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Pogorzelska-Antkowiak A, Gonzalez S. Application of dermoscopy and reflectance confocal microscopy in vivo in the evaluation of nevi in children. Pediatr Dermatol 2024. [PMID: 38632838 DOI: 10.1111/pde.15629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Melanocytic nevi are frequently observed in the pediatric population. While newly acquired nevi can appear during childhood, congenital nevi can continue to grow and clinically change, making patient caregivers concerned. Reflectance confocal microscopy (RCM) in vivo is a noninvasive tool that might enhance the diagnostic accuracy of dermoscopy, reducing the rate of unnecessary surgical procedures. This study aimed to assess the utility of RCM in increasing the diagnostic accuracy of pediatric melanocytic nevi that show pigmentation changes or grow rapidly. METHODS Pediatric patients who presented between January 2022 and February 2023 in a single institution with rapidly growing melanocytic nevi or nevi that presented changes in the pigmentation were included in the study. All nevi were evaluated by means of dermoscopy and RCM. RESULTS Forty-two patients with a total of 42 melanocytic nevi were included. Most lesions showed a honeycombed pattern (n = 21, 50%). On RCM, only 3 of 42 nevi presented atypical cells within the epidermis (7.1%). Evaluation of the dermoepidermal junction (DEJ) revealed the predominance of the meshwork pattern (n = 22, 52.4%). Notably, features considered significant for atypical melanocytic nevi included 9 nevi with scant atypical melanocytes (21.4%) and 3 nevi with nonedge papillae (7.1%). None of the studied lesions required biopsy among this cohort. CONCLUSIONS Most rapidly growing and clinically changing nevi rarely exhibit single atypical cells in the DEJ. The RCM served as a valuable adjunct to dermoscopy, allowing reassurance in the evaluation of these lesions.
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Affiliation(s)
| | - Salvador Gonzalez
- Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, Spain
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Abarzua-Araya A, Bañuls J, Cabo H, Carrera C, Gamo R, González S, Jaimes N, Navarrete-Dechent C, Pérez Anker J, Roldán-Marín R, Segura S, Yélamos O, Puig S, Malvehy J. [Translated article] Reflectance Confocal Microscopy Terminology in Spanish: A Delphi Consensus Study. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T258-T264. [PMID: 38244840 DOI: 10.1016/j.ad.2024.01.018] [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: 09/04/2023] [Accepted: 10/09/2023] [Indexed: 01/22/2024] Open
Abstract
The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.
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Affiliation(s)
- A Abarzua-Araya
- Melanoma Unit, Dermatology Department, Pontificia Universidad Católica de Chile, Santiago, Chile; Dermatology Department, Hospital General Universitario de Alicante Dr. Balmis, ISABIAL, Alicante, Spain; Universidad de Buenos Aires, Buenos Aires, Argentina; Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J Bañuls
- Dermatology Department, Hospital General Universitario de Alicante Dr. Balmis, ISABIAL, Alicante, Spain
| | - H Cabo
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | - C Carrera
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Fundación Alcorcón, Madrid, Spain; Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, Spain; Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, United States; Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), Spain; Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - R Gamo
- Hospital Fundación Alcorcón, Madrid, Spain
| | - S González
- Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, Spain
| | - N Jaimes
- Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - C Navarrete-Dechent
- Melanoma Unit, Dermatology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J Pérez Anker
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - R Roldán-Marín
- Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - S Segura
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), Spain
| | - O Yélamos
- Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Fundación Alcorcón, Madrid, Spain; Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, Spain; Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, United States; Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), Spain; Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain.
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Fundación Alcorcón, Madrid, Spain; Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, Spain; Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, United States; Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), Spain; Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
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3
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Abarzua-Araya A, Bañuls J, Cabo H, Carrera C, Gamo R, González S, Jaimes N, Navarrete-Dechent C, Pérez Anker J, Roldán-Marín R, Segura S, Yélamos O, Puig S, Malvehy J. Reflectance Confocal Microscopy Terminology in Spanish: A Delphi Consensus Study. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:258-264. [PMID: 37890615 DOI: 10.1016/j.ad.2023.10.014] [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: 09/04/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.
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Affiliation(s)
- A Abarzua-Araya
- Melanoma Unit, Dermatology Department, Pontificia Universidad Católica de Chile, Santiago, Chile; Dermatology Department, Hospital General Universitario de Alicante Dr. Balmis, ISABIAL, Alicante, España; Universidad de Buenos Aires, Buenos Aires, Argentina; Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - J Bañuls
- Dermatology Department, Hospital General Universitario de Alicante Dr. Balmis, ISABIAL, Alicante, España
| | - H Cabo
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | - C Carrera
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Hospital Fundación Alcorcón, Madrid, España; Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, España; Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, Estados Unidos; Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), España; Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, España
| | - R Gamo
- Hospital Fundación Alcorcón, Madrid, España
| | - S González
- Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, España
| | - N Jaimes
- Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, Estados Unidos
| | - C Navarrete-Dechent
- Melanoma Unit, Dermatology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J Pérez Anker
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - R Roldán-Marín
- Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - S Segura
- Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), España
| | - O Yélamos
- Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, España
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Hospital Fundación Alcorcón, Madrid, España; Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, España; Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, Estados Unidos; Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), España; Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, España.
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Hospital Fundación Alcorcón, Madrid, España; Department of Medicine and Medical Specialties, Alcalá de Henares University, Madrid, España; Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, Estados Unidos; Clínica de Onco-dermatología, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Dermatology Department, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Universitat de Vic-Universitat central de Catalunya (UVIC), España; Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, España
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Bertoli C, Chester J, Cortelazzi C, Ciardo S, Manfredini M, Di Nuzzo S, Kaleci S, Pellacani G, Farnetani F. Vitiligo Treated with Combined Piperine-Based Topical Treatment and Narrowband Ultraviolet B Therapy: Follow-Up with Reflectance Confocal Microscopy. Diagnostics (Basel) 2024; 14:494. [PMID: 38472966 DOI: 10.3390/diagnostics14050494] [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: 11/23/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Reflectance confocal microscopy (RCM) has a defined in vivo morphology of vitiligo and re-pigmentation. Combination therapies seem more effective than monotherapies. OBJECTIVE We aim to describe the clinical and RCM features of re-pigmentation with combined narrowband ultraviolet B (NB-UVB) and piperine-based topical treatment in localized vitiligo. METHODS Eight patients enrolled at a single center received combined treatment: topical treatment was applied twice daily + NB-UVB twice weekly for 2 × 2-month periods. Clinical changes were analyzed by the Vitiligo Noticeability Scale (VNS) and percentage of re-pigmentation. The evaluator agreement was assessed. Predefined RCM features had the presence/absence of (i) blood vessels, (ii) dendritic cells, and the quantity of (i) an irregular honeycombed pattern and (ii) non-pigmented papillae. Clinical and RCM monitoring was performed at the baseline, 2, 3, 5, and 7 months. RESULTS Macules were "slightly less noticeable" with 25-50% re-pigmentation. Irregular honeycomb patterns and non-pigmented papillae were significantly less frequently observed, and in less extended areas (T1 vs. T2, p = 0.039; T0 vs. T1, p = 0.005 and T2 vs. T4, p = 0.033). Dendritic cells and blood vessels improved, with significant changes in blood vessels (T1 vs. T2, p = 0.005 and T3 vs. T4, p = 0.008). CONCLUSIONS RCM confirms the morphological changes induced by combined treatment for localized vitiligo.
