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Korecka K, Kwiatkowska D, Mazur E, Dańczak-Pazdrowska A, Reich A, Żaba R, Polańska A. An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis-A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1043. [PMID: 39064472 PMCID: PMC11278531 DOI: 10.3390/medicina60071043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024]
Abstract
Nonmelanocytic skin cancers (NMSCs) are currently the most common group of human cancers and include all tumors that are not melanomas. Increased exposure to sunlight over the past few years, the lack of regular and proper use of sunscreen, the aging of the population, and better screening techniques are the reasons for the escalation in their diagnosis. Squamous cell carcinoma (SCC) comprises nearly 37% of the tumors in this group and can originate from actinic keratosis (AK), which usually presents as pink, often scaly plaques, usually located on the face or scalp. Advances in dermatoscopy, as well as the development of other non-invasive skin imaging modalities such as high-frequency ultrasound (HFUS), reflectance confocal microscopy (RCM), and optical coherence tomography (OCT), have allowed for greatly increased sensitivity in diagnosing these lesions and monitoring their treatment. Since AK therapy is usually local, and SCCs must be removed surgically, non-invasive imaging methods enable to correctly qualify difficult lesions. This is especially important given that they are very often located on the face, and achieving an appropriate cosmetic result after treatments in this area is very important for the patients. In this review, the authors describe the use of non-invasive skin imaging methods in the diagnosis of actinic keratosis.
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Affiliation(s)
- Katarzyna Korecka
- Department of Dermatology, Poznań University of Medical Sciences, 61-545 Poznań, Poland; (A.D.-P.); (A.P.)
| | - Dominika Kwiatkowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Ewelina Mazur
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
- Doctoral School, University of Rzeszow, 35-310 Rzeszow, Poland
| | | | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Ryszard Żaba
- Department of Dermatology, Poznań University of Medical Sciences, 61-545 Poznań, Poland; (A.D.-P.); (A.P.)
| | - Adriana Polańska
- Department of Dermatology, Poznań University of Medical Sciences, 61-545 Poznań, Poland; (A.D.-P.); (A.P.)
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Li L, Li Y, Dong H, Yan J, Zhang Y, Zhang C, Xu X. Therapeutic and fluorescence evaluation of 20% 5-aminolevulinic acid-mediated photodynamic therapy in actinic keratosis. Photodiagnosis Photodyn Ther 2024; 47:104100. [PMID: 38663488 DOI: 10.1016/j.pdpdt.2024.104100] [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: 11/02/2023] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Actinic keratosis (AK) is a precancerous lesion that occurs in areas that are chronically exposed to sunlight and has the potential to develop into invasive cutaneous squamous cell carcinoma (cSCC). We investigated the efficacy of 20 % 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) with LED red light for the treatment of AK in Chinese patients by examining changes in dermoscopic features, histopathology and fluorescence after treatment. METHODS Twenty-eight patients with fourty-six AK lesions from March 2022 to September 2023 were treated with 20 % ALA, and 3 h later, they were irradiated with LED red light (80-100 mW/cm2) for 20 min. A session of 20 % ALA-PDT was performed once a week for three consecutive weeks, and the dermoscopic, histopathological, fluorescent and photoaging outcomes were measured one week after the treatment. RESULTS One week after ALA-PDT, complete remission (CR) was reached in 53.6 % of patients. The CR of Grade I AK lesions was 100 %, that of Grade II lesions was 71.4 %, and that of Grade III lesions was 38.1 %. There was a significant improvement in the dermoscopic features, epidermal thickness and fluorescence of the AK lesions. The presence of red fluorescence decreased, and there was an association between CR and post-PDT fluorescence intensity. ALA-PDT also exhibited efficacy in treating photoaging, including fine lines, sallowness, mottled pigmentation, erythema, and telangiectasias, and improved the global score for photoaging. There were no serious adverse effects during or after ALA-PDT, and 82.1 % of the patients were satisfied with the treatment. CONCLUSION AK lesions can be safely and effectively treated with 20 % ALA-PDT with LED red light, which also alleviates photoaging in Chinese patients, including those with multiple AKs. This study highlights the possibility that fluorescence could be used to diagnose AK with peripheral field cancerization and evaluate the efficacy of ALA-PDT.
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Affiliation(s)
- Ling Li
- Department of Dermatology, The Second Hospital of Dalian Medical University, Dalian, 116023, China
| | - Yinuo Li
- Department of Dermatology, The Second Hospital of Dalian Medical University, Dalian, 116023, China
| | - Hongjun Dong
- Department of Dermatology, The Second Hospital of Dalian Medical University, Dalian, 116023, China
| | - Jiayu Yan
- Department of Dermatology, The Second Hospital of Dalian Medical University, Dalian, 116023, China
| | - Yunkun Zhang
- Department of Pathology, The Second Hospital of Dalian Medical University, Dalian, 116023, China
| | - Cong Zhang
- Department of Food Nutrition and Safety, Dalian Medical University, Dalian, 116044, China.
| | - Xuezhu Xu
- Department of Dermatology, The Second Hospital of Dalian Medical University, Dalian, 116023, China.
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Danescu S, Negrutiu M, Focsan M, Baican A. An overview of cutaneous squamous cell carcinoma imaging diagnosis methods. Front Med (Lausanne) 2024; 11:1388835. [PMID: 38737758 PMCID: PMC11084285 DOI: 10.3389/fmed.2024.1388835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024] Open
Abstract
Cutaneous squamous cell carcinoma, a type of non-melanoma skin cancer, is a form of keratinocyte carcinoma that stands as one of the most prevalent cancers, exhibiting a rising frequency. This review provides an overview of the latest literature on imaging methods for diagnosing squamous cell carcinoma (SCC) and actinic keratosis (AK). It discusses the diagnostic criteria, advantages, and disadvantages of various techniques such as dermatoscopy, skin ultrasound (US), in vivo and ex-vivo reflectance confocal microscopy (RCM), and line-field confocal optical coherence tomography (LC-OCT). These methods offer benefits including non-invasiveness, rapidity, comprehensive lesion imaging, and enhanced sensitivity, but face challenges like high costs and the need for specialized expertise. Despite obstacles, the use of these innovative techniques is expected to increase with ongoing technological advancements, improving diagnosis and treatment planning for keratinocyte carcinomas. Standardizing LC-OCT imaging algorithms for AK, Bowen's disease, and SCC remains an area for further research.
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Affiliation(s)
- Sorina Danescu
- Department of Dermatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mircea Negrutiu
- Department of Dermatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Monica Focsan
- Nanobiophotonics and Laser Microspectroscopy Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
- Biomolecular Physics Department, Faculty of Physics, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Adrian Baican
- Department of Dermatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Antonetti P, Pellegrini C, Caponio C, Bruni M, Dragone L, Mastrangelo M, Esposito M, Fargnoli MC. Photodynamic Therapy for the Treatment of Bowen's Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome. Biomedicines 2024; 12:795. [PMID: 38672152 PMCID: PMC11048221 DOI: 10.3390/biomedicines12040795] [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: 02/23/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
Bowen's disease represents the in situ form of cutaneous squamous cell carcinoma; although it has an excellent prognosis, 3-5% of lesions progress to invasive cutaneous squamous cell carcinoma, with a higher risk in immunocompromised patients. Treatment is therefore always necessary, and conventional photodynamic therapy is a first-line option. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen's disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Photodynamic therapy is a valuable option for tumors at sites where wound healing is poor/delayed, in the case of multiple and/or large tumors, and where surgery would be difficult or invasive. Dermoscopy and reflectance confocal microscopy can be used as valuable tools for monitoring the therapeutic response. The treatment is generally well tolerated, with mild side effects, and is associated with a good/excellent cosmetic outcome. Periodic follow-up after photodynamic therapy is essential because of the risk of recurrence and progression to cSCC. As the incidence of keratinocyte tumors increases, the therapeutic space for photodynamic therapy will further increase.
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Affiliation(s)
- Paolo Antonetti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Cristina Pellegrini
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Chiara Caponio
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Manfredo Bruni
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Lorenzo Dragone
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Mirco Mastrangelo
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
| | - Maria Esposito
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
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Khalili M, Mirahmadi S, Shamsimeymandi S, Dabiri S, Amiri R, Rezaei Zadeh Rukerd M, Aflatoonian M. Diagnostic Value of Dermoscopic Structures in Predicting Superficial Basal Cell Carcinoma in the Skin of Color. Adv Biomed Res 2024; 13:23. [PMID: 38808321 PMCID: PMC11132197 DOI: 10.4103/abr.abr_315_23] [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: 08/25/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 05/30/2024] Open
Abstract
Background Basal cell carcinoma (BCC) manifests different dermoscopic patterns in individuals with dark skin complexion compared to those with fair skin types. This study aimed to investigate the diagnostic utility of dermoscopy in discerning superficial BCC from other types of BCC, specifically in patients with dark skin complexion. Materials and Methods This cross-sectional study focuses on patients diagnosed with BCC who were referred for skin biopsy between July 2020 and September 2022. Initially, the demographic characteristics of patients, clinical attributes of lesions, and pathological sub-types of BCC were documented. Subsequently, videodermoscopy was employed to capture comprehensive views and dermoscopic images of the lesions. Univariate logistic regression analysis was then utilized to assess the reliability of dermoscopic structures in distinguishing superficial BCC from other BCC types. Last, the study evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of dermoscopy in the differentiation of superficial BCC from other BCC sub-types. Results The study enrolled 49 patients diagnosed with BCC, with a mean age of 66.22 ± 10.41 years. The most prevalent pathological sub-type observed was nodular (53.1%). Dermoscopy exhibited a higher specificity compared to the naked eye in the differentiation of superficial BCC from other types (55% vs. 35%, respectively). Univariate analysis revealed a significant association between spoke-wheel structures and superficial BCC (P = 0.02, odds ratio = 7.2, 95% confidence interval = 1.35-38.32). Conclusion Dermoscopy exhibited superior specificity compared to the naked eye in differentiating superficial BCC from other BCC types. Notably, the spoke-wheel structure demonstrated the most robust correlation with superficial BCC.
