24/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND There is a need for epidemiological and incidence data on the occurrence of basal cell carcinoma (BCC) in Spain. OBJECTIVES Our study was designed to retrospectively retrieve cases from our computer databases from 2010 through 2016 to provide updated data on the actual incidence of BCC in Valencia, eastern Spain. MATERIAL AND METHODS This was an epidemiological study on basal cell carcinoma conducted in Valencia, eastern Spain. We analyzed a total of 2171 patients and 4047 tumors, and gathered data to estimate the actual incidence of BBC in our region. RESULTS AND CONCLUSIONS Our study confirmed that the incidence of BCC is much higher than previously reported. We calculated a crude incidence of 410.38 BCCs/100 000 person-years, an adjusted rate for the European population of 256.98 BCCs/100 000 person-years, and an adjusted rate for the world population of 196.26 BCCs/100 000 person-years. Risk is up to 29.49% higher for men (464.07 cases/100 000 person-years vs 358.40 cases/100 000 person-years for women). Incidence also increases by an annual 3.91% (a significantly higher annual incidence of 8.28% in women vs a 0.92% annual incidence in men). Overall, the lifetime risk for developing a BCC is 5.8% (5.02% in women and 7% in men).
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Palmisano G, Orte Cano C, Fontaine M, Lenoir C, Cinotti E, Tognetti L, Rubegni P, Perez-Anker J, Puig S, Malvehy J, Perrot JL, Del Marmol V, Peris K, Suppa M. Dermoscopic criteria explained by LC-OCT: Negative maple leaf-like areas. J Eur Acad Dermatol Venereol 2024; 38:e271-e273. [PMID: 37876332 DOI: 10.1111/jdv.19588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Gerardo Palmisano
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Carmen Orte Cano
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Margot Fontaine
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Clément Lenoir
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Elisa Cinotti
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Jean-Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Véronique Del Marmol
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Ketty Peris
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino-Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
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10
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Zhang LW, Wu J, Chen T. Comment on '"Poroma-like" branched vessels with rounded endings in dermoscopy of basal cell carcinoma: a new unusual structure'. Clin Exp Dermatol 2024; 49:175. [PMID: 37811873 DOI: 10.1093/ced/llad349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023]
Abstract
This article advocates for the use of multiple noninvasive diagnostic tools for assessment and mutual validation to improve diagnostic accuracy in BCC. Different imaging techniques, each with its advantages, can provide multimodal preoperative information for management options that aim to meet the needs of clinicians.
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Affiliation(s)
- Li-Wen Zhang
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu
| | - Juan Wu
- Sexually Transmitted Disease Institute, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tao Chen
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu
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11
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Mahatma G, Sinha S, Chhoa J, Wladis EJ. Statistical evaluation and positive predictive value of key features of periorbital basal cell carcinoma. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:550-552. [PMID: 36030818 DOI: 10.1016/j.jcjo.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/30/2022] [Accepted: 07/30/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the accuracy of using the suspicious features of periorbital lesions-telangiectasias, madarosis, and ulceration-to identify basal cell carcinoma (BCC). This may impact whether a histopathologic confirmation is always necessary. METHODS This retrospective review of patients who underwent biopsy of eyelid lesions was conducted over a five-year period, between 2015 and 2020 at a single clinical site. Specifically, the histopathologic diagnosis and the presence or absence of clinical signs of madarosis, ulceration and telangiectasia were recorded. The positive predictive value (PPV) for eyelid BCC and odds ratio of each of these clinical signs was calculated. RESULTS 179 patients underwent incisional biopsies of eye lid lesions. Of the 79 patients with eyelid BCC, 96% had ulceration, 95% had madarosis, and 75% had telangiectasias over the lid lesion; this contrasted with the 3%, 4% and 6% respectively in the 100 patients with benign lid lesions. The PPV for eyelid BCC of ulceration was 95.0%, madarosis was 96.2% and telangiectasias was 90.8%. The presence of two or all three signs in a patient was strongly predictive of BCC (PPV=100%). CONCLUSION The presence of two or more suspicious features almost ensures the accuracy of the suspected diagnosis of a BCC. This suggests that biopsy of eyelid lesions before complete surgical excision that demonstrate several defining features may not be necessary in all cases. However, lesions that do not demonstrate multiple explicit features that indicate a malignancy will still require histopathologic confirmation.
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Affiliation(s)
- Gina Mahatma
- Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA
| | - Shruti Sinha
- Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA
| | - John Chhoa
- Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA
| | - Edward J Wladis
- Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, New York, USA.
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12
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Gellatly ZS, Lagha IB, Ternov NK, Berry E, Nelson KC, Seiverling EV. The Role of Dermoscopy in Provider-to-Provider Store-and-Forward Dermatology eConsults: A Scoping Review of the Recent Literature. CURRENT DERMATOLOGY REPORTS 2023; 12:169-179. [PMID: 38390375 PMCID: PMC10883069 DOI: 10.1007/s13671-023-00407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 02/24/2024]
Abstract
Purpose of Review This scoping review maps recent literature on dermatology provider-to-provider asynchronous store-and-forward (SAF) electronic consult (eConsult) platforms with dermoscopy. It offers a descriptive overview, highlighting benefits and challenges. Recent Findings Incorporating dermoscopy into SAF eConsults improves diagnostic accuracy for benign and malignant skin neoplasms. Diagnostic and treatment concordance with traditional face-to-face (FTF) visits is high. SAF eConsults with dermoscopy enhance access to dermatological care by improving triage and reducing wait times for FTF visits. Pediatric patients benefit with improved evaluation of melanocytic and vascular growths. eConsult platforms with dermoscopy serve as a telementoring opportunity for clinicians interested in improving their dermoscopy skills. Summary Adding dermoscopy to SAF eConsults is valuable and results in improved diagnostic accuracy and reduced need for FTF visits. Implementation barriers can be overcome through collaboration between primary care and dermatology. Dermoscopy in SAF eConsults has significant potential for managing skin conditions and reducing the burden caused by unnecessary FTF visit and biopsies.
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Affiliation(s)
| | - Imene B Lagha
- Tufts Medical Center, Department of Dermatology, Boston, MA 02116, USA
| | - Niels Kvorning Ternov
- Department of Plastic Surgery, Herley and Gentofte University Hospital, Copenhagen, Demark
| | - Elizabeth Berry
- OHSU Department of Dermatology Center for Health and Healing, Portland, OR 97239, USA
| | - Kelly C Nelson
- The University of Texas, Department of Dermatology, Division of Internal Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA
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13
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Arias-Rodriguez C, Muñoz-Monsalve AM, Cuesta D, Mejia-Mesa S, Aluma-Tenorio MS. Dermoscopy of very small basal cell carcinoma (≤3mm). An Bras Dermatol 2023; 98:755-763. [PMID: 37422343 PMCID: PMC10589476 DOI: 10.1016/j.abd.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/18/2022] [Accepted: 12/23/2022] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) dermoscopy is key to lower the biopsy threshold of suspicious lesions. There is a scarcity of published data on the dermoscopy of very small BCC (≤3mm) and its differences from larger BCCs. OBJECTIVE To describe and compare dermoscopic features of BCCs measuring ≤3mm, with those from 3 to 10mm. METHODS An analytical cross-sectional study, included biopsy-proven BCCs that had dermoscopic photographic images, between January 2017 and December 2022 in a Skin Cancer Center in Medellín, Colombia. Demographic, clinic-pathological and dermoscopic features were compared between very small BCCs (vsBCCs) and a reference group. RESULTS A total of 326 BCCs in 196 patients were included, of whom 60% were male. The most common Fitzpatrick phototype was III. vsBCCs accounted for 25% of the lesions (81/326). Face and neck were the most frequent locations (53%), especially in very small tumors. The nodular type was more common in very small tumors than in larger lesions, the superficial type was less frequent, and aggressive types were equally prevalent in both groups. On dermoscopy, very small tumors were statistically more likely to present pigmented structures than reference lesions, especially blue-gray dots (67% vs. 54%), vessels were less frequent, particularly short-fine telangiectasias (SFT) (52% vs. 66%), as were other structures such as shiny white structures (SWS), ulceration, micro-erosions, and scales. STUDY LIMITATIONS Latin-American sample, lacks information on dark phototypes CONCLUSIONS: Pigmented structures, especially blue-gray dots, were most common in vsBCCs when compared to larger lesions; SFT, SWS and other findings were less prevalent.