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Affiliation(s)
- Cristina Bertoli
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Johanna Chester
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Chiara Cortelazzi
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Marco Manfredini
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Sergio Di Nuzzo
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Shaniko Kaleci
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00196 Rome, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, 41123 Modena, Italy
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Faldetta C, Kaleci S, Chester J, Ruini C, Ciardo S, Manfredini M, Guida S, Chello C, Cantisani C, Young JN, Cabral P, Gulati N, Guttman-Yassky E, Pellacani G, Farnetani F. Melanoma clinicopathological groups characterized and compared with dermoscopy and reflectance confocal microscopy. J Am Acad Dermatol 2024; 90:309-318. [PMID: 37988042 DOI: 10.1016/j.jaad.2023.09.084] [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: 05/24/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Dermoscopic and reflectance confocal microscopy (RCM) correlations between morphologic groups of melanoma have not yet been described. OBJECTIVE Describe and compare dermoscopic and RCM features of cutaneous melanomas with histopathological confirmation. METHODS Single center, retrospective analysis of consecutive melanomas evaluated with RCM (2015-2019). Lesions were clinically classified as typical, nevus-like, amelanotic/nonmelanoma skin cancer (NMSC)-like, seborrheic keratosis (SK)-like and lentigo/lentigo maligna (LM)-like. Presence or absence of common facial and nonfacial melanoma dermoscopic and RCM patterns were recorded. Clusters were compared with typical lesions by multivariate logistic regression. RESULTS Among 583 melanoma lesions, significant differences between clusters were evident (compared to typical lesions). Observation of dermoscopic features (>50% of lesions) in amelanotic/NMSC-like lesions consistently displayed 3 patterns (atypical network, atypical vascular pattern + regression structures), and nevus-like and SK-like lesions and lentigo/LM-like lesions consistently displayed 2 patterns (atypical network + regression structures, and nonevident follicles + heavy pigmentation intensity). Differences were less evident with RCM, as almost all lesions were consistent with melanoma diagnosis. LIMITATIONS Small SK-like lesions sample, single RCM analyses (no reproduction of outcome). CONCLUSION RCM has the potential to augment our ability to consistently and accurately diagnose melanoma independently of clinical and dermoscopic features.
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Affiliation(s)
- Cristina Faldetta
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristel Ruini
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany; Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvana Ciardo
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Manfredini
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Guida
- School of Medicine Vita Salute San Raffaele University, Milan, Italy; Dermatologic Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Chello
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Jade N Young
- Department of Dermatology, Mount Sinai, New York, New York
| | | | | | | | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Sheng M, Zhao Y, Wu Z, Zhao J, Lui H, Kalia S, Zeng H. Single source CARS-based multimodal microscopy system for biological tissue imaging [Invited]. BIOMEDICAL OPTICS EXPRESS 2024; 15:131-141. [PMID: 38223172 PMCID: PMC10783911 DOI: 10.1364/boe.504978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 01/16/2024]
Abstract
A coherent anti-Stokes Raman scattering (CARS)-based multimodality microscopy system was developed using a single Ti:sapphire femtosecond laser source for biological imaging. It provides three complementary and co-registered imaging modalities: CARS, MPM (multiphoton microscopy), and RCM (reflectance confocal microscopy). The imaging speed is about 1 frame-per-second (fps) with a digital resolution of 1024 × 1024 pixels. This microscopy system can provide clear 2-dimensional and 3-dimensional images of ex-vivo biological tissue samples. Its spectral selection initiates vibrational excitation in lipid cells (approximately 2850 cm-1) using two filters on the pump and Stokes beam paths. The excitation can be tuned over a wide spectral range with adjustable spectral filters. The imaging capability of this CARS-based multimodal microscopy system was demonstrated using porcine fat, murine skin, and murine liver tissue samples.
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Affiliation(s)
- Mingyu Sheng
- Imaging Unit - Integrative Oncology Department, BC Cancer Research Institute, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
| | - Yuan Zhao
- Imaging Unit - Integrative Oncology Department, BC Cancer Research Institute, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
| | - Zhenguo Wu
- Imaging Unit - Integrative Oncology Department, BC Cancer Research Institute, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Jianhua Zhao
- Imaging Unit - Integrative Oncology Department, BC Cancer Research Institute, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Harvey Lui
- Imaging Unit - Integrative Oncology Department, BC Cancer Research Institute, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Sunil Kalia
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, Canada
- Department of Cancer Control Research, BC Cancer Research Institute, Vancouver, Canada
- BC Children’s Hospital Research Institute, Vancouver, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Haishan Zeng
- Imaging Unit - Integrative Oncology Department, BC Cancer Research Institute, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada
- Photomedicine Institute, Department of Dermatology and Skin Science, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, Canada
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7
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Zou Y, Zhu X, Xia R. Concordance between reflectance confocal microscopy and histopathology for the diagnosis of acral lentiginous melanoma. Skin Res Technol 2024; 30:e13570. [PMID: 38200620 PMCID: PMC10781889 DOI: 10.1111/srt.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Acral lentiginous melanoma (ALM) is a highly malignant and invasive type of melanoma with unique locations of onset. Its incidence is increasing and early diagnosis is challenging. Reflectance confocal microscopy (RCM) is a non-invasive technique that provides an accurate image of tissue pathology. There are few reports on the use of RCM for the assessment of ALM. MATERIALS AND METHODS In this retrospective study, data from 31 patients with a clinical diagnosis of ALM were collected. RCM image features were compared with histopathological findings to determine the concordance between the two methods. The sensitivity, specificity, positive predictive value, and negative predictive value of RCM for the diagnosis of ALM were evaluated. RESULTS RCM and histopathology findings were concordant in 29 of 31 patients (93.5%). There were no false-negative results, although there were two false positives in RCM diagnosis. The sensitivity of RCM for diagnosing ALM was 100%, specificity was 50%, positive predictive value was 93.1%, and negative predictive value was 100%. CONCLUSIONS RCM showed substantial concordance with histopathology in the diagnosis of ALM. It is a reliable and valuable non-invasive diagnostic tool that holds promise for the early diagnosis of ALM.