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Affiliation(s)
- Maryam Khalili
- Department of Dermatology, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Sare Mirahmadi
- Department of Dermatology, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Simin Shamsimeymandi
- Department of Dermatology, Pathology and Stem Cell Research Center, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahriar Dabiri
- Department of Dermatology, Pathology and Stem Cell Research Center, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Rezvan Amiri
- Department of Dermatology, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Rezaei Zadeh Rukerd
- Internal Medicine Department, Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Soare C, Cozma EC, Celarel AM, Rosca AM, Lupu M, Voiculescu VM. Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care. Cancers (Basel) 2024; 16:484. [PMID: 38339236 PMCID: PMC10854727 DOI: 10.3390/cancers16030484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
Non-melanocytic skin cancers represent an important public health problem due to the increasing incidence and the important local destructive potential. Thus, the early diagnosis and treatment of precancerous lesions (actinic keratoses) is a priority for the dermatologist. In recent years, non-invasive skin imaging methods have seen an important development, moving from simple observational methods used in clinical research, to true diagnostic and treatment methods that make the dermatologist's life easier. Given the frequency of these precancerous lesions, their location on photo-exposed areas, as well as the long treatment periods, with variable, imprecise end-points, the need to use non-invasive imaging devices is increasingly evident to complete the clinical observations in the diagnosis and treatment of these lesions, with the aim of increasing accuracy and decreasing the adverse effects due to long treatment duration. This is the first review that brings together all skin imaging methods (dermoscopy, reflectance confocal microscopy, ultrasonography, dermoscopy-guided high frequency ultrasonography, and optical coherence tomography) used in the evaluation of actinic keratoses and their response to different treatment regimens.
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Affiliation(s)
- Cristina Soare
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
| | - Elena Codruta Cozma
- Department of Pathophysiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
| | - Ana Maria Celarel
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
| | - Ana Maria Rosca
- Department of Dermatology, University Military Hospital “Dr. Carol Davila”, 010825 Bucharest, Romania;
| | - Mihai Lupu
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
| | - Vlad Mihai Voiculescu
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
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Khachemoune A, Juan HY, Singh R. Shedding new light on actinic keratoses and squamous cell carcinoma in situ. JAAPA 2024; 37:1-6. [PMID: 38128142 DOI: 10.1097/01.jaa.0000995696.23729.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
ABSTRACT Cutaneous squamous cell carcinoma can arise from various premalignant lesions such as actinic keratosis, Bowen disease, and premalignant genital squamous cell lesions. Identification and treatment can prevent malignant transformation and death. This article describes the causes, epidemiology, and characteristics of suspicious premalignant squamous cell lesions so that clinicians can identify these lesions and refer patients for specialist treatment as appropriate.
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Affiliation(s)
- Amor Khachemoune
- Amor Khachemoune practices at the Brooklyn (N.Y.) Veterans Affairs Medical Center and SUNY Downstate's Department of Dermatology, also in Brooklyn, N.Y. Hui Yu Juan is a fourth-year medical student at the Virginia Commonwealth University School of Medicine in Richmond, Va. At the time this article was written, Rohan Singh was a third-year medical student at the University of Maryland School of Medicine in Baltimore, Md. Dr. Singh now is a first-year resident at the University of Maryland Medical Center's Department of Internal Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise
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El-Ammari S, Elloudi S, Baybay H, Soughi M, Douhi Z, Mernissi FZ, Omari M, El Fakir S, Tahiri L. Cutaneous Squamous Cell Carcinoma: Clinico-Dermoscopic and Histological Correlation: About 72 Cases. Dermatol Pract Concept 2024; 14:dpc.1401a42. [PMID: 38364377 PMCID: PMC10868796 DOI: 10.5826/dpc.1401a42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer, accounting for 20% of malignant skin tumors. Dermoscopy is a very useful tool for diagnosing cSCC, and its findings are confirmed through histopathological studies. OBJECTIVES to describe the different dermoscopic structures of invasive cSCC and investigate their association with the clinical form and histopathological grade of differentiation. METHODS We conducted a cross-sectional study, collecting all patients diagnosed with squamous cell carcinoma over a period of 5 years. The study population was divided into two groups based on histological differentiation (well-differentiated and non-well-differentiated) and clinical form ( nodulo-ulcerative and nodular). Various dermoscopic parameters were compared between these groups. RESULTS Out of 72 invasive cSCC, 81.9% were well-differentiated, while 18.1% were non-well-differentiated. The clinical form of cSCC was nodulo-ulcerative in 83.3% of cases and nodular in 16.7%. Well-differentiated tumors showed dotted, glomerular and hairpin vessels, along with a predominant white pattern characterized by centrally distributed keratin as well as white circles, and whitish perivascular halo (P < 0.05). The distribution of these white structures was radial in nodulo-ulcerarive lesions, whereas in nodular lesions, their distribution, as well as that of keratin, was more diffuse (P < 0.05). Non-well-differentiated tumors showed a combined white-red pattern with the predominance of arborizing vessels (P < 0.05). CONCLUSIONS Our results show the reliability of dermoscopy as a tool for distinguishing between well- and poorly differentiated cSCC. This distinction is characterized by an increase in predominantly arborizing vessels and a corresponding decrease in white structures as the tumor progresses from a well-differentiated to a poorly differentiated state. Additionally, the nodulo-ulcerative form exhibits a central distribution of keratin, while the nodular form displays a diffuse distribution.
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Affiliation(s)
- Sara El-Ammari
- Department of Dermatology, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Sara Elloudi
- Department of Dermatology, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Hanane Baybay
- Department of Dermatology, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Meryem Soughi
- Department of Dermatology, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Zakia Douhi
- Department of Dermatology, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Fatima Zahra Mernissi
- Department of Dermatology, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Mohammed Omari
- Laboratory of Epidemiology, Clinical Research and Community Health-Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Samira El Fakir
- Laboratory of Epidemiology, Clinical Research and Community Health-Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Layla Tahiri
- Anatomical pathology laboratory, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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Toffoli L, Dianzani C, Bonin S, Guarneri C, Guarneri F, Giuffrida R, Zalaudek I, Conforti C. Actinic Keratoses: A Prospective Pilot Study on a Novel Formulation of 4% 5-Fluorouracil Cream and a Review of Other Current Topical Treatment Options. Cancers (Basel) 2023; 15:cancers15112956. [PMID: 37296918 DOI: 10.3390/cancers15112956] [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: 02/11/2023] [Revised: 04/13/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Actinic keratosis (AK) is one of the most common skin diseases, with a low risk of progression into invasive squamous cell carcinoma. We aim to assess efficacy and safety of a novel formulation of 5-Fluorouracil (5-FU) 4% with once daily application for the treatment of multiple AKs. METHODS A pilot study was performed on 30 patients with a clinical and dermoscopic diagnosis of multiple AKs, enrolled between September 2021 and May 2022 at the Dermatology Departments of two Italian hospitals. Patients were treated with 5-FU 4% cream once daily for 30 consecutive days. The Actinic Keratosis Area and Severity Index (AKASI) was calculated before starting therapy, and at each follow-up, to assess objective clinical response. RESULTS The cohort analyzed included 14 (47%) males and 16 (53%) females (mean age: 71 ± 12 years). A significant decrease in AKASI score at both 6 and 12 weeks (p < 0.0001) was observed. Only three patients (10%) discontinued therapy, and 13 patients (43%) did not report any adverse reactions; no unexpected adverse events were observed. CONCLUSIONS In the setting of topical chemotherapy and immunotherapy, the new formulation of 5-FU 4% proved to be a highly effective treatment for AKs and field cancerization.
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Affiliation(s)
- Ludovica Toffoli
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy
| | - Caterina Dianzani
- Department of Plastic Surgery Unit, Section of Dermatology, University Campus Biomedico of Rome, 00128 Rome, Italy
| | - Serena Bonin
- Department of Medical Science, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, 98124 Messina, Italy
| | - Fabrizio Guarneri
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98124 Messina, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98124 Messina, Italy
| | - Iris Zalaudek
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy
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Sgouros D, Theofili M, Zafeiropoulou T, Lallas A, Apalla Z, Zaras A, Liopyris K, Pappa G, Polychronaki E, Kousta F, Panagiotopoulos A, Stratigos A, Rigopoulos D, Katoulis AC. Dermoscopy of Actinic Keratosis: Is There a True Differentiation between Non-Pigmented and Pigmented Lesions? J Clin Med 2023; 12:jcm12031063. [PMID: 36769711 PMCID: PMC9917853 DOI: 10.3390/jcm12031063] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/19/2023] [Accepted: 01/28/2023] [Indexed: 01/31/2023] Open
Abstract
Dermoscopic features of actinic keratosis (AK) have been widely studied, but there is still little evidence for their diagnostic accuracy. Our study investigates whether established dermoscopic criteria are reliable predictors in differentiating non-pigmented actinic keratosis (NPAK) from pigmented actinic keratosis (PAK). For this purpose, dermoscopic images of 83 clinically diagnosed AK (45 NPAK, 38PAK) were examined, and the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were assessed. Features with statistical significance were the red pseudo-network (p = 0.02) for NPAK and the pigmented pseudo-network (p < 0.001) with a pigment intensity value even less than 10% for PAK (p = 0.001). Pigmented pseudo-network (Se: 89%, Sp: 77%, PPV: 77%, NPV: 89%) with a pigment intensity value of more than 10% (Se: 90%, Sp: 86%, PPV: 79%, NPV: 93%) had excellent diagnostic accuracy for PAK. Scale and widened follicular openings with yellowish dots surrounded by white circles were equally represented in both variants of AK. Linear wavy vessels and shiny streaks were more prominently observed in NPAK, as were rosettes in PAK, but these results failed to meet statistical significance. The red starburst pattern was near statistical significance for PAK. Therefore, pigmentation is the strongest dermoscopic predictor for the differentiation between NPAK and PAK.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Correspondence: ; Tel.: +30-2105832496 or +30-6974816025
| | - Melpomeni Theofili
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Theodora Zafeiropoulou
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Aimilios Lallas
- 1st Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54643 Thessaloniki, Greece
| | - Zoe Apalla
- 2nd Dermatology Department, School of Health Sciences, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
| | - Alexios Zaras
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Konstantinos Liopyris
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Georgia Pappa
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Eleni Polychronaki
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Fiori Kousta
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Antonios Panagiotopoulos
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology and Venereology, “Andreas Sygros” Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Alexander C. Katoulis
- 2nd Department of Dermatology and Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
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11
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Non-Invasive Diagnostic Techniques in Dermatology. J Clin Med 2023; 12:jcm12031081. [PMID: 36769729 PMCID: PMC9918024 DOI: 10.3390/jcm12031081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023] Open
Abstract
The search to enhance the clinical diagnostic accuracy for identifying skin cancer has led to the development of non-invasive diagnostic techniques in dermatology including dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) [...].