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Affiliation(s)
- Camilo Arias-Rodriguez
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia; Department of Dermatology, Aurora Center Specialized in Piel Cancer, Medellin, Colombia.
| | | | - Diana Cuesta
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
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14
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Peris K, Fargnoli MC, Kaufmann R, Arenberger P, Bastholt L, Seguin NB, Bataille V, Brochez L, Del Marmol V, Dummer R, Forsea AM, Gaudy-Marqueste C, Harwood CA, Hauschild A, Höller C, Kandolf L, Kellerners-Smeets NWJ, Lallas A, Leiter U, Malvehy J, Marinović B, Mijuskovic Z, Moreno-Ramirez D, Nagore E, Nathan P, Stratigos AJ, Stockfleth E, Tagliaferri L, Trakatelli M, Vieira R, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer 2023; 192:113254. [PMID: 37604067 DOI: 10.1016/j.ejca.2023.113254] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into 'easy-to-treat' (common) and 'difficult-to-treat' according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of 'difficult-to-treat' BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.
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Affiliation(s)
- Ketty Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | | | - Veronique Bataille
- Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London SE1 7EH, UK
| | - Lieve Brochez
- Department of Dermatology, University Hospital Ghent, Ghent, Belgium
| | - Veronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich and University Zurich, Switzerland
| | - Ana-Marie Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | | | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - Christoph Höller
- Department of Dermatology, Medical University of Vienna, Austria
| | - Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - Nicole W J Kellerners-Smeets
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands; Department of Dermatology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
| | - Josep Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | - Branka Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, Croatia
| | - Zeljko Mijuskovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - David Moreno-Ramirez
- Dermatology. Medicine School, University of Seville, University Hospital Virgen Macarena, Seville-Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Alexander J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Eggert Stockfleth
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Rome, Italy
| | - Myrto Trakatelli
- Second Department of Dermatology, Aristotle University Medical School, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ricardo Vieira
- Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
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15
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Cavallo F, Mazzoletti V, Zelin E, Avallone G, Roccuzzo G, Bottomicca F, Quaglino P, Zalaudek I, Ribero S. 'Poroma-like' branched vessels with rounded endings in dermoscopy of basal cell carcinoma: a new unusual structure. Clin Exp Dermatol 2023; 48:1177-1179. [PMID: 37401454 DOI: 10.1093/ced/llad225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/05/2023]
Abstract
We report the cases of three patients with basal cell carcinoma that showed branched vessels with rounded endings, a vascular pattern never described in basal cell carcinoma and previously associated with eccrine poroma. We also speculate about the meaning of this pattern and underline the importance of this atypical vascular presentation in the differential diagnosis of malignant melanoma.
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Affiliation(s)
- Francesco Cavallo
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Vanessa Mazzoletti
- Department of Health Science, University of Eastern Piedmont, Novara, Italy
| | - Enrico Zelin
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Gianluca Avallone
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Gabriele Roccuzzo
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Pietro Quaglino
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Iris Zalaudek
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Simone Ribero
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
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16
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Savant SS. Use of preoperative and perioperative ex vivo dermoscopy for precise mapping of margins for standard surgical excision of primary basal cell carcinoma. Indian J Dermatol Venereol Leprol 2023; 89:793. [PMID: 37317762 DOI: 10.25259/ijdvl_325_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 01/01/2023] [Indexed: 06/16/2023]
Abstract
Background The utility of preoperative and perioperative dermoscopy in standard surgical excision for radical excision of primary basal cell carcinoma remain unexplored. Aims To evaluate the use of preoperative and perioperative dermoscopy for precise mapping of margins during standard surgical excision of primary basal cell carcinoma. Methods In this retrospective, observational study, 17 patients clinically diagnosed with various morphological subtypes of basal cell carcinoma were included. Data about previous history, clinical examination of lesions and regional lymph nodes and preoperative dermoscopy were retrieved. After standard surgical excision had been carried out as per mapping of lateral margins, all the excised surgical specimens were subjected to perioperative dermoscopy and later reconfirmed with histopathology. Results Seventeen patients with mean age of 60.82 ± 9.99 years and median disease duration of 14 months were analysed. Clinically, basal cell carcinomas were of pigmented superficial subtype [6 (35.3%)], followed by pigmented nodular [5 (29.4%)], nodulo-ulcerative [4 (23.5%)] and micro nodular [2 (11.8%)]. Mean extension of clinical margin after dermoscopy was 0.59 ± 0.52 mm. Mean pre-assessed depth of tumour and mean depth of tumour were 3.46 ± 0.89 mm and 3.49 ± 0.92 mm, respectively. No recurrence was reported. Frequently found pre-operative dermoscopic features were maple leaf like structures [6 (35%)], blue grey dots and globules [6 (35%)] and short fine telangiectasias [6 (35%)]. Commonly observed perioperative dermoscopic features were: (1) irregular band with brown-grey pigmentation of dots, globules, streaks and pseudopodia like extensions [3 (50%)]; (2) irregular band of pseudo granulomatous structureless vascular areas in psoriasiform pattern with diffuse white streaks in pseudopodia like manner [1 (50%)]; (3) irregular band of pseudo granulomatous structureless vascular areas in psoriasiform pattern with streaks of white pseudopodia like structureless areas [1 (50%)]. Limitation This was a single-centre study with a small sample size. Conclusion This study highlights significance of preoperative and perioperative dermoscopy for precise planning and radical excision of primary basal cell carcinoma by standard surgical excision.
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Affiliation(s)
- Sushil S Savant
- Department of Dermatology, The Humanitarian Clinic: Skin, Hair and Laser Centre, Mumbai, Maharashtra, India
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17
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Pogorzelska-Dyrbuś J, Lallas A, Szepietowski JC. Morphology of Vessels in Basal Cell Carcinoma in Optical Super-high Magnification Dermoscopy. Acta Derm Venereol 2023; 103:adv11966. [PMID: 37529846 PMCID: PMC10413508 DOI: 10.2340/actadv.v103.11966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/31/2023] [Indexed: 08/03/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland.
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18
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Asodaria P, Hunt S, Kazmi D, Fleming A, Malhotra R. Perifolliculitis mimicking basal cell carcinoma. Orbit 2023:1-3. [PMID: 37428952 DOI: 10.1080/01676830.2023.2227706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/15/2023] [Indexed: 07/12/2023]
Abstract
We present a case of a periocular painless perifolliculitis clinically mimicking basal cell carcinoma (BCC), excised by margin-controlled excision. This case reminds readers that perifolliculitis as a response to rosacea can mimic BCC. The value of diagnostic biopsy and dermoscopy to support management planning and avoid unnecessary surgery is discussed.
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Affiliation(s)
- Priyanka Asodaria
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Samantha Hunt
- Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex
| | - Danish Kazmi
- Kent Integrated Dermatology Service, Worthing, West Sussex
| | - Ann Fleming
- Histopathology Department, Maidstone Hospital, Maidstone, Kent
| | - Raman Malhotra
- Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex
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19
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Pogorzelska-Dyrbuś J, Salwowska N, Bergler-Czop B. Dermoscopic Pattern of Basal Cell Carcinoma in H- and Non-H-zones. Dermatol Pract Concept 2023; 13:e2023125. [PMID: 37557122 PMCID: PMC10412089 DOI: 10.5826/dpc.1303a125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Basal cell carcinoma (BCC) localized in the H-zone, the region of fusion of embryonic masses, has been associated with a higher risk of deeper invasion and more frequent recurrence. OBJECTIVES The aim of the study was to compare dermoscopic features of BCC in H and non-H zone that may most appropriately characterize those two locations. METHODS Dermoscopy images of histopathologically confirmed BCCs from 120 patients were retro-spectively analyzed. Dermoscopy features of BCC in H- and non-H zone were described and a comparative study of the dermoscopic pattern of BCC between the two locations was performed. RESULTS Of 120 BCC cases included in this study, 41 (34.2%) were located in the H-zone. The most frequent histological type was nodular (51.3% in H- zone and 61.6 % in non-H-zone) followed by superficial (5.1% and 19.8 % in H and non-H-zone respectively).In dermoscopy, there was a higher prevalence of ulceration (73.2% versus 43.6%, P < 0.001) in H-zone and a lower prevalence of brown globules (26.8% versus 53.2%; P = 0.01), when compared with the non-H-zone. CONCLUSIONS Our results show that dermoscopic features of BCC on the face fulfill a typical pattern regardless of the region, except for the prevalence of the ulceration which is significantly more frequent in H-zone and the brown globules present significantly more often in the non-H-zone It can be hypothesized that H-zone might predispose to more aggressive course of BCC complicated by ulceration and consequently deeper tissue destruction.