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Affiliation(s)
- Yunmin Zou
- Department of DermatologyWuxi No.2 People's HospitalWuxiJiangsu ProvinceChina
| | - Xiaohong Zhu
- Department of DermatologyWuxi No.2 People's HospitalWuxiJiangsu ProvinceChina
| | - Rushan Xia
- Department of DermatologyWuxi No.2 People's HospitalWuxiJiangsu ProvinceChina
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8
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Fu Z, Zeng J, Zhu L, Wang G, Li P, Li W, Song Z, Su Z, Sun X, Tang H, Luo P, Tan L, Gao L, Wang D, Yan S, Zhou L, Tong X, Tang Z, Zhang H, Tan W, Lu J, Zhu S. Clinical factors associated with remission of obese acanthosis nigricans after laparoscopic sleeve gastrectomy: a prospective cohort study. Int J Surg 2023; 109:3944-3953. [PMID: 37678289 PMCID: PMC10720823 DOI: 10.1097/js9.0000000000000693] [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: 05/08/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Acanthosis nigricans (AN) involves skin hyperpigmentation in body folds and creases. Obesity-associated AN (OB_AN) is the most common type of AN. The skin condition of obese patients with AN can be improved through bariatric surgery, such as laparoscopic sleeve gastrectomy (LSG), after weight loss. However, the contributing factors to the remission of AN after surgery are still not fully determined. The authors aimed to assess the metabolic and pathological factors associated with remission of AN following LSG in obese individuals. METHODS The study included 319 obese patients who underwent LSG at our hospital. The subjects were divided into obesity (OB) only (OB, n =178) or OB with AN (OB_AN, n =141) groups. The basic clinical and metabolic indices and the dermatological features via reflectance confocal microscopy and histology were collected from patients prior to and after LSG. RESULTS OB_AN patients had higher fasting plasma glucose, homeostatic model assessment for insulin resistance, and testosterone levels than OB patients. LSG could significantly improve the biochemical and histopathological features of OB_AN patients. The remissive rate of OB_AN patients was about 86.5% (122 out of 141) after surgery. The remission of OB_AN skin lesions was positively correlated with testosterone levels ( P <0.01). In addition, there was a significant positive correlation between changes in AN scores and epidermal thickness and skin pigmentation scores after surgery ( P <0.01). CONCLUSION The remissive rate of OB_AN after LSG is associated with improved testosterone levels and reduced epidermal thickness and skin pigmentation levels.
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Affiliation(s)
- Zhibing Fu
- Department of General Surgery
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Jinrong Zeng
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | | | | | | | | | | | | | | | | | | | - Lina Tan
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Lihua Gao
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Dan Wang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Siyu Yan
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Lu Zhou
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Xiaoliao Tong
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Zhen Tang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Hanyi Zhang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Wenbin Tan
- Department of Cell Biology and Anatomy, School of Medicine
- Department of Biomedical Engineering, College of Engineering and Computing, University of South Carolina, Columbia, South Carolina, USA
| | - Jianyun Lu
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
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9
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Guida S, Alma A, Fiorito F, Megna A, Chester J, Kaleci S, Ciardo S, Manfredini M, Rongioletti F, Perrot JL, Rubegni P, Chello C, Cantisani C, Pellacani G, Cinotti E, Farnetani F. Lentigo maligna and lentigo maligna melanoma in vivo differentiation with dermoscopy and reflectance confocal microscopy: A retrospective, multicentre study. J Eur Acad Dermatol Venereol 2023; 37:2293-2300. [PMID: 37357442 DOI: 10.1111/jdv.19291] [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: 11/03/2022] [Accepted: 05/26/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Dermoscopic predictors of lentigo maligna (LM) and lentigo maligna melanoma (LMM) have been recently reported, but these have not been reported in reflectance confocal microscopy (RCM). OBJECTIVES (i) To validate dermoscopic predictors for LM/LMM, (ii) to identify RCM patterns in LM and LMM, and (iii) correlations between dermoscopic and RCM features in LM and LMM. MATERIALS AND METHODS A retrospective, multicentre study of consecutive lesions with histologically proven LM or LMM subtypes of the head and face, with complete sets of dermoscopic and RCM images. RESULTS A total of 180 lesions were included (n = 40 LMM). Previously reported differential dermoscopic features for LM subtypes were confirmed. Other features significantly associated with LMM diagnosis included irregular hyperpigmented areas, shiny white streaks, atypical vessels and light brown colour at dermoscopy and medusa head-like structures, dermal nests and nucleated cells within the papillae at RCM (p < 0.05). Correlations among LM lesions between dermoscopic and RCM features included brown to-grey dots and atypical cells (epidermis), grey colour and inflammation and obliterated follicles and medusa head-like structures. Among LMM lesions, significant correlations included obliterated follicles with folliculotropism, both irregular hyperpigmented areas and irregular blotches with widespread atypical cell distribution (epidermis), dermal nests and nucleated cells within the papillae (dermis). Irregular blotches were also associated with medusa head-like structures (dermal epidermal junction [DEJ]). CONCLUSIONS Dermoscopic and RCM features can assist in the in vivo identification of LM and LMM and many are correlated. RCM three-dimensional analysis of skin layers allows the identification of invasive components in the DEJ and dermis.
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Affiliation(s)
- Stefania Guida
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Alma
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Flavio Fiorito
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Megna
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvana Ciardo
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Manfredini
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Franco Rongioletti
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jean L Perrot
- Department of Dermatology, University Hospital of Saint Etienne, Saint-Etienne, France
| | - Pietro Rubegni
- Dermatology Section, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Camilla Chello
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Elisa Cinotti
- Dermatology Section, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Francesca Farnetani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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10
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Corbella-Bagot L, Luque-Luna M, Morgado-Carrasco D. RF - Reflectance Confocal Microscopy for the Diagnosis of Equivocal Pigmented Lesions. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:816-817. [PMID: 36871817 DOI: 10.1016/j.ad.2022.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 03/06/2023] Open
Affiliation(s)
- L Corbella-Bagot
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
| | - M Luque-Luna
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España.
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11
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Corbella-Bagot L, Luque-Luna M, Morgado-Carrasco D. [Translated article] RF-Reflectance Confocal Microscopy for the Diagnosis of Equivocal Pigmented Lesions. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T816-T817. [PMID: 37506830 DOI: 10.1016/j.ad.2022.10.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/04/2022] [Indexed: 07/30/2023] Open
Affiliation(s)
- L Corbella-Bagot
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - M Luque-Luna
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, Spain.