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12
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Gürsel Ürün Y, Fiçicioğlu S, Ürün M, Can N. Clinical, Dermoscopic and Histopathological Evaluation of Basal Cell Carcinoma. Dermatol Pract Concept 2023; 13:dpc.1301a4. [PMID: 36892362 PMCID: PMC9946123 DOI: 10.5826/dpc.1301a4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Dermoscopy aids in identifying histopathological subtypes and the presence of clinically undetectable pigmentation in basal cell carcinoma (BCC). OBJECTIVES To investigate the dermoscopic features of BCC subtypes and better understand non-classical dermoscopic patterns. METHODS Clinical and histopathological findings were recorded by a dermatologist who was blinded to the dermoscopic images. Dermoscopic images were interpreted by two independent dermatologists blinded to the patients' clinical and histopathologic diagnosis. Agreement between the two evaluators and with histopathological findings was evaluated using Cohen's kappa coefficient analysis. RESULTS The study included a total of 96 BBC patients with 6 histopathologic variants: nodular (n=48, 50%), infiltrative (n=14, 14.6%), mixed (n=11, 11.5%), superficial (n=10, 10.4%), basosquamous (n=10, 10.4%), and micronodular (n=3, 3.1%). Clinical and dermoscopic diagnosis of pigmented BCC showed high agreement with histopathological diagnosis. The most common dermoscopic findings according to subtype were as follows: nodular BCC: shiny white-red structureless background (85.4%), white structureless areas (75%), and arborizing vessels (70.7%); infiltrative BCC: shiny white-red structureless background (92.9%), white structureless areas (78.6%), arborizing vessels (71.4%); mixed BCC: shiny white-red structureless background (72.7%), white structureless areas (54.4%), and short fine telangiectasias (54.4%); superficial BCC: shiny white-red structureless background (100%), short fine telangiectasias (70%); basosquamous BCC: shiny white-red structureless background (100%), white structureless areas (80%), keratin masses (80%); micronodular BCC: short fine telangiectasias (100%). CONCLUSIONS In this study, arborizing vessels were the most common classical dermoscopic feature of BCC, while shiny white-red structureless background and white structureless areas were the most frequent non-classical dermoscopic features.
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Affiliation(s)
- Yıldız Gürsel Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Sezin Fiçicioğlu
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Mustafa Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Nuray Can
- Departments of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
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13
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Stahlie EHA, van Akkooi ACJ, Plasmeijer E. Dermoscopy as response evaluation tool for cutaneous malignant melanoma metastases treated with Talimogene Laherparepvec: a prospective feasibility study. J Eur Acad Dermatol Venereol 2022; 36:2373-2378. [PMID: 35920755 DOI: 10.1111/jdv.18479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/24/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Currently, the response of cutaneous melanoma metastases (CMM) to treatment with Talimogene Laherparepvec (T-VEC) is evaluated by clinical examination, macroscopic lesion photography and 3-monthly PET-CT scans. When a complete response (CR) is suspected, biopsies are taken for histopathological confirmation. OBJECTIVES We set out to investigate the feasibility of dermoscopy in monitoring the response to T-VEC in a pilot study. METHODS Six patients with CMM treated with T-VEC monotherapy were enrolled in the pilot study. Patients were treated with T-VEC according to protocol and the response was monitored with clinical examination, macroscopic lesion photography and 3-monthly PET-CT scans. For this study, 1-3 cutaneous metastases per patient were selected. Macroscopic and dermoscopic pictures of these metastases were taken at baseline, prior to each treatment with T-VEC and prior to histological biopsy. The pictures were evaluated by two investigators, using a color-based pattern classification. RESULTS In total 11 CMM were dermoscopically assessed, 93% was located on the extremities. Four metastases had a blue pattern, two metastases had a pink pattern, three metastases had a brown pattern and two metastases had mixed pattern. Metastases with a pink pattern harbored glomerular and arborizing vessels that diminished and vanished during treatment T-VEC, indicating CR. The remaining metastases did not show changes on a dermoscopic level that were not also seen on macroscopic level. Five patients achieved CR to T-VEC, one patient is still on treatment. CONCLUSIONS These results suggest that for CMM with a pink pattern, dermoscopy can provide additional information regarding the response to T-VEC. For cutaneous metastases with a blue, brown or a mixed pattern, dermoscopy did not provide additional information on top of the information obtained through physical examination and lesion photography. More studies would be needed to determine the exact role of dermoscopy in the evaluation of CMM.
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Affiliation(s)
| | | | - E Plasmeijer
- Dermatology, Netherlands Cancer Institute - Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands
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14
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Treatment of Actinic Keratosis: The Best Choice through an Observational Study. J Clin Med 2022; 11:jcm11143953. [PMID: 35887717 PMCID: PMC9316230 DOI: 10.3390/jcm11143953] [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: 05/13/2022] [Revised: 06/08/2022] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
Actinic keratosis (AK) is a precancerous lesion that can progress to invasive squamous cell carcinoma if untreated. However, no gold standard treatment has been established. We aimed to investigate the management of AK by comparing the effectiveness and treatment duration of treatment modalities, including cryotherapy, imiquimod (IMQ), and photodynamic therapy (PDT). We reviewed the medical records of 316 patients diagnosed with AK at Seoul St. Mary’s Hospital from February 2015 to May 2020, and a total of 195 patients were included. The clearance rate was the highest in PDT, followed by cryotherapy and IMQ (82.4%, 71.2%, and 68.0%, respectively). The recurrence rate was the lowest in cryotherapy, followed by PDT and IMQ (3.5%, 6.7%, and 10.5%, respectively, p < 0.05). The average treatment duration was shortest with PDT, followed by IMQ and cryotherapy (5.5 weeks, 6.8 weeks, and 9.1 weeks, respectively, p < 0.05). The number of hospital visits was lowest for PDT, followed by cryotherapy and IMQ (1.8, 2.8, and 3.6, respectively, p < 0.05). PDT showed the highest clearance rate, a moderate recurrence rate, the shortest treatment duration, and the least number of visits, suggesting that PDT could be the first choice for treatment of AK. Considering the advantages as a topical agent, IMQ could also be a treatment option.
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Spyridis I, Papageorgiou C, Apalla Z, Manoli SM, Eftychidoy P, Gkentsidi T, Bobos M, Boutis A, Vakirlis E, Sotiriou E, Ioannides D, Lallas A. The peculiar dermatoscopic pattern of scalp melanoma. J Eur Acad Dermatol Venereol 2022; 36:1564-1567. [DOI: 10.1111/jdv.18145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 11/27/2022]
Affiliation(s)
- I Spyridis
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - C Papageorgiou
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - Z Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - SM Manoli
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - P Eftychidoy
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - T Gkentsidi
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - M Bobos
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
- Department of Biomedical Science School of Health Sciences International Hellenic University, Alexandrian Campus Thessaloniki Greece
| | - A Boutis
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
- First Department of Medical Oncology, Theageneio Cancer Hospital Thessaloniki Greece
| | - E Vakirlis
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - E Sotiriou
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - D Ioannides
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
| | - A Lallas
- First Dermatology Department, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Greece
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16
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Chen ZT, Yan JN, Zhu AQ, Wang LF, Wang Q, Li L, Guo LH, Li XL, Xu HX. High-frequency ultrasound for differentiation between high-risk basal cell carcinoma and cutaneous squamous cell carcinoma. Skin Res Technol 2021; 28:410-418. [PMID: 34923684 PMCID: PMC9907640 DOI: 10.1111/srt.13121] [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: 06/20/2021] [Accepted: 10/16/2021] [Indexed: 12/07/2022]
Abstract
BACKGROUND The similar visual appearance of high-risk basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) may cause confusion for diagnosis. High-frequency ultrasound (HFUS) may provide additional intralesional information and thus help to distinguish them. METHOD In this retrospective study, we analyzed the clinical characteristics, HFUS grayscale, and color Doppler flow imaging (CDFI) features of pathologically confirmed high-risk BCC and cSCC lesions (n = 65 vs n = 68). Subsequently, discrimination models based on the significant HFUS features were established. RESULTS Between high-risk BCC and cSCC lesions, the HFUS grayscale features of the lesion size (10.0 mm vs 17.4 mm), thickness (3.1 mm vs 5.9 mm), internal hyperechoic spots (80.0% vs 23.5%), and posterior acoustic shadowing (16.9% vs 66.2%) were statistically different (all p < 0.001). As for the CDFI features, high-risk BCC lesions mainly appeared as pattern II (47.7%), while cSCC lesions mainly appeared as pattern III (66.2%). Based on the above five features, an optimal discrimination model was established with a sensitivity of 91.2%, a specificity of 87.7%, and an accuracy of 89.5%. CONCLUSION HFUS features, including size, thickness, internal hyperechoic spots, posterior acoustic shadowing, and Doppler vascularity pattern, are useful for differential diagnosis between high-risk BCC and cSCC.
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Affiliation(s)
- Zi-Tong Chen
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Jian-Na Yan
- Department of Dermatologic Surgery, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - An-Qi Zhu
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Li-Fan Wang
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Qiao Wang
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Liang Li
- Department of Dermatologic Surgery, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Le-Hang Guo
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, School of Medicine, Tongji University, Shanghai, China.,Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China.,Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
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17
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Dermoscopic Findings in the Presurgical Evaluation of Basal Cell Carcinoma. A Prospective Study. Dermatol Surg 2021; 47:e37-e41. [PMID: 32804889 DOI: 10.1097/dss.0000000000002471] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Surgery is the best treatment for basal cell carcinoma (BCC); however, incomplete excisions are possible. OBJECTIVE Assessment of the accurateness of dermoscopy and clinical evaluation in the detection of borders of BCC and description of dermoscopic findings in clinically healthy tissue surrounding BCC. MATERIALS AND METHODS Eighty-eight lesions with clinical dermoscopic diagnosis of BCC were examined clinically and dermoscopically, to delineate the correct site of surgical incision, demarcating the respective margins with colred dermographic pencils. Specific dermoscopic features were searched in the skin adjacent to the demarcated clinical margin. RESULTS In 29 of 88 lesions, clinical and dermoscopic margins of the tumor coincided. In the remaining 59 (67%), 10 (16.9%) presented, in the lesion area identified under dermoscopy, classical criteria for BCC and 57 (96.6%) nonclassical criteria. Differences between clinical and dermoscopic margins were significantly more frequent in superficial BCCs (p = .006). The frequency was not significantly different (p = .85) in relation to body sites. CONCLUSION Dermoscopy improves the identification of margins for surgical excision in BCC. The observation of nontraditional dermoscopic criteria of BCC, mainly pink-white areas and short telangiectasias in the area between clinically and dermoscopically detected margins, helps to define the actual tumoral margins and to achieve a really radical excision.