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Affiliation(s)
| | - Natalia Salwowska
- Department of Dermatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Bergler-Czop
- Department of Dermatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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20
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Yamazaki K, Maejima M, Saeki H, Osada SI. Recurrence or de novo? Intradermal Basal Cell Carcinoma of the Scrotum: A Report of Two Cases. Dermatopathology (Basel) 2023; 10:128-135. [PMID: 37092530 PMCID: PMC10123599 DOI: 10.3390/dermatopathology10020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common cutaneous malignancy, usually occurring in sun-exposed areas. Although BCC in the scrotal region is uncommon, it carries a higher risk of metastasis than BCC at other sites. Here, we report two cases of BCC that developed in the scrotal region: Case 1 presented as a superficial nodule and Case 2 as a subcutaneous nodule. Histopathologically, both tumors lacked continuity with the surface epidermis and formed an intradermal nodule. In Case 1, BCC occurred for the first time and presumably developed de novo. Case 2 underwent excision of a scrotal BCC 5 years previously, and the histopathological diagnosis at that time was nodular BCC. However, when the original specimen was re-examined, it was determined that, although the tumor had been completely resected, part of the lesion had moved away from the nodular area to represent a micronodular phenotype, an aggressive BCC subtype. We hypothesized that partial evolution from a nodular to a micronodular phenotype may have contributed to the recurrence of BCC in Case 2.
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21
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Backman E, Oxelblom M, Gillstedt M, Dahlén Gyllencreutz J, Paoli J. Basal cell carcinoma: Epidemiological impact of clinical versus histopathological diagnosis. J Eur Acad Dermatol Venereol 2023; 37:521-527. [PMID: 36433707 DOI: 10.1111/jdv.18774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Low-risk basal cell carcinomas (BCCs) are to an increasing extent diagnosed by dermatologists through dermoscopic examination only and treated with non-surgical methods. Reports on increasing incidence as well as trends regarding subtypes, anatomical sites and differences related to gender are based solely on histopathologically verified tumours. How unreported clinically diagnosed BCCs affect the epidemiological data has not been sufficiently investigated. OBJECTIVES To analyse the tumour and patient characteristics of clinically diagnosed versus histopathologically confirmed primary BCCs and to make a gross estimate on how unreported BCCs could influence the total number of new cases. METHODS We retrospectively reviewed all primary BCCs diagnosed in 2016 at the Department of Dermatology, Sahlgrenska University Hospital in Gothenburg, Sweden. We also reviewed all histopathologically verified primary BCCs at the two largest pathology laboratories in Western Sweden during the same year to estimate the proportion of BCCs diagnosed by dermatologists. RESULTS In total, 2365 primary BCCs were diagnosed at our centre. More than half of these tumours were clinically diagnosed (55.8%). Superficial subtype (41.7%), location on the trunk (46.3%) and destructive treatment methods (60.0%) were most common. The reports from the two pathology laboratories showed that histopathologically verified BCCs (n = 5837) were more commonly of the infiltrative or nodular subtype and located in the head and neck area. Dermatologists managed 56.0% of them. CONCLUSIONS This study indicates that a substantial number of BCCs are not visualized in the official statistics which are solely based on reports from pathology laboratories. When taking clinically diagnosed tumours into account, truncal location and superficial subtype are more common than previously believed. Further, based on the regional calculations, the real burden of BCC in Sweden might be up to 70% higher than what is reported in official statistics.
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Affiliation(s)
- Eva Backman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Oxelblom
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Gillstedt
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Johan Dahlén Gyllencreutz
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology, Region Västra Götaland, Frölunda Specialist Hospital, Gothenburg, Sweden
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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22
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Infrared Macrothermoscopy Patterns-A New Category of Dermoscopy. J Imaging 2023; 9:jimaging9020036. [PMID: 36826955 PMCID: PMC9960988 DOI: 10.3390/jimaging9020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/13/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
(1) Background: The authors developed a new non-invasive dermatological infrared macroimaging analysis technique (MacroIR) that evaluates microvascular, inflammatory, and metabolic changes that may be dermoscopy complimentary, by analyzing different skin and mucosal lesions in a combined way-naked eye, polarized light dermatoscopy (PLD), and MacroIR-and comparing results; (2) Methods: ten cases were evaluated using a smartphone coupled with a dermatoscope and a macro lens integrated far-infrared transducer into specific software to capture and organize high-resolution images in different electromagnetic spectra, and then analyzed by a dermatologist; (3) Results: It was possible to identify and compare structures found in two dermoscopic forms. Visual anatomical changes were correlated with MacroIR and aided skin surface dermatological analysis, presenting studied area microvascular, inflammatory, and metabolic data. All MacroIR images correlated with PLD, naked eye examination, and histopathological findings; (4) Conclusion: MacroIR and clinic dermatologist concordance rates were comparable for all dermatological conditions in this study. MacroIR imaging is a promising method that can improve dermatological diseases diagnosis. The observations are preliminary and require further evaluation in larger studies.
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23
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Yuki A, Takatsuka S, Abe R, Takenouchi T. Diagnostic accuracy of dermoscopy for 934 basal cell carcinomas: A single-center retrospective study. J Dermatol 2023; 50:64-71. [PMID: 36229917 DOI: 10.1111/1346-8138.16607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 01/04/2023]
Abstract
Although the efficacy of dermoscopic diagnosis of basal cell carcinoma (BCC) has already been established, most studies have been conducted in Western countries. However, there are racial differences in the clinicopathological characteristics of BCC, highlighting the need for a survey among Asians. Herein, we aimed to investigate the diagnostic accuracy of dermoscopy in 934 Japanese patients with BCC and statistically analyze the clinicopathological factors affecting diagnostic accuracy. We analyzed 5093 skin lesions, including 934 BCCs that were diagnosed consecutively from 1998 to 2018. The sensitivity and specificity of dermoscopic diagnosis for BCC were calculated. The sensitivity and specificity of dermoscopic diagnosis were 92.2% and 96.0%, respectively. There were 73 false-negative cases of BCCs that were clinically diagnosed with other diseases. The most common incorrect clinical diagnosis was seborrheic keratosis (n = 18), followed by melanocytic nevus (n = 15). Multiple logistic regression analysis showed that sensitivity was significantly lower in BCCs located on the trunk and extremities, which showed low pigmentation (less than 10% of the lesion surface) and were diagnosed by a resident dermatologist. Experience of 3-6 months of 12 resident dermatologists revealed increased sensitivity. Dermoscopy is a reliable tool for the accurate diagnosis of BCC in Japanese individuals. Care should be taken when diagnosing BCCs of the trunk and extremities, and the less-pigmented subtype because of lower sensitivity. A certain amount of experience is required to improve the skills for dermoscopy.
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Affiliation(s)
- Akihiko Yuki
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Sumiko Takatsuka
- Department of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Riichiro Abe
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tatsuya Takenouchi
- Department of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan
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24
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Navarrete-Dechent C, Uribe P, Rabinovitz H, Abarzua-Araya A, Kittler H. Basal Cell Carcinomas Presenting as Flat Pigmented Macules on the Face Mimicking Lentigo Maligna on Dermoscopy: A Case Series. Dermatol Pract Concept 2023; 13:dpc.1301a38. [PMID: 36892346 PMCID: PMC9946124 DOI: 10.5826/dpc.1301a38] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Cristian Navarrete-Dechent
- Melanoma and Skin Cancer Unit, Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Uribe
- Melanoma and Skin Cancer Unit, Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Harold Rabinovitz
- Department of Dermatology, Medical College of Georgia, Augusta, GA, USA
| | - Alvaro Abarzua-Araya
- Melanoma and Skin Cancer Unit, Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Harald Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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25
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Di Brizzi EV, Argenziano G, Brancaccio G, Scharf C, Ronchi A, Moscarella E. The current clinical approach to difficult-to-treat basal cell carcinomas. Expert Rev Anticancer Ther 2023; 23:43-56. [PMID: 36579630 DOI: 10.1080/14737140.2023.2161517] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Basal cell carcinoma (BCC) is the most common malignant tumor in adult white populations. If BCCs are not treated for years, if they cause massive destruction of the surrounding tissues, if they are considered unresectable or not eligible for radiotherapy they become progressively 'locally advanced' (laBCC) or metastatic (mBCC). These tumors are defined as 'difficult-to-treat BCC.' AREAS COVERED A comprehensive search on PubMed was conducted to identify relevant literature about the several approved and recommended treatment options for the management of difficult-to-treat BCC published from January 2012 to July 2022. Surgical options, radiotherapy, hedgehog inhibitors, immunotherapy, and combined treatments are discussed. The keywords used were basal cell carcinoma; difficult-to-treat BCC; management of difficult-to-treat BCC; surgical therapy; radiotherapy; hedgehog inhibitors; immunotherapy. EXPERT OPINION Identifying the best approach to DTT BCCs is one of the main challenges for the dermato-oncologist. The introduction of HHI for the treatment of advanced BCCs has revolutionized the clinical management of DTT BCCs. The immune checkpoint inhibitor cemiplimab has been approved for the treatment of locally advanced or metastatic BCC refractory to HHI therapy or in patients intolerant to HHI therapy. Multidisciplinary teams (MDTs) play a key role in managing these complex patients.