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12
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Caruntu C, Ilie MA, Neagu M. Looking into the Skin in Health and Disease: From Microscopy Imaging Techniques to Molecular Analysis. Int J Mol Sci 2023; 24:13737. [PMID: 37762038 PMCID: PMC10531494 DOI: 10.3390/ijms241813737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
The skin is a complex organ that includes a wide variety of tissue types with different embryological origins [...].
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Affiliation(s)
- Constantin Caruntu
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | | | - Monica Neagu
- Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, 050095 Bucharest, Romania;
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
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13
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Grossarth S, Mosley D, Madden C, Ike J, Smith I, Huo Y, Wheless L. Recent Advances in Melanoma Diagnosis and Prognosis Using Machine Learning Methods. Curr Oncol Rep 2023; 25:635-645. [PMID: 37000340 PMCID: PMC10339689 DOI: 10.1007/s11912-023-01407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE OF REVIEW The purpose was to summarize the current role and state of artificial intelligence and machine learning in the diagnosis and management of melanoma. RECENT FINDINGS Deep learning algorithms can identify melanoma from clinical, dermoscopic, and whole slide pathology images with increasing accuracy. Efforts to provide more granular annotation to datasets and to identify new predictors are ongoing. There have been many incremental advances in both melanoma diagnostics and prognostic tools using artificial intelligence and machine learning. Higher quality input data will further improve these models' capabilities.
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Affiliation(s)
- Sarah Grossarth
- Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | | | - Christopher Madden
- Department of Dermatology, Vanderbilt University Medicine Center, Nashville, TN, USA
- State University of New York Downstate College of Medicine, Brooklyn, NY, USA
| | - Jacqueline Ike
- Department of Dermatology, Vanderbilt University Medicine Center, Nashville, TN, USA
- Meharry Medical College, Nashville, TN, USA
| | - Isabelle Smith
- Department of Dermatology, Vanderbilt University Medicine Center, Nashville, TN, USA
- Vanderbilt University, Nashville, TN, USA
| | - Yuankai Huo
- Department of Computer Science and Electrical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Lee Wheless
- Department of Dermatology, Vanderbilt University Medicine Center, Nashville, TN, USA.
- Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA.
- Tennessee Valley Healthcare System VA Medical Center, Nashville, TN, USA.
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14
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Chiara FRANCESCHINI, Desmond MANDELV, Gary PETERSON, Valentina MANCIOCCO, Pascale GUITERA, Milind RAJADHYAKSHA, Marco ARDIGÒ. Role of reflectance confocal microscopy for in vivo investigation of oral disorders: White, red and pigmented lesions. Exp Dermatol 2023; 32:648-659. [PMID: 36710524 PMCID: PMC10159980 DOI: 10.1111/exd.14758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/06/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
In vivo reflectance confocal microscopy (RCM) is poorly investigated in oral pathology due to the peculiar anatomical and topographical oral mucosa features. A dedicated handheld confocal microscope with an intra-oral probe was developed for oral mucosa imaging. The main objective was to describe the healthy oral mucosa and the cytoarchitectural findings detectable in different oral disorders by means of the newly designed handheld confocal microscope. Secondary aim was to identify the main RCM criteria that differentiate oral lesions in order to provide algorithm for a rapid non-invasive evaluation. This observational retrospective study included all consecutive patients with oral disorders and volunteers with healthy oral mucosa who underwent RCM examination in our outpatient clinic from September 2018 to December 2021. Three different investigators examined together the RCM images to detect the key features and secondary criteria for each type of oral lesion collected. The study population included 110 patients affected by oral lesions and seven volunteers with healthy oral mucosae. A total of 15 oral disorders were imaged and divided in three main groups: white, red and pigmented lesions. Key features and secondary criteria were identified for every single type of oral disease. RCM permits a cytoarchitectural evaluation of the oral mucosae affected by inflammatory, dysplastic and neoplastic diseases, thus orienting the clinicians towards non-invasive diagnosis and enhancing the diagnostic management. The "tree diagrams" proposed allow a schematic and simplified view of confocal features for each type of oral disease, thus drastically reducing the diagnostic timing.
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Affiliation(s)
- FRANCESCHINI Chiara
- Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - MANDEL Victor Desmond
- Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
| | - PETERSON Gary
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - MANCIOCCO Valentina
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute - IRCCS, Rome, Italy
| | - GUITERA Pascale
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, USA
- The Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Melanoma institute Australia, and the University of Sydney, Sydney, Australia
| | | | - ARDIGÒ Marco
- Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy
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15
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Atak MF, Farabi B, Navarrete-Dechent C, Rubinstein G, Rajadhyaksha M, Jain M. Confocal Microscopy for Diagnosis and Management of Cutaneous Malignancies: Clinical Impacts and Innovation. Diagnostics (Basel) 2023; 13:diagnostics13050854. [PMID: 36899999 PMCID: PMC10001140 DOI: 10.3390/diagnostics13050854] [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] [Received: 12/28/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Cutaneous malignancies are common malignancies worldwide, with rising incidence. Most skin cancers, including melanoma, can be cured if diagnosed correctly at an early stage. Thus, millions of biopsies are performed annually, posing a major economic burden. Non-invasive skin imaging techniques can aid in early diagnosis and save unnecessary benign biopsies. In this review article, we will discuss in vivo and ex vivo confocal microscopy (CM) techniques that are currently being utilized in dermatology clinics for skin cancer diagnosis. We will discuss their current applications and clinical impact. Additionally, we will provide a comprehensive review of the advances in the field of CM, including multi-modal approaches, the integration of fluorescent targeted dyes, and the role of artificial intelligence for improved diagnosis and management.
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Affiliation(s)
- Mehmet Fatih Atak
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Banu Farabi
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago 8331150, Chile
| | | | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Manu Jain
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Dermatology Service, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
- Correspondence: ; Tel.: +1-(646)-608-3562
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16
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Dobre EG, Surcel M, Constantin C, Ilie MA, Caruntu A, Caruntu C, Neagu M. Skin Cancer Pathobiology at a Glance: A Focus on Imaging Techniques and Their Potential for Improved Diagnosis and Surveillance in Clinical Cohorts. Int J Mol Sci 2023; 24:ijms24021079. [PMID: 36674595 PMCID: PMC9866322 DOI: 10.3390/ijms24021079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/08/2023] Open
Abstract
Early diagnosis is essential for completely eradicating skin cancer and maximizing patients' clinical benefits. Emerging optical imaging modalities such as reflectance confocal microscopy (RCM), optical coherence tomography (OCT), magnetic resonance imaging (MRI), near-infrared (NIR) bioimaging, positron emission tomography (PET), and their combinations provide non-invasive imaging data that may help in the early detection of cutaneous tumors and surgical planning. Hence, they seem appropriate for observing dynamic processes such as blood flow, immune cell activation, and tumor energy metabolism, which may be relevant for disease evolution. This review discusses the latest technological and methodological advances in imaging techniques that may be applied for skin cancer detection and monitoring. In the first instance, we will describe the principle and prospective clinical applications of the most commonly used imaging techniques, highlighting the challenges and opportunities of their implementation in the clinical setting. We will also highlight how imaging techniques may complement the molecular and histological approaches in sharpening the non-invasive skin characterization, laying the ground for more personalized approaches in skin cancer patients.