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18
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Evaluation of dermatoscopic criteria for early detection of squamous cell carcinoma arising on an actinic keratosis. J Am Acad Dermatol 2021; 86:791-796. [PMID: 33852928 DOI: 10.1016/j.jaad.2021.03.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/10/2021] [Accepted: 03/28/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Advanced squamous cell carcinoma (SCC) can be discriminated easily from actinic keratosis (AK) based on clinical and dermatoscopic features. However, at the initial stage of dermal invasion, SCC might still be clinically flat and discrimination from AK remains challenging, even with the addition of dermatoscopy. OBJECTIVE The aim of this study was to investigate the clinical and dermatoscopic criteria that could suggest early invasion and serve as potent predictors to discriminate early SCC from AK. METHODS Clinical and dermatoscopic images of histopathologically diagnosed AKs and early SCCs were evaluated for the presence of predefined criteria by 3 independent investigators. RESULTS A total of 50 early SCCs and 45 AKs were included. The main positive dermatoscopic predictors of early SCC were dotted/glomerular vessels (odds ratio [OR] 3.83), hairpin vessels (OR 12.12), and white structureless areas (OR 3.58), whereas background erythema represented a negative SCC predictor (OR 0.22). LIMITATIONS The retrospective evaluation of images. Moreover, the differential diagnosis included in the study is restricted between AK and early SCC. CONCLUSIONS We identified potent predictors for the discrimination of AK and early SCC that may better guide management decisions in everyday clinical practice.
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Sgouros D, Theofili M, Damaskou V, Theotokoglou S, Theodoropoulos K, Stratigos A, Theofilis P, Panayiotides I, Rigopoulos D, Katoulis A. Dermoscopy as a Tool in Differentiating Cutaneous Squamous Cell Carcinoma From Its Variants. Dermatol Pract Concept 2021; 11:e2021050. [PMID: 33954021 DOI: 10.5826/dpc.1102a50] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2020] [Indexed: 12/17/2022] Open
Abstract
Background Dermoscopic features of cutaneous squamous cell carcinoma (cSCC) have been widely studied, but their accuracy should be further investigated. Objectives This study assessed the diagnostic accuracy of a set of predetermined dermoscopic structures for 3 variants of cSCC, namely Bowen disease, keratoacanthoma and invasive cSCC. Methods Dermoscopic images of 56 histopathologically confirmed cSCC lesions (9 Bowen disease lesions, 7 keratoacanthomas, and 40 invasive cSCCs) were examined, and the diagnostic accuracy of dermoscopic structures was assessed. Discriminative ability of statistically significant positive predictors was determined using receiver operating characteristic (ROC) curves, and defined as an area under the ROC curve >0.700. Results Dermoscopic structures with statistical significance and discriminative ability were: for Bowen disease, clustered glomerular vessels and erosions; for keratoacanthoma, a central keratin plug; and for invasive cSCC, a mixed color of the background. Clustered and glomerular vessels had, for Bowen disease, perfect diagnostic accuracy, with: sensitivity of 88.9% for both features; specificity of 97.9% and 93.6%, respectively; positive predictive value (PPV) of 88.9% and 72.7%, respectively; and negative predictive value (NPV) of 97.8% for both. Erosions had, for BD, high specificity (87.2%) and NPV (91.1%), but low sensitivity (55.6%) and PPV (45.5%). A central keratin plug had, for keratoacanthoma, high specificity (87.8%) and NPV (93.5%), but low sensitivity (57.1%) and PPV (40%). A mixed background color had, for invasive cSCC, high specificity (81.3%) and PPV (89.7%), but low sensitivity (65%) and NPV (48.2%). Conclusion Dermoscopy accurately differentiates BD, through clustered glomerular vessels, from keratoacanthoma and invasive cSCC. Dermoscopic structures of keratoacanthoma and invasive cSCC overlap, and only histopathologic analysis differentiates them precisely.
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Affiliation(s)
- Dimitrios Sgouros
- First Department of Dermatology & Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Melpomeni Theofili
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Vasileia Damaskou
- Second Department of Pathology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Sofia Theotokoglou
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Konstantinos Theodoropoulos
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Alexander Stratigos
- First Department of Dermatology & Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Theofilis
- Department of Internal Medicine, General Hospital of Nikaia Agios Panteleimon, Piraeus, Greece
| | - Ioannis Panayiotides
- Second Department of Pathology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Rigopoulos
- First Department of Dermatology & Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Alexander Katoulis
- Second Department of Dermatology & Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Quiñones-Venegas R, Paniagua-Santos JE, Guevara-Gutierrez E, Esteban-Salerni G, Gonzalez-Ramirez RA, Tlacuilo-Parra A. Basal cell carcinoma, blue-white variant: Dermatoscopic findings in 32 cases. Indian J Dermatol Venereol Leprol 2021; 87:29-33. [PMID: 31417071 DOI: 10.4103/ijdvl.ijdvl_452_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/01/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND The diagnosis of basal cell carcinoma is histopathological, but there are dermatoscopic criteria that confer high sensitivity and specificity to help the clinician improve its identification. However, the basal cell carcinoma blue-white variant does not totally meet these dermatoscopic criteria, and thus can be confused with other pigmented tumors. In the literature reviewed, we found only five cases of this variant. AIMS The present objective is to describe the dermatoscopic characteristics of the blue-white variant of basal cell carcinoma observed in a tertiary dermatology institute. METHODS The dermatoscopy files of patients with a histopathological diagnosis of basal cell carcinoma between January 1, 2006 and December 31, 2015 were reviewed. RESULTS A total of 32 cases with blue-white variant of basal cell carcinoma were observed over a period of 10 years. Of these cases, 97% presented dermatoscopic findings not included in the aforementioned criteria, such as whitish septa, structureless white areas, homogenous blue pigmentation and shiny white structures. LIMITATIONS The small sample size and the retrospective nature of the design. CONCLUSION We consider it important for dermatologists to know this rare variant of basal cell carcinoma and to familiarize themselves with their dermatoscopic findings, in order to prevent erroneous diagnoses or inadequate treatments.
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Affiliation(s)
- Ricardo Quiñones-Venegas
- Department of Dermatology, Dermatology Institute of Jalisco, "Dr. José Barba Rubio", Jalisco Secretary of Health, Zapopan
| | - Juan Enrique Paniagua-Santos
- Department of Dermatology, Dermatology Institute of Jalisco, "Dr. José Barba Rubio", Jalisco Secretary of Health, Zapopan
| | - Elizabeth Guevara-Gutierrez
- Department of Dermatology, Dermatology Institute of Jalisco, "Dr. José Barba Rubio", Jalisco Secretary of Health, Zapopan
| | | | - Roger Adrian Gonzalez-Ramirez
- Department of Introduction to Clinical Medicine, Faculty of Medicine, Autonomous University of Nuevo Leon, Nuevo Leon, Mexico
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Fania L, Didona D, Morese R, Campana I, Coco V, Di Pietro FR, Ricci F, Pallotta S, Candi E, Abeni D, Dellambra E. Basal Cell Carcinoma: From Pathophysiology to Novel Therapeutic Approaches. Biomedicines 2020; 8:biomedicines8110449. [PMID: 33113965 PMCID: PMC7690754 DOI: 10.3390/biomedicines8110449] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/13/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common human cancer worldwide, and is a subtype of nonmelanoma skin cancer, characterized by a constantly increasing incidence due to an aging population and widespread sun exposure. Although the mortality from BCC is negligible, this tumor can be associated with significant morbidity and cost. This review presents a literature overview of BCC from pathophysiology to novel therapeutic approaches. Several histopathological BCC subtypes with different prognostic values have been described. Dermoscopy and, more recently, reflectance confocal microscopy have largely improved BCC diagnosis. Although surgery is the first-line treatment for localized BCC, other nonsurgical local treatment options are available. BCC pathogenesis depends on the interaction between environmental and genetic characteristics of the patient. Specifically, an aberrant activation of Hedgehog signaling pathway is implicated in its pathogenesis. Notably, Hedgehog signaling inhibitors, such as vismodegib and sonidegib, are successfully used as targeted treatment for advanced or metastatic BCC. Furthermore, the implementation of prevention measures has demonstrated to be useful in the patient management.
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Affiliation(s)
- Luca Fania
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
- Correspondence:
| | - Dario Didona
- Department of Dermatology and Allergology, Philipps University, 35043 Marburg, Germany;
| | - Roberto Morese
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Irene Campana
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Valeria Coco
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Francesca Romana Di Pietro
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Francesca Ricci
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Sabatino Pallotta
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Eleonora Candi
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Damiano Abeni
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Elena Dellambra
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
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22
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Grajdeanu IA, Vata D, Statescu L, Adriana Popescu I, Porumb-Andrese E, Ionela Patrascu A, Stincanu A, Taranu T, Crisan M, Gheuca Solovastru L. Use of imaging techniques for melanocytic naevi and basal cell carcinoma in integrative analysis (Review). Exp Ther Med 2020; 20:78-86. [PMID: 32508998 PMCID: PMC7271701 DOI: 10.3892/etm.2020.8620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 02/27/2020] [Indexed: 12/31/2022] Open
Abstract
Early detection of skin cancer is essential in order to obtain an improved prognosis. Clinicians need more objective and non-invasive examination methods to support their decision whether to biopsy or not tumoral lesions. These may include several imaging techniques such as dermoscopy, videodermoscopy, also known as sequential digital dermoscopy (SDD), computer-aided diagnosis (CAD), total body photography, imaging and high-frequency ultrasonography (HFUS), reflectance confocal microscopy, multiphoton tomography, electrical impedance spectroscopy, Raman spectroscopy, stepwise two-photon-laser spectroscopy and quantitative dynamic infrared. This review summarizes the current developments in the field of melanocytic lesions, such as naevi and basal cell carcinoma (BCC) imaging techniques. The aim was to collect and analyze data concerning types, indications, advantages and disadvantages of modern imaging techniques for in vivo skin tumor diagnosis. Two main methods were focused on, namely videodermoscopy and HFUS, which can be included in daily dermatologists' practice. In skin tumors HFUS allows the assessment of tumoral lesions with depth smaller than 1.5 cm, being described a correlation between ultrasonographic depth and the histologic index.