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Affiliation(s)
| | | | | | - Camila Scharf
- Dermatology Unit, University of Campania, Naples, Italy
| | - Andrea Ronchi
- Pathology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
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26
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Lam JH, Tu KJ, Kim J, Kim S. Smartphone-based single snapshot spatial frequency domain imaging. BIOMEDICAL OPTICS EXPRESS 2022; 13:6497-6507. [PMID: 36589565 PMCID: PMC9774861 DOI: 10.1364/boe.470665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
We report a handheld, smartphone-based spatial frequency domain imaging device. We first examined the linear dynamic range of the smartphone camera sensor. We then calculated optical properties for a series of liquid phantoms with varying concentrations of nigrosin ink and Intralipid, demonstrating separation of absorption and scattering. The device was then tested on a human wrist, where optical properties and hemoglobin-based chromophores were calculated. Finally, we performed an arterial occlusion on a human hand and captured hemodynamics using our device. We hope to lay the foundation for an accessible SFDI device with mass-market appeal designed for dermatological and cosmetic applications.
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Affiliation(s)
- Jesse H. Lam
- Dankook University, Beckman Laser Institute Korea, School of Medicine, Cheonan, Chungnam, Republic of Korea
| | - Kelsey J. Tu
- Dankook University, Department of Biomedical Engineering, Cheonan, Chungnam, Republic of Korea
| | - Jeonghun Kim
- Dankook University, Department of Biomedical Engineering, Cheonan, Chungnam, Republic of Korea
- MEDiThings Co. Ltd., Industry-Academia Cooperation, Dankook University, Cheonan, Chungnam, Republic of Korea
| | - Sehwan Kim
- Dankook University, Department of Biomedical Engineering, Cheonan, Chungnam, Republic of Korea
- University of California, Irvine, Beckman Laser Institute, Department of Biomedical Engineering, Irvine, CA, USA
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27
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Navarrete‐Dechent C, Abarzúa‐Araya A, Andreani S, Villaseca MA. Traumatic tattoo as a clinical and dermoscopic mimicker of pigmented basal cell carcinoma and other tumors: a series of three cases. Int J Dermatol 2022. [DOI: 10.1111/ijd.16516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/13/2022] [Accepted: 11/06/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Cristian Navarrete‐Dechent
- Department of Dermatology, Escuela de Medicina Pontificia Universidad Católica de Chile Santiago Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina Pontificia Universidad Católica de Chile Santiago Chile
| | - Alvaro Abarzúa‐Araya
- Department of Dermatology, Escuela de Medicina Pontificia Universidad Católica de Chile Santiago Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina Pontificia Universidad Católica de Chile Santiago Chile
| | | | - Miguel A. Villaseca
- Melanoma and Skin Cancer Unit, Escuela de Medicina Pontificia Universidad Católica de Chile Santiago Chile
- Department of Pathology, Escuela de Medicina Pontificia Universidad Católica de Chile Santiago Chile
- Department of Pathology Universidad de la Frontera Temuco Chile
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28
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Caruntu C, Tsatsakis AM, Tampa M, Georgescu SR, Gonzalez S. Editorial: Recent advances in keratinocyte carcinomas: From molecular mechanisms to clinical perspectives. Front Med (Lausanne) 2022; 9:1078020. [DOI: 10.3389/fmed.2022.1078020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
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29
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Lim SS, Hui L, Ohn J, Cho Y, Oh CC, Mun JH. Diagnostic accuracy of dermoscopy for onychomycosis: A systematic review. Front Med (Lausanne) 2022; 9:1048913. [PMID: 36388930 PMCID: PMC9659606 DOI: 10.3389/fmed.2022.1048913] [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] [Received: 09/20/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background Dermoscopy is a non-invasive adjuvant diagnostic tool that allows clinicians to visualize microscopic features of cutaneous disorders. Recent studies have demonstrated that dermoscopy can be used to diagnose onychomycosis. We performed this systematic review to identify the characteristic dermoscopic features of onychomycosis and understand their diagnostic utility. Methods We searched the Medline, Embase, Scopus, and Cochrane databases from conception until May 2021. Studies on the dermoscopic features of onychomycosis were screened. The exclusion criteria were as follows: fewer than 5 cases of onychomycosis, review articles, and studies including onychomycosis cases that were not mycologically verified. Studies on fungal melanonychia were analyzed separately. We adhered to the MOOSE guidelines. Independent data extraction was performed. Data were pooled using a random effects model to account for study heterogeneity. The primary outcome was the diagnostic accuracy of the dermoscopic features of onychomycosis. This was determined by pooling the sensitivity and specificity values of the dermoscopic features identified during the systematic review using the DerSimonian-Laird method. Meta-DiSc version 1.4 and Review Manager 5.4.1 were used to calculate these values. Results We analyzed 19 articles on 1693 cases of onychomycosis and 5 articles on 148 cases of fungal melanonychia. Commonly reported dermoscopic features of onychomycosis were spikes or spiked pattern (509, 30.1%), jagged or spiked edges or jagged edge with spikes (188, 11.1%), jagged proximal edge (175, 10.3%), subungual hyperkeratosis (131, 7.7%), ruins appearance, aspect or pattern (573, 33.8%), and longitudinal striae (929, 54.9%). Commonly reported features of fungal melanonychia included multicolor (101, 68.2%), non-longitudinal homogenous pigmentation (75, 50.7%) and longitudinal white or yellow streaks (52, 31.5%). Conclusion This study highlights the commonly identified dermoscopic features of onychomycosis. Recognizing such characteristic dermoscopic features of onychomycosis can assist clinicians diagnose onychomycosis by the bedside.
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Affiliation(s)
| | - Laura Hui
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Jungyoon Ohn
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Human-Environment Interface Biology, Seoul National University, Seoul, South Korea
| | - Youngjoo Cho
- Department of Applied Statistics, Konkuk University, Seoul, South Korea
| | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Human-Environment Interface Biology, Seoul National University, Seoul, South Korea
- *Correspondence: Je-Ho Mun
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30
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Basal Cell Carcinoma. Dermatol Clin 2022; 41:13-21. [DOI: 10.1016/j.det.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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31
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Jiang J, Chen Y, He Q, Yang J, Zhang Z, Yang H, Zhang H, Yang C. Syringocystadenoma Papilliferum and Basal Cell Carcinoma Arising in Nevus Sebaceous. Clin Cosmet Investig Dermatol 2022; 15:2021-2026. [PMID: 36176943 PMCID: PMC9514293 DOI: 10.2147/ccid.s378746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Abstract
Nevus sebaceous (NS) is a benign congenital hamartoma with the potential to develop into a secondary benign or malignant skin tumors. Two or more skin tumors rarely arise simultaneously from a single NS lesion. Herein, we report a case of syringocystadenoma papilliferum and basal cell carcinoma arising in an NS, based on dermoscopic, reflectance confocal microscopic, and histopathological findings.