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Affiliation(s)
- Elena-Georgiana Dobre
- Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, 050095 Bucharest, Romania
| | - Mihaela Surcel
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
| | - Carolina Constantin
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
| | | | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
- Correspondence:
| | - Monica Neagu
- Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, 050095 Bucharest, Romania
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
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17
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Mehta PP, Oh Y, Cordova M, Chen CS, Halpern A, Harris U, Kentley J, Kurtansky NR, Kose K, Lee EH, Marchetti MA, Marghoob A, Markova A, Navarrete-Dechent C, Nehal K, Rajadhyaksha M, Rossi A, Sahu A, Sun M, Jain M, Rotemberg V. Patterns of the use of reflectance confocal microscopy at a tertiary referral dermatology clinic. J Am Acad Dermatol 2022; 87:882-884. [PMID: 34875302 PMCID: PMC9166163 DOI: 10.1016/j.jaad.2021.11.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Paras P Mehta
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yuna Oh
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Miguel Cordova
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chih-Shan Chen
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Allan Halpern
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ucalene Harris
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jonathan Kentley
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nicholas R Kurtansky
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kivanc Kose
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Erica H Lee
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael A Marchetti
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ashfaq Marghoob
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alina Markova
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cristian Navarrete-Dechent
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Kishwer Nehal
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Milind Rajadhyaksha
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anthony Rossi
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Aditi Sahu
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mary Sun
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Manu Jain
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Veronica Rotemberg
- Division of Dermatology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
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18
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Lentsch G, Baugh EG, Lee B, Aszterbaum M, Zachary CB, Kelly KM, Balu M. Research Techniques Made Simple: Emerging Imaging Technologies for Noninvasive Optical Biopsy of Human Skin. J Invest Dermatol 2022; 142:1243-1252.e1. [PMID: 35461534 PMCID: PMC9802025 DOI: 10.1016/j.jid.2022.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/07/2022] [Accepted: 01/18/2022] [Indexed: 01/03/2023]
Abstract
Over the past few years, high-resolution optical imaging technologies such as optical coherence tomography (OCT), reflectance confocal microscopy (RCM), and multiphoton microscopy (MPM) have advanced significantly as new methodologies for clinical research and for real-time detection, diagnosis, and therapy monitoring of skin diseases. Implementation of these technologies into clinical research and practice requires clinicians to have an understanding of their capabilities, benefits, and limitations. This concise review provides insights on the application of OCT, RCM, and MPM for clinical skin imaging through images acquired in vivo from the same lesions. The presented data are limited to pigmented lesions and basal cell carcinoma.
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Affiliation(s)
- Griffin Lentsch
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
| | - Erica G. Baugh
- Department of Dermatology, University of California, Irvine, California, USA
| | - Bonnie Lee
- Department of Dermatology, University of California, Irvine, California, USA
| | - Michelle Aszterbaum
- Department of Dermatology, University of California, Irvine, California, USA
| | | | - Kristen M. Kelly
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA,Department of Dermatology, University of California, Irvine, California, USA
| | - Mihaela Balu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
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19
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Lindholm V, Raita-Hakola AM, Annala L, Salmivuori M, Jeskanen L, Saari H, Koskenmies S, Pitkänen S, Pölönen I, Isoherranen K, Ranki A. Differentiating Malignant from Benign Pigmented or Non-Pigmented Skin Tumours-A Pilot Study on 3D Hyperspectral Imaging of Complex Skin Surfaces and Convolutional Neural Networks. J Clin Med 2022; 11:jcm11071914. [PMID: 35407522 PMCID: PMC8999463 DOI: 10.3390/jcm11071914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/28/2022] [Indexed: 02/08/2023] Open
Abstract
Several optical imaging techniques have been developed to ease the burden of skin cancer disease on our health care system. Hyperspectral images can be used to identify biological tissues by their diffuse reflected spectra. In this second part of a three-phase pilot study, we used a novel hand-held SICSURFIS Spectral Imager with an adaptable field of view and target-wise selectable wavelength channels to provide detailed spectral and spatial data for lesions on complex surfaces. The hyperspectral images (33 wavelengths, 477–891 nm) provided photometric data through individually controlled illumination modules, enabling convolutional networks to utilise spectral, spatial, and skin-surface models for the analyses. In total, 42 lesions were studied: 7 melanomas, 13 pigmented and 7 intradermal nevi, 10 basal cell carcinomas, and 5 squamous cell carcinomas. All lesions were excised for histological analyses. A pixel-wise analysis provided map-like images and classified pigmented lesions with a sensitivity of 87% and a specificity of 93%, and 79% and 91%, respectively, for non-pigmented lesions. A majority voting analysis, which provided the most probable lesion diagnosis, diagnosed 41 of 42 lesions correctly. This pilot study indicates that our non-invasive hyperspectral imaging system, which involves shape and depth data analysed by convolutional neural networks, is feasible for differentiating between malignant and benign pigmented and non-pigmented skin tumours, even on complex skin surfaces.
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Affiliation(s)
- Vivian Lindholm
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (M.S.); (L.J.); (S.K.); (S.P.); (K.I.); (A.R.)
- Correspondence: (V.L.); (A.-M.R.-H.); Tel.: +358-9471-86355 (V.L.)
| | - Anna-Maria Raita-Hakola
- Faculty of Information Technology, University of Jyväskylä, 40100 Jyväskylä, Finland; (L.A.); (I.P.)