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Affiliation(s)
- Ioana-Alina Grajdeanu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania
| | - Dan Vata
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Laura Statescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Adriana Popescu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Elena Porumb-Andrese
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Ionela Patrascu
- Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Alina Stincanu
- Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Tatiana Taranu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Dental Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, CF Iasi Hospital, 700506 Iasi, Romania
| | - Maria Crisan
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Laura Gheuca Solovastru
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, Faculty of Medicine, 700115 Iasi, Romania.,Clinic of Dermatology, Department of Dermatology, 'St. Spiridon' County Emergency Clinical Hospital, 700111 Iasi, Romania
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23
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Conforti C, Pizzichetta MA, Vichi S, Toffolutti F, Serraino D, Di Meo N, Giuffrida R, Deinlein T, Giacomel J, Rosendahl C, Gourhant JY, Zalaudek I. Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features. J Eur Acad Dermatol Venereol 2020; 35:79-87. [PMID: 32401364 DOI: 10.1111/jdv.16597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/21/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Among the various types of basal cell carcinoma, the sclerodermiform variant has a high risk of recurrence and local invasiveness. A systematic description of the dermatoscopic features associated with specific body localization is lacking. OBJECTIVES To describe the clinical and dermoscopic features of sclerodermiform basal cell carcinoma (BCC) according to localization in the body confronting with superficial and nodular types. METHODS Clinical and dermoscopic images of sclerodermiform, nodular and superficial BCCs were retrospectively evaluated to study the location in the various body districts, maximum diameter, clinical appearance of the lesion, features of edges and presence or absence of specific dermatoscopic criteria of BCCs. RESULTS We examined 291 histopathologically proven BCCs showing that in nodular BCCs, classical arborizing vessels were more frequently found in the body macro-area (trunk and limbs; n = 46, 97.9%) than in the head/neck area (n = 43, 82.7%); within sclerodermiform BCCs, short arborizing vessels were found more frequently in the head/neck district (n = 35, 49.3%) than in the body (n = 6, 23.1%; P-value 0.02); within nodular BCCs, multiple blue-grey dots and globules were more frequently found on the trunk (n = 23, 48.9%) than in the head/neck district (n = 12, 23.1%; P-value 0.01). In sclerodermiform BCCs, ulceration was found more frequently in the head/neck district (n = 38, 53.5%) than in the body (n = 4, 15.4%; P-value > 0.01), and in superficial BCCs, ulceration was found more frequently in the head/neck district (n = 5, 38.5%) than in the body (n = 8, 9.8%; P-value 0.02). CONCLUSION Our study shows that superficial BCC are found frequently in the head/neck district dermoscopically characterized by ulceration and arborizing vessels; nodular BCCs are more frequently found in the body than in the head/neck district, and the dermoscopic pattern is characterized by the combination of three features: (i) classical arborizing vessels, (ii) multiple blue-grey dots and (iii) globules. Instead, sclerodermiform BCC is preferentially located in areas at high-moderate risk of recurrence; if pink-white areas and/or fine arborizing vessels are seen, clinicians should consider this diagnosis. Furthermore, location-specific dermatoscopic criteria have been described.
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Affiliation(s)
- C Conforti
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - M A Pizzichetta
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy.,Department of Medical Oncology-Preventive Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - S Vichi
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - F Toffolutti
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - D Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - N Di Meo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - R Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology Section, University of Messina, Messina, Italy
| | - T Deinlein
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - J Giacomel
- Skin Spectrum Medical Services, Como, WA, Australia
| | - C Rosendahl
- School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - I Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
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24
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Tamošiūnas M, Plorina EV, Lange M, Derjabo A, Kuzmina I, Bļizņuks D, Spigulis J. Autofluorescence imaging for recurrence detection in skin cancer postoperative scars. JOURNAL OF BIOPHOTONICS 2020; 13:e201900162. [PMID: 31909557 DOI: 10.1002/jbio.201900162] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/25/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
This clinical study is a first attempt to use autofluorescence for recurrence diagnosis of skin cancer in postoperative scars. The proposed diagnostic parameter is based on a reduction in scar autofluorescence, evaluated in the green spectral channel. The validity of the method has been tested on 110 postoperative scars from 56 patients suspected of non-melanoma skin cancer, with eight patients (13 scars) available for the repeated examination. The recurrence diagnosis within a scar has been made after two subsequent autofluorescence check-ups, representing the temporal difference between the scar autofluorescence amplitudes as a vector. The recognition of recurrence has been discussed to represent the significant deviations from the value of vector angle θ. This new autofluorescence-based method can be easily integrated into the postoperative monitoring of surgical scars and can help diagnose the recurrence of skin cancer from the early stage of scar development.
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Affiliation(s)
- Mindaugas Tamošiūnas
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
| | - Emilija V Plorina
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
| | - Marta Lange
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
| | - Aleksandrs Derjabo
- Oncology Centre of Latvia, Riga Eastern University Hospital, Riga, Latvia
| | - Ilona Kuzmina
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
| | - Dmitrijs Bļizņuks
- Faculty of Computer Science and Information Technology, Riga Technical University, Riga, Latvia
| | - Janis Spigulis
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Riga, Latvia
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25
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Neagu N, Lallas K, Maskalane J, Salijuma E, Papageorgiou C, Gkentsidi T, Spyridis I, Morariu S, Apalla Z, Lallas A. Minimizing the dermatoscopic morphologic overlap between basal and squamous cell carcinoma: a retrospective analysis of initially misclassified tumours. J Eur Acad Dermatol Venereol 2020; 34:1999-2003. [DOI: 10.1111/jdv.16207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/31/2019] [Indexed: 01/05/2023]
Affiliation(s)
- N. Neagu
- State Clinic of Dermatology Mureș County Hospital Tîrgu Mureș Romania
| | - K. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - J. Maskalane
- Postgraduate Study Program in Dermatology, Venereology University of Latvia Riga Latvia
| | - E. Salijuma
- Postgraduate Study Program in Dermatology, Venereology RigaStradiņš University Riga Latvia
| | - C. Papageorgiou
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - T. Gkentsidi
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - I. Spyridis
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - S.‐H. Morariu
- State Clinic of Dermatology Mureș County Hospital Tîrgu Mureș Romania
| | - Z. Apalla
- State Clinic of Dermatology Hippokration Hospital Thessaloniki Greece
| | - A. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
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26
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Accuracy of dermoscopic criteria for the differential diagnosis between irritated seborrheic keratosis and squamous cell carcinoma. J Am Acad Dermatol 2020; 85:1143-1150. [PMID: 32068050 DOI: 10.1016/j.jaad.2020.02.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Even with the addition of dermoscopy, a significant morphologic overlap exists between irritated seborrheic keratosis (ISK) and squamous cell carcinoma (SCC). OBJECTIVE The aim of this study was to investigate the dermoscopic criteria that could serve as potent predictors for the differential diagnosis between ISK and SCC. METHODS Dermoscopic images of histopathologically diagnosed ISKs and SCCs were evaluated by 3 independent investigators for the presence of predefined criteria. RESULTS A total of 104 SCCs and 61 ISKs were included. The main dermoscopic predictors of SCC were dotted vessels (odds ratio [OR], 10.4), branched linear vessels (OR, 5.30), white structureless areas (OR, 6.78), white circles surrounding follicles (OR, 23.45), a diffuse irregular (OR, 2.55) or peripheral (OR, 2.8) vessel arrangement, and a central scale arrangement (OR, 3.35). Dermoscopic predictors of ISK were hairpin vessels (OR, 0.38), a diffuse regular vessel arrangement (OR, 0.39 and OR, 0.36), and white halos surrounding vessels covering more than 10% of the lesion (OR, 0.29 and OR, 0.12). LIMITATIONS First, the retrospective design of the study; second, the differential diagnosis included in the study was restricted to ISK and SCC. CONCLUSIONS We confirmed the significant morphologic overlap between ISK and SCC, but we also identified potent predictors for the differential diagnosis between these 2 entities.
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27
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Kato J, Horimoto K, Sato S, Minowa T, Uhara H. Dermoscopy of Melanoma and Non-melanoma Skin Cancers. Front Med (Lausanne) 2019; 6:180. [PMID: 31497603 PMCID: PMC6712997 DOI: 10.3389/fmed.2019.00180] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/29/2019] [Indexed: 12/24/2022] Open
Abstract
Dermoscopy is a widely used non-invasive technique for diagnosing skin tumors. In melanocytic tumors, e.g., melanoma and basal cell carcinoma (BCC), the effectiveness of dermoscopic examination has been fully established over the past two decades. Moreover, dermoscopy has been used to diagnose non-melanocytic tumors. Here, we review novel findings from recent reports concerning dermoscopy of melanoma and non-melanoma skin cancers including BCC, sebaceous carcinoma, actinic keratosis, Bowen's disease, squamous cell carcinoma (SCC), Merkel cell carcinoma (MCC), extramammary Paget's disease (EMPD), and angiosarcoma.
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Affiliation(s)
- Junji Kato
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Sayuri Sato
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomoyuki Minowa
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
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28
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Badash I, Shauly O, Lui CG, Gould DJ, Patel KM. Nonmelanoma Facial Skin Cancer: A Review of Diagnostic Strategies, Surgical Treatment, and Reconstructive Techniques. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2019; 12:1179550619865278. [PMID: 31384136 PMCID: PMC6657122 DOI: 10.1177/1179550619865278] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 12/13/2022]
Abstract
Nonmelanoma skin cancer is the most common form of cancer in the United States, and the face is a common area for skin cancer development due to its frequent exposure to the sun. This article focuses on the surgical management of facial nonmelanoma skin cancers, including diagnostic considerations, biopsy techniques, and staging. In addition, we discuss surgical treatment options, including indications, techniques, outcomes, and facial reconstruction following tumor excision.