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Affiliation(s)
- Jingjing Jiang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Yujuan Chen
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Qi He
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Jiao Yang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Zhengzhong Zhang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Hao Yang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Huan Zhang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Chuan Yang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
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32
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Niculet E, Bobeica C, Craescu M, Nicolescu AC, Tocu G, Onisor C, Arbune M, Tatu AL. Multimodal Considerations Concerning Basal Cell Carcinoma Clefting – Profile of Structural and Aggressive Traits – Perspectives. Clin Cosmet Investig Dermatol 2022; 15:2087-2095. [PMID: 36199384 PMCID: PMC9529228 DOI: 10.2147/ccid.s385213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/11/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Correspondence: Mihaela Craescu, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40751869864, Email
| | | | - George Tocu
- Department of Pharmaceutical Sciences, “Dunărea de Jos” University, Galati, Romania
- George Tocu, Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40773819438, Email
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Manuela Arbune
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galați, Romania
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33
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Alonso-Belmonte C, Montero-Vilchez T, Arias-Santiago S, Buendía-Eisman A. [Translated article] Current State of Skin Cancer Prevention: A Systematic Review. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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34
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Situación actual de la prevención del cáncer de piel: una revisión sistemática. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:781-791. [DOI: 10.1016/j.ad.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 11/20/2022] Open
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35
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Ma W, Zhan R, Sui C, Zhou F, Liu H, Zhang X, Ruan Z, Wang Y, Cai X. Clinical Retrospective Analysis of 243 Patients with Rhinofacial Ulcers. Clin Cosmet Investig Dermatol 2022; 15:1475-1483. [PMID: 35935600 PMCID: PMC9355335 DOI: 10.2147/ccid.s371029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Weiyuan Ma
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People’s Republic of China
- Correspondence: Weiyuan Ma, Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People’s Republic of China, Email
| | - Ruyu Zhan
- Scientific Research Center, Anxi County Hospital, Quanzhou, Fujian, People’s Republic of China
| | - Changlin Sui
- Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, Shandong, People’s Republic of China
| | - Fushan Zhou
- Scientific Research Center, Anxi County Hospital, Quanzhou, Fujian, People’s Republic of China
| | - Haidong Liu
- Department of Dermatology, Liaocheng People’s Hospital, Liaocheng, Shandong, People’s Republic of China
| | - Xiuwen Zhang
- Department of Dermatology, Weihai Municipal Hospital, Weihai, Shandong, People’s Republic of China
| | - Zhenqiang Ruan
- Department of Dermatology, Jinan Dermatosis Prevention and Control Hospital, Jinan, Shandong, People’s Republic of China
| | - Yukun Wang
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China
| | - Xiaolan Cai
- Department of Otolaryngology, Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China
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36
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Zhang L, Shen X, Fu L, Meng H, Lu Y, Chen T, Xu R. Dermoscopy, reflectance confocal microscopy, and high‐frequency ultrasound for the noninvasive diagnosis of morphea‐form basal cell carcinoma. Skin Res Technol 2022; 28:766-768. [PMID: 35871487 PMCID: PMC9907648 DOI: 10.1111/srt.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Li‐Wen Zhang
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu Sichuan China
| | - Xue Shen
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu Sichuan China
| | - Li‐Xin Fu
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu Sichuan China
| | - Hui‐Min Meng
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu Sichuan China
| | - Yong‐Hong Lu
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu Sichuan China
| | - Tao Chen
- Department of Dermatovenereology Chengdu Second People's Hospital Chengdu Sichuan China
| | - Rong‐Hua Xu
- Institute of Dermatology Chengdu Second People's Hospital Chengdu Sichuan China
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Pellacani G, Farnetani F, Ciardo S, Chester J, Kaleci S, Mazzoni L, Bassoli S, Casari A, Pampena R, Mirra M, Lai M, Magi S, Mandel VD, Di Matteo S, Colombo GL, Stanganelli I, Longo C. Effect of Reflectance Confocal Microscopy for Suspect Lesions on Diagnostic Accuracy in Melanoma: A Randomized Clinical Trial. JAMA Dermatol 2022; 158:754-761. [PMID: 35648432 PMCID: PMC9161119 DOI: 10.1001/jamadermatol.2022.1570] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Previous systematic reviews and meta-analyses have concluded that given data paucity, a comparison of reflectance confocal microscopy (RCM) with dermoscopy is complex. They recommend comparative prospective studies in a real-world setting of suspect lesions. Objective To test the hypothesis that RCM reduces unnecessary lesion excision by more than 30% and identifies all melanoma lesions thicker than 0.5 mm at baseline. Design, Setting, and Participants This randomized clinical trial included 3165 patients enrolled from 3 dermatology referral centers in Italy between January 2017 and December 2019, with a mean (SD) follow-up of 9.6 (6.9) months (range, 1.9-37.0 months). The consecutive sample of 3165 suspect lesions determined through dermoscopy were eligible for inclusion (10 patients refused). Diagnostic analysis included 3078 patients (48 lost, 39 refused excision). Data were analyzed between April and September 2021. Interventions Patients were randomly assigned 1:1 to standard therapeutic care (clinical and dermoscopy evaluation) with or without adjunctive RCM. Information available guided prospective clinical decision-making (excision or follow-up). Main Outcomes and Measures Hypotheses were defined prior to study initiation. All lesions excised (baseline and follow-up) were registered, including histopathological diagnoses/no change at dermoscopy follow-up (with or without adjunctive RCM). Number needed to excise (total number of excised lesions/number of melanomas) and Breslow thickness of delayed diagnosed melanomas were calculated based on real-life, prospective, clinical decision-making. Results Among the 3165 participants, 1608 (50.8%) were male, and mean (SD) age was 49.3 (14.9) years. When compared with standard therapeutic care only, adjunctive RCM was associated with a higher positive predictive value (18.9 vs 33.3), lower benign to malignant ratio (3.7:1.0 vs 1.8:1.0), and a number needed to excise reduction of 43.4% (5.3 vs 3.0). All lesions (n = 15) with delayed melanoma diagnoses were thinner than 0.5 mm. Conclusions and Relevance This randomized clinical trial shows that adjunctive use of RCM for suspect lesions reduces unnecessary excisions and assures the removal of aggressive melanomas at baseline in a real-life, clinical decision-making application for referral centers with RCM. Trial Registration ClinicalTrials.gov Identifier: NCT04789421.
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Affiliation(s)
- Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Clinic, Sapienza University of Rome, Rome, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Mazzoni
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Bassoli
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alice Casari
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Pampena
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Marica Mirra
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michela Lai
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Serena Magi
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Victor D Mandel
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Giorgio Lorenzo Colombo
- CEFAT Center of Pharmaceuticals Economics and Medical Technologies Evaluation, University of Pavia, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) IRCCS, Meldola, Italy.,Dermatology Unit, University of Parma, Parma, Italy
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoscopically narrowed surgical margins for head and neck basal cell carcinoma: A retrospective case-control study. J Dtsch Dermatol Ges 2022; 20:807-816. [PMID: 35581699 PMCID: PMC9321004 DOI: 10.1111/ddg.14757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) can cause extensive tissue damage if untreated. Complete surgical excision is the treatment of choice, but especially in the head-and neck area, defining both radical and healthy skin sparing surgical margins is complex. MATERIALS AND METHODS Excised, small (≤ 1 cm), BCCs of the head and neck were retrospectively analyzed, comparing histological properness of surgical margins after clinical-dermatoscopical preoperative evaluation (cases), vs. clinical evaluation only (controls) and recurrences. RESULTS Of 281 BCCs: 6 % (8/139) of cases and 8 % (12/142) of controls had unproper deep margins; 4 % (5/139) of cases, 20 % (29/142) of controls had unproper lateral margins (P < 0.001). Surgical 3 mm lateral margins were unproper in 0 % (15/66) of cases, 15 % (10/66) of controls (P > 0.005); surgical 1-2 mm lateral margins were unproper in 7 % (5/73) of cases, 25 % (19/76) of controls (P < 0.01). Of cases excised at 3 mm, 1-2 mm, and controls, 1.5 %, 0 %, and 7.7 % recurred, respectively. CONCLUSIONS BCC excision at 3 mm may be appropriate in the head and neck for small, dermatoscopically well-defined and non-aggressive BCCs, attaining surgical cure rates of 100 % and 1.5 % recurrences. Excision at 1-2 mm should be reserved only for BCCs in very difficult-to-treat areas, as the surgical cure rate was only 93 %.
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Affiliation(s)
- Astrid Herzum
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Martina Burlando
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Pietro Paolo Tavilla
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Claudia Micalizzi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Mattia Fabio Molle
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Emanuele Cozzani
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Aurora Parodi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoskopisch kontrollierte, schmalere Resektionsränder bei Basalzellkarzinomen an Kopf und Hals: Retrospektive Fallkontrollstudie. J Dtsch Dermatol Ges 2022; 20:807-817. [PMID: 35711047 DOI: 10.1111/ddg.14757_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
Hintergrund: Unbehandelt kann das Basalzellkarzinom (BCC) erhebliche Gewebezerstörungen verursachen. Die komplette chirurgische Exzision ist die Behandlung der Wahl. Allerdings stellt es besonders im Gesichts- und Halsbereich eine Herausforderung dar, den Tumor vollständig zu entfernen und möglichst viel gesundes Gewebe zu erhalten. Material und Methoden: Bereits exzidierte kleine BCC (≤ 1 cm) von Kopf oder Hals wurden retrospektiv analysiert. Verglichen wurde die histologisch kontrolliert angemessene Breite des Resektionsrandes nach präoperativer dermatoskopischer Untersuchung (Fälle) im Vergleich zur rein klinischen Untersuchung (Kontrollen), sowie die Rezidivrate. Ergebnisse: Bei 281 BCC: 6 % (8/139) der Fälle und 8 % (12/142) der Kontrollen zeigten inadäquate basale Resektionsränder; 4 % (5/139) der Fälle und 20 % (29/142) der Kontrollen zeigten inadäquate laterale Resektionsränder (P < 0.001). Laterale Resektionsränder von 3 mm waren in 0 % (15/66) der Fälle, jedoch in 15 % (10/66) der Kontrollen inadäquat (P >0.005); laterale Resektionsränder von 1-2 mm waren in 7 % (5/73) der Fälle und in 25 % (19/76) der Kontrollen inadäquat (P < 0.01). Rezidive traten in den Fällen mit 3 mm Resektionsrand in 1,5 % auf, in den Fällen mit 1-2 mm Resektionsrand bei 0 %, und bei den Kontrollen bei 7,7 %. Schlussfolgerung: Für BCC im Kopf- und Halsbereich erscheint ein Resektionsrand von 3 mm angemessen, sofern das BCC klein, dermatoskopisch gut definiert und wenig aggressiv ist. Hier zeigten sich operative Heilungsraten von 100 % mit 1,5 % Rezidiven. Resektionsränder von 1-2 mm sollten nur für BCC in sehr schwierig zu behandelnden Bereichen in Betracht gezogen werden, da die Heilungsrate hier nur bei 93 % lag.