- Correspondence: (V.L.); (A.-M.R.-H.); Tel.: +358-9471-86355 (V.L.)
| | - Leevi Annala
- Faculty of Information Technology, University of Jyväskylä, 40100 Jyväskylä, Finland; (L.A.); (I.P.)
| | - Mari Salmivuori
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (M.S.); (L.J.); (S.K.); (S.P.); (K.I.); (A.R.)
| | - Leila Jeskanen
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (M.S.); (L.J.); (S.K.); (S.P.); (K.I.); (A.R.)
| | - Heikki Saari
- VTT Technical Research Centre of Finland, 02150 Espoo, Finland;
| | - Sari Koskenmies
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (M.S.); (L.J.); (S.K.); (S.P.); (K.I.); (A.R.)
| | - Sari Pitkänen
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (M.S.); (L.J.); (S.K.); (S.P.); (K.I.); (A.R.)
| | - Ilkka Pölönen
- Faculty of Information Technology, University of Jyväskylä, 40100 Jyväskylä, Finland; (L.A.); (I.P.)
| | - Kirsi Isoherranen
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (M.S.); (L.J.); (S.K.); (S.P.); (K.I.); (A.R.)
| | - Annamari Ranki
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; (M.S.); (L.J.); (S.K.); (S.P.); (K.I.); (A.R.)
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20
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Pellacani G, Farnetani F, Chester J, Kaleci S, Ciardo S, Bassoli S, Casari A, Longo C, Manfredini M, Cesinaro AM, Giusti F, Iacuzio A, Migaldi M. Cutaneous Melanoma Systematic Diagnostic Workflows and Integrated Reflectance Confocal Microscopy Assessed with a Retrospective, Comparative Longitudinal (2009-2018) Study. Cancers (Basel) 2022; 14:cancers14030838. [PMID: 35159105 PMCID: PMC8834176 DOI: 10.3390/cancers14030838] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/05/2022] [Accepted: 02/04/2022] [Indexed: 02/02/2023] Open
Abstract
Simple Summary A retrospective study (2009–2018), where the integration of education, a diagnostic-therapeutical workflow (with centralized and immediate assessment of suspicious lesions) and high-performance technology in a single province, seems to improve melanoma detection accuracy, as measured by the number needed to excise. From 40,832 lesions excised there was 279% increase number of melanoma excised. A systemic diagnostic-therapeutical workflow including reflectance confocal micrscopy (RCM) was described. The impact was assessed with the number of lesions needed to excise (NNE) according to excision location: reference hospital (DP) or other (NDP), NNE decreased almost 3-fold at DP and by half at NDP. Aggressive melanoma detection remained unchanged over the study period. Hypothetical cost analyses estimated health service savings. Abstract Background: The increasing global burden of melanoma demands efficient health services. Accurate early melanoma diagnosis improves prognosis. Objectives: To assess melanoma prevention strategies and a systematic diagnostic-therapeutical workflow (improved patient access and high-performance technology integration) and estimate cost savings. Methods: Retrospective analysis of epidemiological data of an entire province over a 10-year period of all excised lesions suspicious for melanoma (melanoma or benign), registered according to excision location: reference hospital (DP) or other (NDP). A systematic diagnostic-therapeutical workflow, including direct patient access, primary care physician education and high-performance technology (reflectance confocal microscopy (RCM)) integration, was implemented. Impact was assessed with the number of lesions needed to excise (NNE). Results: From 40,832 suspicious lesions excised, 7.5% (n = 3054) were melanoma. There was a 279% increase in the number of melanomas excised (n = 203 (2009) to n = 567 (2018)). Identification precision improved more than 100% (5.1% in 2009 to 12.0% in 2018). After RCM implementation, NNE decreased almost 3-fold at DP and by half at NDP. Overall NNE for DP was significantly lower (NNE = 8) than for NDP (NNE = 20), p < 0.001. Cost savings amounted to EUR 1,476,392.00. Conclusions: Melanoma prevention strategies combined with systematic diagnostic-therapeutical workflow reduced the ratio of nevi excised to identify each melanoma. Total costs may be reduced by as much as 37%.
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Affiliation(s)
- Giovanni Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Dermatology Clinic, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
- Correspondence: ; Tel.: +39-33-3485-7774
| | - Johanna Chester
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
| | - Shaniko Kaleci
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
| | - Silvana Ciardo
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
| | - Sara Bassoli
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
| | - Alice Casari
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
| | - Caterina Longo
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Marco Manfredini
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
| | - Anna Maria Cesinaro
- Department of Anatomic Pathology, Azienda Ospedaliero—Universitario Modena, 41124 Modena, Italy;
| | - Francesca Giusti
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (G.P.); (J.C.); (S.K.); (S.C.); (S.B.); (A.C.); (C.L.); (M.M.); (F.G.)
| | - Antonio Iacuzio
- 5th Engineer Regiment, Italian Army, Macomer, 08100 Nuoro, Italy;
- Department of Anatomic Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Mario Migaldi
- Department of Anatomic Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy;
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21
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Di Matteo E, Pampena R, Pizzichetta MA, Cinotti E, Chester J, Kaleci S, Manfredini M, Guida S, Dika E, Moscarella E, Lallas A, Apalla Z, Argenziano G, Perrot JL, Tognetti L, Lai M, Cantisani C, Roberti V, Fiorani D, Baraldi C, Veneziano L, Papageorgiou C, Ciardo S, Rubegni P, Zalaudek I, Patrizi A, Longo C, Bianchi L, Pellacani G, Farnetani F. Unusual Dermoscopic Patterns of Basal Cell Carcinoma Mimicking Melanoma. Exp Dermatol 2022; 31:890-898. [PMID: 35102605 PMCID: PMC9305787 DOI: 10.1111/exd.14533] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/23/2021] [Accepted: 01/27/2022] [Indexed: 12/25/2022]
Abstract
Background Basal cell carcinoma can simulate melanoma and specific dermoscopic criteria have not yet been defined in a large cohort. Objective To identify dermoscopic “trump” characteristics for differential diagnosis, identify cluster groups and assess the clinical impact of this study's findings. Methods Retrospective, multicentric comparative study of atypical, non‐facial basal cell carcinoma (≥1 seven‐point checklist criteria) and melanoma (with at least one BCC criteria) at dermoscopy. Observed dermoscopic features were used to develop a proposed score. Lesion clusters were defined with hierarchical analysis. Clinical impact was assessed with a blinded reader study following this study's results. Results A total of 146 basal cell carcinoma and 76 melanoma were included. Atypical vascular pattern was common to most lesions (74.5%). Twelve trump features were included in the proposed score (sensitivity 94.1% and specificity 79.5%). Cluster analysis identified 3 basal cell carcinoma and 3 melanoma clusters. Findings improved overall diagnostic accuracy and confidence (26.8% and 13.8%, respectively; p < 0.001). Conclusions These findings support the notion that atypical vascular pattern should be considered a shared feature of both melanoma and atypical basal cell carcinoma. Our proposed score improves diagnostic accuracy and confidence. Absence of pigmented features was associated with lower diagnostic accuracy and confidence.