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Affiliation(s)
- Ido Badash
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Orr Shauly
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christopher G Lui
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel J Gould
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ketan M Patel
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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29
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Cameron MC, Lee E, Hibler BP, Giordano CN, Barker CA, Mori S, Cordova M, Nehal KS, Rossi AM. Basal cell carcinoma: Contemporary approaches to diagnosis, treatment, and prevention. J Am Acad Dermatol 2019; 80:321-339. [PMID: 29782901 DOI: 10.1016/j.jaad.2018.02.083] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 02/12/2018] [Accepted: 02/17/2018] [Indexed: 12/21/2022]
Abstract
As the most common human cancer worldwide and continuing to increase in incidence, basal cell carcinoma is associated with significant morbidity and cost. Continued advances in research have refined both our insight and approach to this seemingly ubiquitous disease. This 2-part continuing medical education series provides a comprehensive and contemporary review of basal cell carcinoma. The second article in this series will present both the current standard of care and newly developed approaches to diagnosis, treatment, and prevention of this disease.
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Affiliation(s)
- Michael C Cameron
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Erica Lee
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Brian P Hibler
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cerrene N Giordano
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christopher A Barker
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shoko Mori
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Miguel Cordova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kishwer S Nehal
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anthony M Rossi
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
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30
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Peccerillo F, Mandel V, Di Tullio F, Ciardo S, Chester J, Kaleci S, de Carvalho N, Del Duca E, Giannetti L, Mazzoni L, Nisticò S, Stanganelli I, Pellacani G, Farnetani F. Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy. Dermatology 2018; 235:35-44. [DOI: 10.1159/000493727] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/10/2018] [Indexed: 11/19/2022] Open
Abstract
Background: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. Objectives: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). Methods: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the re visited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. Results: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p < 0.001), tumor islands located in the epidermis (100%, p < 0.001), smaller vascular diameter (100%, p < 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p < 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p < 0.001) with a larger vascular diameter (50%, p < 0.001). Conclusions: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.
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31
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Sgouros D, Apalla Z, Ioannides D, Katoulis A, Rigopoulos D, Sotiriou E, Stratigos A, Vakirlis E, Lallas A. Dermoscopy of Common Inflammatory Disorders. Dermatol Clin 2018; 36:359-368. [PMID: 30201145 DOI: 10.1016/j.det.2018.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In addition to its "traditional" application for the early diagnosis of melanoma and nonmelanoma skin cancers, dermoscopy gains appreciation in fields beyond dermato-oncology. Nowadays, dermoscopy has been established as a reliable adjunctive tool to the everyday clinical practice of general dermatology. Morphology and distribution of vascular structures, background colors, follicular abnormalities, and the presence of scales are important features that should be evaluated. Clinical examination remains the undoubted mainstay of diagnosis in inflammatory and infectious diseases.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology - Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, 1 Rimini Street, Chaidari, Athens 12462, Greece
| | - Zoe Apalla
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Dimitrios Ioannides
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Alexander Katoulis
- 2nd Department of Dermatology - Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, 1 Rimini Street, Chaidari, Athens 12462, Greece
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology - Venereology, National Kapodistrian University of Athens, A. Syggros Hospital, 5 I.Dragoumi Street, Athens 16121, Greece
| | - Elena Sotiriou
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology - Venereology, National Kapodistrian University of Athens, A. Syggros Hospital, 5 I.Dragoumi Street, Athens 16121, Greece
| | - Efstratios Vakirlis
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece
| | - Aimilios Lallas
- 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece.
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Papageorgiou C, Apalla Z, Vakirlis E, Sotiriou E, Ioannides D, Lallas A. Use of Dermoscopy to Diagnose and Select BCCs that can be Treated Empirically. CURRENT DERMATOLOGY REPORTS 2018. [DOI: 10.1007/s13671-018-0215-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Husein-ElAhmed H. Sclerodermiform basal cell carcinoma: how much can we rely on dermatoscopy to differentiate from non-aggressive basal cell carcinomas? Analysis of 1256 cases. An Bras Dermatol 2018; 93:229-232. [PMID: 29723362 PMCID: PMC5916395 DOI: 10.1590/abd1806-4841.20186699] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/05/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The behaviour of each basal cell carcinoma is known to be different according to the histological growth pattern. Among these aggressive lesions, sclerodermiform basal cell carcinomas are the most common type. This is a challenging-to-treat lesion due to its deep tissue invasion, rapid growth, risk of metastasis and overall poor prognosis if not diagnosed in early stages. OBJECTIVE To investigate if sclerodermiform basal cell carcinomas are diagnosed later compared to non-sclerodermiform basal cell carcinoma Method: All lesions excised from 2000 to 2010 were included. A pathologist classified the lesions in two cohorts: one with specimens of non-aggressive basal cell carcinoma (superficial, nodular and pigmented), and other with sclerodermiform basal cell carcinoma. For each lesion, we collected patient's information from digital medical records regarding: gender, age when first attending the clinic and the tumor location. RESULTS 1256 lesions were included, out of which 296 (23.6%) corresponded to sclerodermiform basal cell carcinoma, whereas 960 (76.4%) were non-aggressive subtypes of basal cell carcinoma. The age of diagnosis was: 72.78±12.31 years for sclerodermiform basal cell and 69.26±13.87 years for non-aggressive basal cell carcinoma (P<.0001). Sclerodermiform basal cell carcinomas are diagnosed on average 3.52 years later than non-aggressive basal cell carcinomas. Sclerodermiform basal cell carcinomas were diagnosed 3.40 years and 2.34 years later than non-aggressive basal cell carcinomas in younger and older patients respectively (P=.002 and P=.03, respectively). STUDY LIMITATIONS retrospective design. CONCLUSION The diagnostic accuracy and primary clinic conjecture of sclerodermiform basal cell carcinomas is quite low compared to other forms of basal cell carcinoma such as nodular, superficial and pigmented. The dermoscopic vascular patterns, which is the basis for the diagnosis of non-melanocytic nonpigmented skin tumors, may not be particularly useful in identifying sclerodermiform basal cell carcinomas in early stages. As a distinct entity, sclerodermiform basal cell carcinomas show a lack of early diagnosis compared to less-aggressive subtypes of BCC, and thus, more accurate diagnostic tools apart from dermatoscopy are required to reach the goal of early-stage diagnosis of sclerodermiform basal cell carcinomas.
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Papageorgiou V, Apalla Z, Sotiriou E, Papageorgiou C, Lazaridou E, Vakirlis S, Ioannides D, Lallas A. The limitations of dermoscopy: false-positive and false-negative tumours. J Eur Acad Dermatol Venereol 2018; 32:879-888. [PMID: 29314288 DOI: 10.1111/jdv.14782] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/13/2017] [Indexed: 12/25/2022]
Abstract
Dermoscopy has been documented to increase the diagnostic accuracy of clinicians evaluating skin tumours, improving their ability to detect skin cancer and better recognize benign moles. However, dermoscopically 'false-positive' and 'false-negative' tumours do exist. False-positive diagnosis usually leads to unnecessary excisions. False-negative diagnosis is much more dangerous, as it might result in overlooking a cancer, with severe undesirable consequences for the patient and the physician. Therefore, management strategies should mainly focus on addressing the risk of dermoscopically false-negative tumours. The most frequent benign tumours that might acquire dermatoscopic characteristics suggestive of malignancy are seborrhoeic keratosis (SK), including solar lentigo, melanoacanthoma, irritated, clonal and regressive SK, angioma (mainly thrombosed angioma and angiokeratoma), dermatofibroma, benign adnexal tumours and naevi (Clark, Spitz, recurrent, combined, sclerosing). The most useful clues to recognize these tumours are the following: solar lentigo - broad network; melanoacanthoma - sharp border; irritated SK - regularly distributed white perivascular halos; clonal SK - classic SK criteria; regressive SK - remnants of SK; targetoid haemosiderotic haemangioma - dark centre and reddish periphery; thrombosed angioma - sharp demarcation; angiokeratoma - dark lacunae; atypical dermatofibromas - palpation; follicular tumours - white colour; sebaceous tumours - yellow colour; Clark naevi - clinical context; Spitz/Reed naevi - age; combined naevi - blue central area; recurrent naevi - pigmentation within the scar; sclerosing naevi - age and location on the upper back; blue naevi - history. Malignant tumours that might mimic benign ones and escape detection are melanoma (in situ, nevoid, spitzoid, verrucous, regressive, amelanotic), squamous cell carcinoma (mainly well-differentiated variants) and rarely basal cell carcinoma (non-pigmented variants). The most useful clues to recognize the peculiar melanoma subtypes are as follows: melanoma in situ - irregular hyperpigmented areas; nevoid melanoma - history of growth; spitzoid melanoma - age; verrucous melanoma - blue-black sign; regressive melanoma - peppering or scar-like depigmentation; amelanotic melanoma - pink colour, linear irregular vessels, dotted vessels. In this article, we summarized the most frequent dermoscopic variations of common skin tumours that are often misinterpreted, aiming to assist clinicians to reduce the number of false diagnoses.
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Affiliation(s)
- V Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece.,Cosmetic Derma Medicine Medical Group, Athens, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Lazaridou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - S Vakirlis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Wozniak-Rito A, Zalaudek I, Rudnicka L. Dermoscopy of basal cell carcinoma. Clin Exp Dermatol 2018; 43:241-247. [PMID: 29341291 DOI: 10.1111/ced.13387] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2017] [Indexed: 11/29/2022]
Abstract
Dermoscopy is widely used in dermatological practice. The method increases the accuracy of basal cell carcinoma (BCC) detection. Pigmented and nonpigmented variants of basal cell carcinoma present different dermoscopic features. Specific dermoscopy criteria have been recognized in different subtypes of BCC. Differentiation of superficial BCC from other subtypes is the most important issue, as it may determine further management decisions.