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Affiliation(s)
- Astrid Herzum
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Martina Burlando
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Pietro Paolo Tavilla
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Claudia Micalizzi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Mattia Fabio Molle
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Emanuele Cozzani
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Aurora Parodi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
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Backman EJ, Polesie S, Berglund S, Gillstedt M, Sjöholm A, Modin M, Paoli J. Curettage versus cryosurgery for superficial basal cell carcinoma: a prospective, randomised and controlled trial. J Eur Acad Dermatol Venereol 2022; 36:1758-1765. [PMID: 35543079 PMCID: PMC9544261 DOI: 10.1111/jdv.18209] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
Background Basal cell carcinoma (BCC) is the most common cancer in the world and has a rising incidence. Current guidelines for low‐risk BCC including superficial BCC (sBCC) recommend several treatment options including destructive treatment methods, such as cryosurgery with or without prior curettage or curettage and electrodesiccation. Curettage only (i.e. without subsequent cryosurgery or electrodesiccation) is a simple and quick destructive treatment method used for many benign skin lesions but has not been sufficiently evaluated for the treatment of sBCCs. Objectives The objective was to compare the effectiveness of curettage vs. cryosurgery for sBCCs in terms of overall clinical clearance rates after 1 year as well as wound healing times. Methods A single‐centre non‐inferiority clinical trial was conducted. Non‐facial sBCCs with a diameter of 5–20 mm were randomised to either cryosurgery using one freeze–thaw cycle or curettage. At follow‐up visits, treatment areas were evaluated regarding the presence of residual tumour after 3–6 months and recurrence after 1 year. Further, wound healing times were assessed. Results In total, 228 sBCCs in 97 patients were included in the analysis. At 3–6 months, no residual tumours were seen in any of the treated areas. After 1 year, the clinical clearance rates for curettage and cryosurgery were 95.7% and 100%, respectively (P = 0.060). However, the non‐inferiority analysis was inconclusive. Wound healing times were shorter for curettage (4 weeks) compared to cryosurgery (5 weeks; P < 0.0001). Overall, patient satisfaction at 1 year was high. Conclusions Both treatment methods showed high clinical clearance rates after 1 year, whilst curettage reduced the wound healing time.
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Affiliation(s)
- E J Backman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - S Polesie
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - S Berglund
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - M Gillstedt
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - A Sjöholm
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - M Modin
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - J Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
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Goodall R, Chicco M, Wietek N, Borsky K, Harrison C, Rodrigues J. A systematic review of observational management of cutaneous basal cell carcinoma. J Plast Reconstr Aesthet Surg 2022; 75:2277-2285. [PMID: 35680535 DOI: 10.1016/j.bjps.2022.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cutaneous basal cell carcinoma (BCC) is the commonest cancer in the United Kingdom and United States. Surgical excision is the most common treatment. This review summarises all published outcomes of observational/non-interventional management of cutaneous BCC. METHODS This PRISMA-compliant systematic review searched MEDLINE, EMBASE and CENTRAL databases from inception-June 2021. All studies reporting outcomes of observational management for BCC were included. RESULTS We identified 2529 titles, from which 4 full-text articles were eligible, reporting on 2298 individuals. Two studies were randomised controlled trials (RCTs) comparing histological clearance rates and adverse events following treatment with an inactive strategy (placebo cream) versus topical 5%-imiquimod (at different frequencies) for 6-12 weeks. Clearance rates ranged from 52-100% for imiquimod and 2-19% for placebo, with more adverse events associated with imiquimod. The other two studies used prospective cohort designs. One study assessed the natural history of BCCs managed expectantly in 39 individuals aged ≥80years. During the 15.8-month follow-up, 46.2% of lesions did not increase in size and 10.3% resolved. The remaining study compared treatment patterns of 1360 patients with non-melanoma skin cancer (NMSC) in individuals with or without limited life-expectancy (LLE). The LLE subgroup had a 5-year mortality rate of 43.3%, with no deaths attributed to NMSC. Only 3.3% of individuals with LLE underwent observational treatment. No study examined quality-of-life or cost-effectiveness. CONCLUSION There has been limited investigation of observational management of BCC, despite possible advantages of this strategy. Future RCTs should compare quality-of-life outcomes and utility-adjusted survival following interventional or observational management of BCC.
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Affiliation(s)
- R Goodall
- Department of Plastic Surgery, Buckinghamshire Healthcare NHS Trust, UK; Department of Surgery and Cancer, Imperial College London, UK.
| | - M Chicco
- Department of Plastic Surgery, Buckinghamshire Healthcare NHS Trust, UK
| | - N Wietek
- Nuffield Department of Women's & Reproductive Health, University of Oxford, UK
| | - K Borsky
- Department of Plastic Surgery, Buckinghamshire Healthcare NHS Trust, UK
| | - C Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - J Rodrigues
- Department of Plastic Surgery, Buckinghamshire Healthcare NHS Trust, UK; Warwick Clinical Trials Unit, University of Warwick, UK
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Anushree U, Shetty S, Kumar R, Bharati S. Adjunctive Diagnostic Methods for Skin Cancer Detection: A Review of Electrical Impedance-Based Techniques. Bioelectromagnetics 2022; 43:193-210. [PMID: 35181899 DOI: 10.1002/bem.22396] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 12/06/2021] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
Skin cancer is among the fastest-growing cancers with an excellent prognosis, if detected early. However, the current method of diagnosis by visual inspection has several disadvantages such as overlapping tumor characteristics, subjectivity, low sensitivity, and specificity. Hence, several adjunctive diagnostic techniques such as thermal imaging, optical imaging, ultrasonography, tape stripping methods, and electrical impedance imaging are employed along with visual inspection to improve the diagnosis. Electrical impedance-based skin cancer detection depends upon the variations in electrical impedance characteristics of the transformed cells. The information provided by this technique is fundamentally different from other adjunctive techniques and thus has good prospects. Depending on the stage, type, and location of skin cancer, various impedance-based devices have been developed. These devices when used as an adjunct to visual methods have increased the sensitivity and specificity of skin cancer detection up to 100% and 87%, respectively, thus demonstrating their potential to minimize unnecessary biopsies. In this review, the authors track the advancements and progress made in this technique for the detection of skin cancer, focusing mainly on the advantages and limitations in the clinical setting. © 2022 Bioelectromagnetics Society.
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Affiliation(s)
- U Anushree
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sachin Shetty
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sanjay Bharati
- Department of Nuclear Medicine, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Diagnostic accuracy of basal cell carcinoma in dermatology setting in Serbia: A single-center study. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp201207012i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. The growing incidence of skin tumors requires an accurate diagnosis. Dermoscopy, especially in vivo, enhances the diagnosis of basal cell carcinoma (BCC). Total body skin examination (TBSE), a visual inspection of the patient?s total body surface, is considered a basic step in the dermatological exam, especially in skin cancer screening. However, TBSE is still a matter of debate regarding its expediency in a real clinical setting. The aim of this study was to analyze the diagnostic accuracy of BCC detected and treated by referred dermatologists. Methods. The retrospective analysis included a five-year period of BCC detection during TBSE by visual inspection and dermoscopy. We calculated sensitivity, specificity and positive predictive value for BCC using histopathological results as the correct diagnosis. Results. Out of 3,346 biopsied skin tumors, 49.58% were malignant and 50.42% benign. The most common malignant tumor was BCC, accounting for 84.09%. Localization of BCCs was mainly on the trunk (38.92%) and the H-zone of the face (37.63%). Other localizations were face (non-H-zone) (6.67%), neck (3.01%), scalp (3.37%), arms (6.88%) and limbs (3.51%). Of all BCCs, 0.83% were recurrent BCC. The sensitivity for the diagnosis of BCC was 97.71%, and the positive predictive value was 95.08%. Conclusion. In the dermatology setting, TBSE and visual inspection with in vivo dermoscopy result in a very good diagnostic performance of BCC.
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Maldonado D, Sturgeon A, Tarbox MB. Basal cell carcinoma arising within a longstanding hemangioma. Proc AMIA Symp 2022; 35:76-77. [PMID: 34970041 DOI: 10.1080/08998280.2021.1960132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Basal cell carcinomas have been reported to arise within several different tumors. Without careful attention to detail, basal cell carcinomas may go unnoticed when presenting within or directly adjacent to another distinct tumor. The increased use and accessibility of dermoscopy has allowed dermatologists to detect skin cancers that might otherwise be undetected by the naked eye. This case report details a collision, detected by dermoscopy, of a basal cell carcinoma developing within a long-standing hemangioma (cherry angioma) on the left lower eyelid of a 75-year-old man.