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Affiliation(s)
- Eleonora Di Matteo
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133, Rome, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria A Pizzichetta
- Division Medical Oncology and Preventive Oncology, National Cancer Institute, Aviano, Italy.,Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, 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
| | - Marco Manfredini
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Guida
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Emi Dika
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Zoe Apalla
- Second Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | | | - Jian L Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne Cedex 2 42055, France
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, 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
| | - Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Roberti
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Diletta Fiorani
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, Italy
| | - Carlotta Baraldi
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, Italy
| | - Leonardo Veneziano
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, Italy
| | - Chryssoula Papageorgiou
- Second Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Annalisa Patrizi
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, 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
| | - Luca Bianchi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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22
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Skudalski L, Waldman R, Kerr PE, Grant-Kels JM. Melanoma: How and When to Consider Clinical Diagnostic Technologies. J Am Acad Dermatol 2021; 86:503-512. [PMID: 34915058 DOI: 10.1016/j.jaad.2021.06.901] [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: 04/06/2021] [Revised: 06/09/2021] [Accepted: 06/13/2021] [Indexed: 11/26/2022]
Abstract
In response to rising rates of melanoma worldwide, novel non-invasive melanoma detection techniques are emerging to facilitate the early detection of melanoma and decrease unnecessary biopsies of benign pigmented lesions. Because they often report similar study findings, it may be difficult to determine how best to incorporate these technologies into clinical practice based on their supporting studies alone. As an expansion of the recent article by Fried et al.1, which reviewed the clinical data supporting these non-invasive melanoma detection techniques, the first article in this continuing medical education series provides practical advice on how and when to use various non-invasive melanoma detection techniques into clinical practice.
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Affiliation(s)
- Lauren Skudalski
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Reid Waldman
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Philip E Kerr
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA.
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23
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Jung JM, Cho JY, Lee WJ, Chang SE, Lee MW, Won CH. Emerging Minimally Invasive Technologies for the Detection of Skin Cancer. J Pers Med 2021; 11:951. [PMID: 34683091 PMCID: PMC8538732 DOI: 10.3390/jpm11100951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 12/23/2022] Open
Abstract
With the increasing incidence of skin cancer, many noninvasive technologies to detect its presence have been developed. This review focuses on reflectance confocal microscopy (RCM), optical coherence tomography (OCT), high-frequency ultrasound (HFUS), electrical impedance spectroscopy (EIS), pigmented lesion assay (PLA), and Raman spectroscopy (RS) and discusses the basic principle, clinical applications, advantages, and disadvantages of each technology. RCM provides high cellular resolution and has high sensitivity and specificity for the diagnosis of skin cancer. OCT provides lower resolution than RCM, although its evaluable depth is deeper than that of RCM. RCM and OCT may be useful in reducing the number of unnecessary biopsies, evaluating the tumor margin, and monitoring treatment response. HFUS can be mainly used to delineate tumor depths or margins and monitor the treatment response. EIS provides high sensitivity but low specificity for the diagnosis of skin malignancies. PLA, which is based on the genetic information of lesions, is applicable for the detection of melanoma with high sensitivity and moderate-to-high specificity. RS showed high accuracy for the diagnosis of skin cancer, although more clinical studies are required. Advances in these technologies for the diagnosis of skin cancer can lead to the realization of optimized and individualized treatments.
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Affiliation(s)
- Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Ji Young Cho
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea;
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
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24
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Kišonas J, Venius J, Grybauskas M, Dabkevičienė D, Burneckis A, Rotomskis R. Acute Radiation Dermatitis Evaluation with Reflectance Confocal Microscopy: A Prospective Study. Diagnostics (Basel) 2021; 11:diagnostics11091670. [PMID: 34574012 PMCID: PMC8471711 DOI: 10.3390/diagnostics11091670] [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: 07/20/2021] [Revised: 08/17/2021] [Accepted: 09/07/2021] [Indexed: 11/24/2022] Open
Abstract
Background: During radiotherapy (RT), most breast cancer patients experience ionizing radiation (IR)-induced skin injury—acute radiation dermatitis (ARD). The severity of ARD is determined by a physician according to CTCAE or RTOG scales, which are subjective. Reflectance confocal microscopy (RCM) is a noninvasive skin imaging technique offering cellular resolution. Digital dermoscopy (DD) performed in conjugation with RCM can provide more information regarding skin toxicity. The purpose of this study is to create an RCM and DD features-based ARD assessment scale, to assess the association with CTCAE scale and possible predictive value. Methods: One hundred and three breast cancer patients during RT were recruited; every week, clinical symptoms of ARD (CTCAE scale) were evaluated and RCM, together with digital dermoscopy (DD), was performed. Results: According to RCM; after 2 RT weeks, exocytosis and/or spongiosis were present in 94% of patients; after 3 weeks, mild contrast cells (MMCs) were detected in 45%; disarrayed epidermis (DE) was present in 66% of patients after 4 weeks and in 93% after 5 weeks; abnormal dermal papillae (ADP) were present in 68% of patients after 5 weeks. The coefficients of RCM features (RCMcoef) alone and together with dermoscopically determined erythema (RCM-ERYcoef) were significantly associated with ARD severity grade. RCMcoef is a significant predictive factor for the clinical manifestation of ARD. Conclusions: RCM features of irradiated skin appear earlier than clinical symptoms, have a characteristic course, and allow the severity of ARD to be predicted.