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Affiliation(s)
- A Wozniak-Rito
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - I Zalaudek
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.,Department of Neuropeptides, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
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Xiaoqin Y, Chan H, Long W, Yuting X, Keyal U, Guolong Z, Peiru W, Xiuli W. Dermoscopic Monitoring for Treatment and Follow-Up of Actinic Keratosis With 5-Aminolaevulinic Acid Photodynamic Therapy. Technol Cancer Res Treat 2018. [PMCID: PMC6311653 DOI: 10.1177/1533033818820091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Yang Xiaoqin
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
| | - Hu Chan
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
| | - Wen Long
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
| | - Xu Yuting
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
| | - Uma Keyal
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
| | - Zhang Guolong
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
| | - Wang Peiru
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
| | - Wang Xiuli
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People’s Republic of China
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37
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Lallas A, Argenziano G, Ioannides D. Dermoscopy for basal cell carcinoma subtype prediction. Br J Dermatol 2017; 175:674-5. [PMID: 27650744 DOI: 10.1111/bjd.14657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Lallas
- First Department of Dermatology, Aristotle University, 124 Delfon Street, 54643, Thessaloniki, Greece.
| | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
| | - D Ioannides
- First Department of Dermatology, Aristotle University, 124 Delfon Street, 54643, Thessaloniki, Greece
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Manfredini M, Longo C, Ferrari B, Piana S, Benati E, Casari A, Pellacani G, Moscarella E. Dermoscopic and reflectance confocal microscopy features of cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 31:1828-1833. [PMID: 28696052 DOI: 10.1111/jdv.14463] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/22/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Squamous cell carcinoma (SCC) of the skin is a highly prevalent neoplasm. The management and the prognosis of this tumour are dependent on its invasiveness and its grade of differentiation. OBJECTIVES To evaluate whether specific dermoscopic and reflectance confocal microscopy (RCM) criteria can predict the diagnosis of invasive SCC vs. in situ SCC and poorly differentiated compared with well- and moderately differentiated SCC. METHODS Dermoscopic and RCM images of SCC were retrospectively evaluated for the presence of predefined criteria. RESULTS Among 143 SCCs, 121 cases had a complete set of images and thus were included in the study set. The head and neck area was the most frequently involved body site (74/121; 61.1%) followed by extremities (36/121, 29.7%) and trunk (11/121, 9.1%). Seventy tumours were in situ (57.8%), while 51 were invasive (42.1%), of these 11 were poorly differentiated (21.5%), 16 were moderately differentiated (31.3%), and 24 were well differentiated (47.0%). Chi-squared analysis demonstrated that invasive SCCs were characterized by polymorphic vessels, erosion/ulceration, architectural disarrangement, speckled nucleated cells in the dermis, irregularly dilated vessels and absence of hyperkeratosis. Buttonhole vessels, white structureless areas and dotted or glomerular vessels were significantly associated with in situ lesions. Poorly differentiated SCCs were typified by red areas, erosion/ulceration and architectural disarrangement. Well- or moderately differentiated SCCs were associated with white areas and speckled nucleated cells in the epidermis. CONCLUSION Clinical, dermoscopic and RCM images provide useful information that should be integrated in order to achieve the optimal therapeutic management for the patient.
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Affiliation(s)
- M Manfredini
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - B Ferrari
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Piana
- Pathology Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - E Benati
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - A Casari
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - E Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
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Imbernón-Moya A, Sidro M, Malvehy J, Puig S. Negative maple-leaf-like areas: a new clue for basal cell carcinoma margin recognition. Br J Dermatol 2016; 175:818-20. [DOI: 10.1111/bjd.14620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Imbernón-Moya
- Dermatology Department; Hospital Severo Ochoa; Leganés Madrid Spain
- Melanoma Unit; Dermatology Department; Hospital Clínic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer); Barcelona Spain
| | - M. Sidro
- Hospital del Espiritu Santo; Santa Coloma de Gramenet; Barcelona Spain
| | - J. Malvehy
- Melanoma Unit; Dermatology Department; Hospital Clínic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer); Barcelona Spain
- Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Instituto de Salud Carlos III (ISCIII); Barcelona Spain
- Departament de Medicina; Universitat de Barcelona; Barcelona Spain
| | - S. Puig
- Melanoma Unit; Dermatology Department; Hospital Clínic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer); Barcelona Spain
- Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Instituto de Salud Carlos III (ISCIII); Barcelona Spain
- Departament de Medicina; Universitat de Barcelona; Barcelona Spain
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The invisible basal cell carcinoma: how reflectance confocal microscopy improves the diagnostic accuracy of clinically unclear facial macules and papules. Lasers Med Sci 2016; 31:1727-1732. [PMID: 27492373 DOI: 10.1007/s10103-016-2043-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
Difficult to diagnose and early non-melanoma skin cancer lesions are frequently seen in daily clinical practice. Besides precancerous lesions such as actinic keratosis, basal cell carcinomas (BCCs) score the highest frequency in skin tumors. While infiltrative and nodular BCCs require a surgical treatment with a significant impact on the patients' quality of life, early and superficial BCCs might benefit from numerous conservative treatments, such as topical immune-modulators or photodynamic therapy. Dermoscopy has shown a high sensitivity and specificity in the diagnosis of early BCCs, and non-invasive imaging techniques like reflectance confocal microscopy (RCM) have proven to be helpful. The aim of our study was to investigate the importance of RCM in the diagnosis of BCCs with indistinct clinical and dermoscopic features. We retrospectively examined 27 histologically proven BCCs in which diagnosis was not possible based on naked eye examination; we separately reviewed clinical, dermoscopic, and confocal microscopy features and evaluated the lesions meeting the common diagnostic criteria for BCCs, and our diagnostic confidence. All lesions were clinically unclear, with no characteristic features suggestive for BCC; dermoscopy showed in most cases unspecific teleangiectasias (74 %) and micro-erosions (52 %). Confocal microscopy revealed in most of the cases the presence of specific criteria: peripheral palisading of the nuclei (89 %), clefting (70 %), stromal reaction (70 %), dark silhouettes (70 %), inflammatory particles (70 %), and tumor islands (67 %). In the absence of significant diagnostic clinical signs and with unclear dermoscopic features, specific confocal patterns were present in most of the lesions and enabled a correct diagnosis. In the absence of significant clinical features of BCC and in the case of uncertain dermoscopy, striking confocal features are detectable and easy to recognize in most cases. Confocal microscopy can therefore be instrumentful in the diagnosis of the so-called invisible BCCs.
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Lallas A, Tschandl P, Kyrgidis A, Stolz W, Rabinovitz H, Cameron A, Gourhant J, Giacomel J, Kittler H, Muir J, Argenziano G, Hofmann-Wellenhof R, Zalaudek I. Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis. Br J Dermatol 2016; 174:1079-85. [DOI: 10.1111/bjd.14355] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 11/26/2022]
Affiliation(s)
- A. Lallas
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - P. Tschandl
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - A. Kyrgidis
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42100 Reggio Emilia Italy
| | - W. Stolz
- Department of Dermatology, Allergology and Environmental Medicine II; Hospital Thalkirchner Straße; Städtisches Klinikum Munich Munich Germany
| | | | - A. Cameron
- School of Medicine; University of Queensland; Brisbane Qld Australia
| | | | - J. Giacomel
- Skin Spectrum Medical Services; Como WA Australia
| | - H. Kittler
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - J. Muir
- School of Medicine; The University of Queensland; Brisbane Qld Australia
| | - G. Argenziano
- Dermatology Unit; Second University of Naples; Naples Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Non-Melanoma Skin Cancer Unit; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venerology; Non-Melanoma Skin Cancer Unit; Medical University of Graz; Graz Austria
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Imiquimod 5% as Adjuvant Therapy for Incompletely Excised Infiltrative Nodular Basal Cell Carcinoma and Dermoscopy to Monitor Treatment Response. Dermatol Ther (Heidelb) 2015; 5:265-272. [PMID: 26538104 PMCID: PMC4674454 DOI: 10.1007/s13555-015-0088-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Indexed: 12/31/2022] Open
Abstract
Introduction A relatively novel application for dermoscopy is its use in the monitoring of topical treatment response for non-melanoma skin cancer. Basal cell carcinoma (BCC) is the most frequent type of skin cancer in humans. Surgical excision is still considered the “gold-standard” of treatment. However, a number of topical therapies are now available for the treatment of different types of basal cell carcinoma. Case Report This case report exemplifies the usefulness of dermoscopy in the monitoring of residual disease after incomplete surgical excision and also in the monitoring of topical treatment response. Imiquimod 5% cream acts as a topical immune response modifier promoting a Th-1 immune response enhancing the removal of neoplastic cells and has proven to reduce deregulated Hedgehog (HH)/GLI signal strength independent of Toll-like receptor signaling, which makes it a valuable adjuvant topical therapy for the treatment of basal cell carcinoma. Conclusion Imiquimod 5% cream is a valuable adjuvant therapy for the treatment of incompletely excised BCC. This case report adds further evidence to the usefulness of dermoscopy in the assessment and monitoring of treatment outcome. Electronic supplementary material The online version of this article (doi:10.1007/s13555-015-0088-z) contains supplementary material, which is available to authorized users.
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Lallas A, Apalla Z, Ioannides D, Argenziano G, Castagnetti F, Moscarella E, Longo C, Palmieri T, Ramundo D, Zalaudek I. Dermoscopy in the diagnosis and management of basal cell carcinoma. Future Oncol 2015; 11:2975-84. [PMID: 26450622 DOI: 10.2217/fon.15.193] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The dermoscopic findings of basal cell carcinoma (BCC) were first described more than a decade ago and the list of BCC-related criteria has been several times updated and enriched. Today, the dermatoscope is considered the key tool for the diagnosis of BCC, since it allows its early detection and enables its discrimination from other pigmented and nonpigmented skin tumors. The dermoscopic pattern of BCC results from several combinations of well-known BCC criteria, depending on several factors, including histopathologic subtype, location, gender, age and pigmentary trait. In addition, recent evidence highlighted that dermoscopy is also useful in the management of BCC, since it provides information on the tumor subtype, the presence of pigmentation or ulceration and the response to nonablative treatments.