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Affiliation(s)
- Dylan Maldonado
- Department of Dermatology, Texas Tech Health Sciences Center, Lubbock, Texas
| | - Ashley Sturgeon
- Department of Dermatology, Texas Tech Health Sciences Center, Lubbock, Texas
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Campanella G, Navarrete-Dechent C, Liopyris K, Monnier J, Aleissa S, Minhas B, Scope A, Longo C, Guitera P, Pellacani G, Kose K, Halpern AC, Fuchs TJ, Jain M. Deep Learning for Basal Cell Carcinoma Detection for Reflectance Confocal Microscopy. J Invest Dermatol 2022; 142:97-103. [PMID: 34265329 PMCID: PMC9338423 DOI: 10.1016/j.jid.2021.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 01/03/2023]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, with over 2 million cases diagnosed annually in the United States. Conventionally, BCC is diagnosed by naked eye examination and dermoscopy. Suspicious lesions are either removed or biopsied for histopathological confirmation, thus lowering the specificity of noninvasive BCC diagnosis. Recently, reflectance confocal microscopy, a noninvasive diagnostic technique that can image skin lesions at cellular level resolution, has shown to improve specificity in BCC diagnosis and reduced the number needed to biopsy by 2-3 times. In this study, we developed and evaluated a deep learning-based artificial intelligence model to automatically detect BCC in reflectance confocal microscopy images. The proposed model achieved an area under the curve for the receiver operator characteristic curve of 89.7% (stack level) and 88.3% (lesion level), a performance on par with that of reflectance confocal microscopy experts. Furthermore, the model achieved an area under the curve of 86.1% on a held-out test set from international collaborators, demonstrating the reproducibility and generalizability of the proposed automated diagnostic approach. These results provide a clear indication that the clinical deployment of decision support systems for the detection of BCC in reflectance confocal microscopy images has the potential for optimizing the evaluation and diagnosis of patients with skin cancer.
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Affiliation(s)
- Gabriele Campanella
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Cristian Navarrete-Dechent
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile; Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Konstantinos Liopyris
- Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jilliana Monnier
- Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Dermatology and Skin Cancer Department, Aix-Marseille University, La Timone Hospital, Marseille, France; Marseille Cancer Research Centre (CRCM) Inserm1068, CNRS 7258, Aix-Marseille University, Marseille, France; The Computer Science and Systems Laboratory, CNRS 7020, Aix-Marseille University, Marseille, France
| | - Saud Aleissa
- Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Dermatology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Brahmteg Minhas
- Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alon Scope
- Department of Dermatology, The Kittner Skin Cancer Screening & Research Institute, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Azienda Unita Sanitaria Locale, Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy
| | - Pascale Guitera
- Sydney Melanoma Diagnostic Centre, Faculty of Medicine and Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia; Melanoma Institute Australia, Sydney, Australia
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Kivanc Kose
- Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Allan C Halpern
- Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| | - Thomas J Fuchs
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA; Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Manu Jain
- Dermatology Service, Division of Subspecialty Medicine, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Dermatology, Weill Cornell Medicine, New York, New York, USA.
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46
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Niculet E, Craescu M, Rebegea L, Bobeica C, Nastase F, Lupasteanu G, Stan DJ, Chioncel V, Anghel L, Lungu M, Tatu AL. Basal cell carcinoma: Comprehensive clinical and histopathological aspects, novel imaging tools and therapeutic approaches (Review). Exp Ther Med 2021; 23:60. [PMID: 34917186 PMCID: PMC8630439 DOI: 10.3892/etm.2021.10982] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
Basal cell carcinoma (BCC) is one of the most common malignant tumors worldwide, involving the skin. It is also part of keratinocyte carcinomas, alongside its squamous counterpart. It has low mortality and extremely low metastatic rates (although when present, it indicates a poor patient prognosis); it also has a high morbidity rate through local destruction and recurrence, particularly when perineural invasion is observed, clinically or histopathologically. BCC development is the result of environmental and patient factors, with genetics and ultraviolet radiation playing major roles. The clinical and histopathological aspects vary according to tumor subtype, being classified as high-risk tumors (nodular, superficial, pigmented and infundibulocystic BCC with adnexal differentiation) and fibroepithelial subtypes, or as high-risk tumors (micronodular, infiltrating, sclerosing/morphoeic and basosquamous subtype or the type with sarcomatoid differentiation). Dermoscopy is now complimented by novel in vivo diagnostic tools (optical coherence tomography, reflectance confocal microscopy, high-resolution ultrasonography, Raman spectroscopy or terahertz pulse imaging), improving the diagnostic accuracy and providing tumor depth and lateral margins without the use of invasive techniques. Novel treatment approaches for the treatment of BCC have recently been investigated with the use of hedgehog pathway inhibitors, such as Vismodegib. These approaches aim for complete resolution, minimal side-effects, high patient satisfaction with the optimal cosmetic results, particularly in key areas, such as the face. The present review article summarizes and discusses the comprehensive clinical and histopathological aspects of BCC, and presents novel imaging tools and therapeutic approaches that have been identified.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania
| | - Laura Rebegea
- Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania.,Department of Neuropsychomotor Rehabilitation, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Florentina Nastase
- Department of Neuropsychomotor Rehabilitation, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galați, Romania
| | - Gabriela Lupasteanu
- Department of Infectious Diseases, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Medical Doctoral School, 'Ovidius' University, 900573 Constanta, Romania
| | - Daniela Jicman Stan
- Department of Otorhinolaryngology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania.,Biomedical Doctoral School, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galați, 800010 Galați, Romania
| | - Valentin Chioncel
- Department of Cardio-Thoracic Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Clinical Cardiology, 'Bagdasar Arseni' Emergency Hospital, 041915 Bucharest, Romania
| | - Lucretia Anghel
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Mihaela Lungu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Alin Laurentiu Tatu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Dermatology, 'Sfanta Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunărea de Jos' University, 800010 Galați, Romania
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47
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Sahu A, Cordero J, Wu X, Kossatz S, Harris U, Demetrio Desouza Franca P, Kurtansky NR, Everett N, Dusza S, Monnier J, Kumar P, Alessi-Fox C, Brand C, Roberts S, Kose K, Phillip W, Lee E, Jason Chen CS, Rossi A, Nehal K, Pulitzer M, Longo C, Halpern A, Reiner T, Rajadhyaksha M, Jain M. Combined PARP1-targeted nuclear contrast and reflectance contrast enhances confocal microscopic detection of basal cell carcinoma. J Nucl Med 2021; 63:912-918. [PMID: 34649941 DOI: 10.2967/jnumed.121.262600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/26/2021] [Indexed: 11/16/2022] Open
Abstract
Reflectance confocal microscopy (RCM) with endogenous backscattered contrast can noninvasively image basal cell carcinomas (BCCs) in skin. However, BCCs present with high nuclear density and the relatively weak backscattering from nuclei impose a fundamental limit on contrast, detectability, and diagnostic accuracy. We investigated PARPi-FL, an exogenous nuclear poly (ADP-ribose) polymerase (PARP1)-targeted fluorescent contrast agent and fluorescence confocal microscopy (FCM) towards improving BCC diagnosis. Methods: We tested PARP1 expression in 95 BCC tissues using immunohistochemistry, followed by PARPi-FL staining in 32 fresh surgical BCC specimens. Diagnostic accuracy of PARPi-FL contrast was evaluated in 83 surgical specimens. Optimal parameters for trans-epidermal permeability of PARPi-FL through intact skin was tested ex vivo on 5 human skin specimens and in vivo in 3 adult Yorkshire pigs. Results: We found significantly higher PARP1 expression and PARPi-FL binding in BCCs, as compared to normal skin structures. Blinded reading of RCM-and-FCM images by two experts demonstrated a higher diagnostic accuracy for BCCs with combined fluorescence and reflectance contrast, as compared to RCM-alone. Optimal parameters (time and concentration) for PARPi-FL trans-epidermal permeation through intact skin were successfully determined. Conclusion: Combined fluorescence and reflectance contrast may improve noninvasive BCC diagnosis with confocal microscopy.