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Affiliation(s)
- Juras Kišonas
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
- Department of Neurobiology and Biophysics, Vilnius University, LT-01513 Vilnius, Lithuania
- Correspondence: ; Tel.: +370-61237696
| | - Jonas Venius
- Medical Physics Department, National Cancer Institute, LT-08660 Vilnius, Lithuania;
- Biomedical Physics Laboratory, National Cancer Institute, LT-08660 Vilnius, Lithuania;
| | - Mindaugas Grybauskas
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
| | | | - Arvydas Burneckis
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
| | - Ričardas Rotomskis
- Biomedical Physics Laboratory, National Cancer Institute, LT-08660 Vilnius, Lithuania;
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25
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Farnetani F, Pedroni G, Lippolis N, Giovani M, Ciardo S, Chester J, Kaleci S, Pezzini C, Cantisani C, Dattola A, Manfredini M, Dika E, Patrizi A, Pellacani G. Facial seborrheic keratosis with unusual dermoscopic patterns can be differentiated from other skin malignancies by in vivo reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2021; 35:e784-e787. [PMID: 34161654 DOI: 10.1111/jdv.17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/17/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022]
Affiliation(s)
- F Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - G Pedroni
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - N Lippolis
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - M Giovani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Ciardo
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - J Chester
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Kaleci
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Pezzini
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - A Dattola
- Department of Dermatology, University of Rome 'Tor Vergata', Rome, Italy
| | - M Manfredini
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - E Dika
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - A Patrizi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - G Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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26
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Guida S, Pellacani G, Ciardo S, Longo C. Reflectance Confocal Microscopy of Aging Skin and Skin Cancer. Dermatol Pract Concept 2021; 11:e2021068. [PMID: 34123564 DOI: 10.5826/dpc.1103a68] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 01/08/2023] Open
Abstract
Skin aging is a complex process that causes morphologic variations. Some of these variations have been hypothesized to be involved in skin cancer development. This paper reviews current knowledge of the features of aged skin as seen with reflectance confocal microscopy (RCM). Basic principles of the technique are described, and the RCM features of healthy skin and skin cancer are briefly discussed. Moreover, the RCM features at different layers of young and elderly skin are described, as are the variations that occur with passing years and in relation to sun exposure that contribute to photoaging and the development of skin cancer. RCM enables the noninvasive evaluation, at quasi-histologic resolution, of aging-related skin changes, some of which are shared with skin cancer; this ability helps avoid skin biopsy. Further research is needed to understand the relation between skin aging and skin cancer development.
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Affiliation(s)
- Stefania Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvana Ciardo
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Longo
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy
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27
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Dynamic dermoscopic and reflectance confocal microscopic changes of melanocytic lesions excised during follow up. J Am Acad Dermatol 2021; 86:1049-1057. [PMID: 33823198 DOI: 10.1016/j.jaad.2021.03.081] [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: 02/23/2021] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Digital dermoscopy follow up (DDF) is useful in improving the recognition of melanoma, catching early changes over time, although benign nevi can also show changes. Reflectance confocal microscopy (RCM) improves accuracy in diagnosing melanoma and decreases the number of unnecessary resections. OBJECTIVE To evaluate dynamic dermoscopic and RCM changes during follow up of equivocal melanocytic lesions and assess the impact of adjunctive RCM to DDF for melanoma diagnosis. METHODS A retrospective, multicenter study of extrafacial atypical melanocytic lesions excised during follow up was performed. Morphologic changes were evaluated, comparing dermoscopy and RCM baseline and follow-up images. RESULTS One hundred thirty-seven atypical melanocytic lesions were studied, including 14 melanomas and 123 benign nevi. Significantly greater changes in DDF of atypical network, regression, atypical streaks, and asymmetrical growth as well as in dynamic RCM of atypical cells and dermal-epidermal junction disarray were noted in melanomas. With adjunctive dynamic RCM and major changes at DDF, sensitivity reached 100%, with 40.6% specificity. LIMITATIONS Selected series of difficult to recognize lesions, with both DDF and dynamic RCM images. CONCLUSION Adjunctive dynamic RCM improves early melanoma recognition sensitivity.
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Martín-Alcalde J, Gamo-Villegas R, Floristán-Muruzábal MU, Pampín-Franco A, Pinedo-Moraleda F, López-Estebaranz JL. Nevoid melanoma: Dermoscopic and in vivo reflectance confocal microscopic aspects in 4 cases. JAAD Case Rep 2021; 11:132-136. [PMID: 33997213 PMCID: PMC8099597 DOI: 10.1016/j.jdcr.2021.03.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Javier Martín-Alcalde
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Reyes Gamo-Villegas
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | - Ana Pampín-Franco
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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29
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Clinical Applications of In Vivo and Ex Vivo Confocal Microscopy. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11051979] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Confocal laser scanning microscopy (CLSM) has been introduced in clinical settings as a tool enabling a quasi-histologic view of a given tissue, without performing a biopsy. It has been applied to many fields of medicine mainly to the skin and to the analysis of skin cancers for both in vivo and ex vivo CLSM. In vivo CLSM involves reflectance mode, which is based on refractive index of cell structures serving as endogenous chromophores, reaching a depth of exploration of 200 μm. It has been proven to increase the diagnostic accuracy of skin cancers, both melanoma and non-melanoma. While histopathologic examination is the gold standard for diagnosis, in vivo CLSM alone and in addition to dermoscopy, contributes to the reduction of the number of excised lesions to exclude a melanoma, and to improve margin recognition in lentigo maligna, enabling tissue sparing for excisions. Ex vivo CLSM can be performed in reflectance and fluorescent mode. Fluorescence confocal microscopy is applied for “real-time” pathological examination of freshly excised specimens for diagnostic purposes and for the evaluation of margin clearance after excision in Mohs surgery. Further prospective interventional studies using CLSM might contribute to increase the knowledge about its application, reproducing real-life settings.
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30
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Naik PP. Cutaneous Malignant Melanoma: A Review of Early Diagnosis and Management. World J Oncol 2021; 12:7-19. [PMID: 33738001 PMCID: PMC7935621 DOI: 10.14740/wjon1349] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
Cutaneous melanoma (CM) is a malignant tumor formed from pigment-producing cells called melanocytes. It is one of the most aggressive and fatal forms of skin malignancy. In the last decades, CM's incidence has gradually risen, with 351,880 new cases in 2015. Since the 1960s, its incidence has increased steadily, in 2019, with approximately 96,000 new cases. A greater understanding of early diagnosis and management of CM is urgently needed because of the high mortality rates due to metastatic melanoma. Timely detection of melanoma is crucial for successful treatment, but diagnosis with histopathology may also pose a significant challenge to this objective. Early diagnosis and management are essential and contribute to better survival rates of the patient. To better control this malignancy, such information is expected to be particularly useful in the early detection of possible metastatic lesions and the development of new therapeutic approaches. This article reviews the available information on the early diagnosis and management of CM and discusses such information's potential in facilitating the future prospective.
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Affiliation(s)
- Piyu Parth Naik
- Department of Dermatology, Saudi German Hospitals and Clinics, Hessa Street 331 West, Al Barsha 3, Exit 36 Sheikh Zayed Road, Opposite of American School, Dubai, United Arab Emirates.
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31
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Muzumdar S, Wu R, Rothe MJ, Grant-Kels JM. Reflectance confocal microscopy decreases the cost of skin lesion diagnosis: A single institution retrospective chart review. J Am Acad Dermatol 2021; 86:209-211. [PMID: 33515630 DOI: 10.1016/j.jaad.2021.01.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Sonal Muzumdar
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Rong Wu
- Connecticut Convergence Institute for Translation in Regenerative Engineering, Farmington, Connecticut
| | - Marti J Rothe
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; University of Florida Dermatology Department, Gainesville, Florida.
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