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Affiliation(s)
- Aimilios Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Zoe Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | - Fabio Castagnetti
- Surgery Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Elvira Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Tamara Palmieri
- Radiotherapy Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Dafne Ramundo
- Radiotherapy Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Iris Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Witkowski AM, Łudzik J, DeCarvalho N, Ciardo S, Longo C, DiNardo A, Pellacani G. Non-invasive diagnosis of pink basal cell carcinoma: how much can we rely on dermoscopy and reflectance confocal microscopy? Skin Res Technol 2015; 22:230-7. [PMID: 26338448 DOI: 10.1111/srt.12254] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Non-pigmented 'pink' cutaneous lesions in differential diagnosis with basal cell carcinoma may present a challenge for clinicians. Our objective was to determine the potential improvement of diagnostic accuracy using combined dermoscopy-reflectance confocal microscopy (RCM) image evaluation. METHODS Two hundred and sixty clinically equivocal 'pink' cutaneous lesions were evaluated retrospectively. Reader accuracy was tested with dermoscopy images only vs. RCM and combined dermoscopy-RCM images. RESULTS Out of 260 equivocal 'pink' cutaneous lesions, there were 114 basal cell carcinomas within a total of 140 malignancies that included 12 melanomas, 13 squamous cell carcinomas, and 1 other malignancy type. Dermoscopy only evaluation resulted in an overall sensitivity of 85.1% and specificity of 92.4%, resulting in a positive predictive value (PPV) of 89.8%, with 1 of 12 melanomas misdiagnosed. RCM evaluation resulted in an overall sensitivity of 85.1% and specificity of 93.8%, resulting in a PPV of 91.5%, with no melanomas misdiagnosed. Combined dermoscopy-RCM evaluation resulted in an overall sensitivity of 77.2% and specificity of 96.6%, resulting in a PPV of 94.6%. CONCLUSION The combination of dermoscopy-RCM evaluation significantly improves the accuracy and safety threshold in equivocal 'pink' cutaneous lesions in the differential diagnosis of basal cell carcinoma.
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Affiliation(s)
- A M Witkowski
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - J Łudzik
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Department of Biostatistics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland
| | - N DeCarvalho
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Longo
- Skin Cancer Unit Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - A DiNardo
- Division of Dermatology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Lallas A, Pyne J, Kyrgidis A, Andreani S, Argenziano G, Cavaller A, Giacomel J, Longo C, Malvestiti A, Moscarella E, Piana S, Specchio F, Hofmann-Wellenhof R, Zalaudek I. The clinical and dermoscopic features of invasive cutaneous squamous cell carcinoma depend on the histopathological grade of differentiation. Br J Dermatol 2015; 172:1308-15. [PMID: 25363081 DOI: 10.1111/bjd.13510] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Little is known about the variability of the dermoscopic criteria of squamous cell carcinoma (SCC) according to the histopathological differentiation grade. OBJECTIVES To evaluate whether specific dermoscopic criteria can predict the diagnosis of poorly differentiated SCC compared with well- and moderately differentiated SCC. METHODS Clinical and dermoscopic images of SCCs were retrospectively evaluated for the presence of predefined criteria. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver-operator characteristic curves. RESULTS Of 143 SCCs included, 48 (33·5%) were well differentiated, 45 (31·5%) were moderately differentiated and 50 (35·0%) were poorly differentiated. Flat tumours had a fourfold increased probability of being poorly differentiated. Dermoscopically, the presence of a predominantly red colour posed a 13-fold possibility of poor differentiation, whereas a predominantly white and white-yellow colour decreased the odds of poorly differentiated SCC by 97% each. The presence of vessels in more than 50% of the tumour's surface, a diffuse distribution of vessels and bleeding were significantly associated with poor differentiation, while scale/keratin was a potent predictor of well- or moderately differentiated tumours. CONCLUSIONS Dermoscopy may be regarded as a reliable preoperative tool to distinguish poorly from well- and moderately differentiated SCC. Given that poor differentiation of SCC represents an independent risk factor for recurrence, metastasis and disease-specific death, identifying poorly differentiated tumours in vivo may enhance their appropriate management.
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Affiliation(s)
- A Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - J Pyne
- School of Medicine, The University of Queensland, Brisbane, Australia
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - S Andreani
- Dermatology Service Hospital Salvador, Santiago, Chile
| | - G Argenziano
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | | | - J Giacomel
- Skin Spectrum Medical Services, Como, Western Australia, Australia
| | - C Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - A Malvestiti
- Albert Einstein Israelite Hospital, São Paulo, Brazil
| | - E Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - S Piana
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - F Specchio
- Department of Dermatology, University of Rome Tor Vergata, Italy
| | | | - I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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46
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Moscarella E, Kyrgidis A, Sperduti I, Abramavicus A, Argenziano G, Cota C, Eibenschutz L, De Simone P, Longo C, Hofmann-Wellenhof R, Zalaudek I. Age-related prevalence and morphological appearance of facial skin tumours: a prospective, cross-sectional, observational, multicentre study with special emphasis on melanocytic tumours. J Eur Acad Dermatol Venereol 2014; 29:1331-8. [DOI: 10.1111/jdv.12844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- E. Moscarella
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - A. Kyrgidis
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - I. Sperduti
- Biostatistical Unit; Regina Elena National Cancer Institute; Rome Italy
| | - A. Abramavicus
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - G. Argenziano
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - C. Cota
- Dermatopathology Unit; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - L. Eibenschutz
- Oncologic Dermatology; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - P. De Simone
- Oncologic Dermatology; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - C. Longo
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
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47
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Lallas A, Apalla Z, Argenziano G, Longo C, Moscarella E, Specchio F, Raucci M, Zalaudek I. The dermatoscopic universe of basal cell carcinoma. Dermatol Pract Concept 2014; 4:11-24. [PMID: 25126452 PMCID: PMC4131992 DOI: 10.5826/dpc.0403a02] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 03/08/2014] [Indexed: 11/09/2022] Open
Abstract
Following the first descriptions of the dermatoscopic pattern of basal cell carcinoma (BCC) that go back to the very early years of dermatoscopy, the list of dermatoscopic criteria associated with BCC has been several times updated and renewed. Up to date, dermatoscopy has been shown to enhance BCC detection, by facilitating its discrimination from other skin tumors and inflammatory skin diseases. Furthermore, upcoming evidence suggests that the method is also useful for the management of the tumor, since it provides valuable information about the histopathologic subtype, the presence of clinically undetectable pigmentation, the expansion of the tumor beyond clinically visible margins and the response to non-ablative treatments. In the current article, we provide a summary of the traditional and latest knowledge on the value of dermatoscopy for the diagnosis and management of BCC.
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Affiliation(s)
- Aimilios Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Zoe Apalla
- Dermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Elvira Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Francesca Specchio
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Margaritha Raucci
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Iris Zalaudek
- Department of Dermatology, Medical University of Graz, Austria
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48
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Roldán-Marín R, Leal-Osuna S, Lammoglia-Ordiales L, Toussaint-Caire S. Infundibulocystic basal cell carcinoma: dermoscopic findings and histologic correlation. Dermatol Pract Concept 2014; 4:51-4. [PMID: 25126459 PMCID: PMC4131999 DOI: 10.5826/dpc.0403a09] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 03/15/2014] [Indexed: 11/11/2022] Open
Abstract
Infundibulocystic basal cell carcinoma is a rare variant. It was first described in 1987 and proposed as a new basal cell carcinoma (BCC) subtype by Ackerman and Walsh in 1990. Dermoscopy is a noninvasive diagnostic technique that allows prompt identification of many types of BCC. However, dermoscopic findings for the infundibulocystic variant have not been reported. In our patient the dermoscopic findings were maple leaf-like areas in the periphery of the tumor, multiple scattered blue-gray dots and globules, short, fine telangiectasia and chrysalis or white-shiny streaks. All these structures had an underlying anatomopathological correlation.
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Affiliation(s)
- Rodrigo Roldán-Marín
- Dermatology Department, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico
| | - Sergio Leal-Osuna
- Dermatology Department, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico
| | | | - Sonia Toussaint-Caire
- Dermatology Department, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico
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49
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Longo C, Lallas A, Kyrgidis A, Rabinovitz H, Moscarella E, Ciardo S, Zalaudek I, Oliviero M, Losi A, Gonzalez S, Guitera P, Piana S, Argenziano G, Pellacani G. Classifying distinct basal cell carcinoma subtype by means of dermatoscopy and reflectance confocal microscopy. J Am Acad Dermatol 2014; 71:716-724.e1. [PMID: 24928707 DOI: 10.1016/j.jaad.2014.04.067] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 04/24/2014] [Accepted: 04/30/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The current guidelines for the management of basal cell carcinoma (BCC) suggest a different therapeutic approach according to histopathologic subtype. Although dermatoscopic and confocal criteria of BCC have been investigated, no specific studies were performed to evaluate the distinct reflectance confocal microscopy (RCM) aspects of BCC subtypes. OBJECTIVES To define the specific dermatoscopic and confocal criteria for delineating different BCC subtypes. METHODS Dermatoscopic and confocal images of histopathologically confirmed BCCs were retrospectively evaluated for the presence of predefined criteria. Frequencies of dermatoscopic and confocal parameters are provided. Univariate and adjusted odds ratios were calculated. Discriminant analyses were performed to define the independent confocal criteria for distinct BCC subtypes. RESULTS Eighty-eight BCCs were included. Dermatoscopically, superficial BCCs (n=44) were primarily typified by the presence of fine telangiectasia, multiple erosions, leaf-like structures, and revealed cords connected to the epidermis and epidermal streaming upon RCM. Nodular BCCs (n=22) featured the classic dermatoscopic features and well outlined large basaloid islands upon RCM. Infiltrative BCCs (n=22) featured structureless, shiny red areas, fine telangiectasia, and arborizing vessels on dermatoscopy and dark silhouettes upon RCM. LIMITATIONS The retrospective design. CONCLUSION Dermatoscopy and confocal microscopy can reliably classify different BCC subtypes.
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Affiliation(s)
- Caterina Longo
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy.
| | - Aimilios Lallas
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Athanassios Kyrgidis
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | | | - Elvira Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Iris Zalaudek
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy; Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - Amanda Losi
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvador Gonzalez
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | - Simonetta Piana
- Pathology Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Giuseppe Argenziano
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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50
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Stefanello B, Rezende PM, Argenziano G, Piana S, Moscarella E, Longo C, Zalaudek I, Lallas A. Uncovering a hidden basal cell carcinoma. J Am Acad Dermatol 2014; 70:e99-101. [PMID: 24742859 DOI: 10.1016/j.jaad.2013.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 10/17/2013] [Accepted: 10/20/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Betina Stefanello
- Professor Rubem David Azulay Institute of Dermatology, Rio de Janeiro, Brazil
| | | | | | - Simonetta Piana
- Pathology Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Elvira Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Iris Zalaudek
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Aimilios Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
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