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Affiliation(s)
- Aditi Sahu
- Memorial Sloan Kettering Cancer Center, United States
| | - Jose Cordero
- University of Puerto Rico - Medical Sciences Campus
| | | | | | | | | | | | | | - Stephen Dusza
- Memorial Sloan Kettering Cancer Center, United States
| | | | | | | | | | | | - Kivanc Kose
- Memorial Sloan Kettering Cancer Center, United States
| | | | - Erica Lee
- Memorial Sloan Kettering Cancer Center, United States
| | | | - Anthony Rossi
- Memorial Sloan Kettering Cancer Center, United States
| | - Kishwer Nehal
- Memorial Sloan Kettering Cancer Center, United States
| | | | | | - Allan Halpern
- Memorial Sloan Kettering Cancer Center, United States
| | | | | | - Manu Jain
- Memorial Sloan Kettering Cancer Center, United States
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48
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Ungureanu L, Cosgarea I, Şenilǎ S, Vasilovici A. Role of Dermoscopy in the Assessment of Basal Cell Carcinoma. Front Med (Lausanne) 2021; 8:718855. [PMID: 34490305 PMCID: PMC8417571 DOI: 10.3389/fmed.2021.718855] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Basal cell carcinoma is one of the most common cancers in white people, with a continuous increase worldwide. Dermoscopy, a non-invasive technique, allows early diagnosis based on the presence of typical vascular structures, pigmented structures, and ulceration and the absence of specific melanocytic structures. Moreover, dermoscopy is useful in basal cell carcinoma management, enabling the differentiation between multiple histological subtypes, between pigmented and non-pigmented variants and allowing a more accurate assessment of surgical margins. After non-ablative therapies, dermoscopy allows the accurate detection of residual disease. The purpose of this review is to highlight the dermoscopic features encountered in basal cell carcinoma and to outline the role of dermoscopy for diagnosis and therapeutic response in this cancer.
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Affiliation(s)
- Loredana Ungureanu
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Cosgarea
- Department of Dermatology, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Simona Şenilǎ
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alina Vasilovici
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Seidl-Philipp M, Frischhut N, Höllweger N, Schmuth M, Nguyen VA. Known and new facts on basal cell carcinoma. J Dtsch Dermatol Ges 2021; 19:1021-1041. [PMID: 34288482 PMCID: PMC8361778 DOI: 10.1111/ddg.14580] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumor in light‐skinned people and amounts to about 75 % of all cases of skin cancer. Increasing incidence rates have been reported for decades all over the world. The main risk factors include UV radiation, male sex, light skin type, advanced age, long‐term immunosuppression, a positive individual or family history, and certain genodermatoses. BCC metastasizes only rarely, and its mortality is low, but it is associated with significant morbidity. Genetic mutations especially in the hedgehog pathway play an important role in BCC pathogenesis. Non‐invasive procedures such as optical coherence tomography or confocal laser scan microscopy are increasingly utilized for diagnostics in addition to visual inspection and dermatoscopy, but only in exceptional cases can histological confirmation of the diagnosis be dispensed with. Various clinical and histological subtypes have been defined. Differentiating between BCC with high and low risk of recurrence has a significant influence on the choice of treatment. Most BCC can be treated effectively and safely with standard surgery, or in selected cases with topical treatment. Locally advanced and metastasized BCC must be treated with radiation or systemic therapy. Radiation is also an option for older patients with contraindications for surgery. The hedgehog inhibitors vismodegib and sonidegib are currently approved for systemic therapy of BCC in Europe. Approval for the PD1 inhibitor cemiplimab as second‐line therapy is expected in the near future.
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Affiliation(s)
- Magdalena Seidl-Philipp
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nina Frischhut
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nicole Höllweger
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Matthias Schmuth
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Van Anh Nguyen
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
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Giovannacci I, Meleti M, Garbarino F, Cesinaro AM, Mataca E, Pedrazzi G, Reggiani C, Paganelli A, Truzzi A, Elia F, Giacomelli L, Magnoni C. Correlation between Autofluorescence Intensity and Histopathological Features in Non-Melanoma Skin Cancer: An Ex Vivo Study. Cancers (Basel) 2021; 13:cancers13163974. [PMID: 34439130 PMCID: PMC8393486 DOI: 10.3390/cancers13163974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/24/2021] [Accepted: 07/29/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Non-melanoma skin cancers (NMSC) are the most prevalent neoplasms worldwide, especially in the Caucasian population. Radical surgical excision is considered the therapeutic gold standard, while incomplete tumor removal is invariably associated with recurrence and the need for reintervention. Autofluorescence (AF) spectroscopy has recently been investigated for early diagnosis of NMSC and assessment of tumor margins. Understanding changes in AF intensity in association with peculiar histological features could improve the diagnostic accuracy of skin fluorescence spectroscopy. The main goal of our work was to investigate the correlation between the intensity of cutaneous AF and the histopathological features of NMSC. The intensity of fluorescence emission in tissues obtained from NMSC samples was approximately 4 times lower than that in healthy conditions. In fact, mean AF intensity for BCC group was 4.5 and 4.4 for SCCs, with further variability being recorded according to histopathologic subtypes. Histopathological features such as hyperkeratosis, neoangiogenesis, fibrosis and elastosis are statistically associated with a decrease in AF intensity. Our data suggest that such tissue alterations could be responsible for the difference in AF emission between neoplastic and healthy tissue. These results support the potential application of AF as a useful non-invasive diagnostic tool for NMSCs. Abstract Non-melanoma skin cancer (NMSC) is the most common malignant tumor affecting fair-skinned people. Increasing incidence rates of NMSC have been reported worldwide, which is an important challenge in terms of public health management. Surgical excision with pre-operatively identified margins is one of the most common and effective treatment strategies. Incomplete tumor removal is associated with a very high risk of recurrence and re-excision. Biological tissues can absorb and re-emit specific light wave-lengths, detectable through spectrophotometric devices. Such a phenomenon is known as autofluorescence (AF). AF spectroscopy has been widely explored for non-invasive, early detection of NMSC as well as for evaluation of surgical margins before excision. Fluorescence-aided diagnosis is based on differences in spectral characteristics between healthy and neoplastic skin. Understanding the biological basis of such differences and correlating AF intensity to histological features could improve the diagnostic accuracy of skin fluorescence spectroscopy. The primary objective of the present pre-clinical ex vivo study is to investigate the correlation between the intensity of cutaneous AF and the histopathological features of NMSC. Ninety-eight lesions suggestive for NMSCs were radically excised from 75 patients (46 M; 29 F; mean age: 79 years). After removal, 115 specific reference points on lesions (“cases”; 59 on BBC, 53 on SCC and 3 on other lesions) and on peri-lesional healthy skin (controls; 115 healthy skin) were identified and marked through suture stitches. Such reference points were irradiated at 400–430 nm wavelength, and resulting emission AF spectra were acquired through spectrophotometry. For each case, AFIR (autofluorescence intensity ratio) was measured as the ratio between the number of photons emitted at a wavelength ranging between 450 and 700 nm (peak: 500 nm) in the healthy skin and that was captured in the pathological tissue. At the histological level, hyperkeratosis, neoangiogenesis, cellular atypia, epithelial thickening, fibrosis and elastosis were quantified by light microscopy and were assessed through a previously validated grading system. Statistical correlation between histologic variables and AFIR was calculated through linear regression. Spectrometric evaluation was performed on 230 (115 cases + 115 controls) reference points. The mean AFIR for BCC group was 4.5, while the mean AFIR for SCC group was 4.4 and the fluorescence peaks at 500 nm were approximately 4 times lower (hypo-fluorescent) in BCCs and in SCCs than in healthy skin. Histological variables significantly associated with alteration of AFIR were fibrosis and elastosis (p < 0.05), neoangiogenesis, hyperkeratosis and epithelial thickening. Cellular atypia was not significantly associated with alteration of AFIR. The intensity of fluorescence emission in neoplastic tissues was approximately 4 times lower than that in healthy tissues. Histopathological features such as hyperkeratosis, neoangiogenesis, fibrosis and elastosis are statistically associated with the decrease in AFIR. We hypothesize that such tissue alterations are among the possible biophysical and biochemical bases of difference in emission AF between neoplastic and healthy tissue. The results of the present evaluation highlighted the possible usefulness of autofluorescence as diagnostic, non-invasive and real-time tool for NMSCs.
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Affiliation(s)
- Ilaria Giovannacci
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
| | - Marco Meleti
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy;
| | - Federico Garbarino
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Anna Maria Cesinaro
- Department of Anatomic Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.M.C.); (E.M.)
| | - Ema Mataca
- Department of Anatomic Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.M.C.); (E.M.)
| | - Giuseppe Pedrazzi
- Department of Medicine and Surgery and Robust Statistics Academy, University of Parma, 43121 Parma, Italy;
| | - Camilla Reggiani
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Alessia Paganelli
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Arianna Truzzi
- School of Dentistry, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (F.E.)
| | - Federica Elia
- School of Dentistry, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (F.E.)
| | | | - Cristina Magnoni
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- Correspondence: ; Tel.: +39-059-422-2464; Fax: +39-059-422-4271
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