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Moscarella E, Piana S, Specchio F, Kyrgidis A, Nazzaro G, Eliceche ML, Savoia F, Bugatti L, Filosa G, Zalaudek I, Scarfi F, Inskip M, Rosendahl C, Pyne JH, Siggs G, Toğral AK, Cabo H, Drlik L, Lallas A, Longo C, Argenziano G. Dermoscopy features of atypical fibroxanthoma: A multicenter study of the International Dermoscopy Society. Australas J Dermatol 2018; 59:309-314. [PMID: 29569417 DOI: 10.1111/ajd.12802] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/15/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND/OBJECTIVES Little is known about the dermoscopic features of atypical fibroxanthoma. METHODS This was a case-control study. Atypical fibroxanthoma lesions were compared with a control group with non-melanoma skin cancer. RESULTS Altogether 40 atypical fibroxanthoma were collected. Most developed in men (93%), appearing mainly as nodular (63%), amelanotic (93%) and ulcerated (78%) lesions. Most lesions were located on the scalp (55%) and the ears (13%). Dermoscopically, most atypical fibroxanthoma displayed red (83%) and white (70%) structureless areas and irregular linear vessels (43%). A series of features achieved statistical significance when comparing atypical fibroxanthoma with non-melanoma skin cancer. The presence of red and white structureless areas and white lines, and the absence of yellowish-white opaque scales, hairpin vessels and arborising vessels were predictive of atypical fibroxanthoma in univariate analysis. However, when squamous cell carcinoma was excluded from the analysis, none of the criteria achieved statistical significance. When basal cell carcinoma was excluded, three variables achieved statistical significance in predicting atypical fibroxanthoma: red, structureless areas, the absence of opaque yellowish-white scales and absence of white circles. CONCLUSIONS Atypical fibroxanthomas seem to be barely distinguishable from basal cell carcinoma dermoscopically, but they are more easily distinguishable from a well to moderately differentiated squamous cell carcinoma. A histopathological examination is needed for the final diagnosis.
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Affiliation(s)
- Elvira Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.,Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Simonetta Piana
- Pathology Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Francesca Specchio
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.,Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Athanassios Kyrgidis
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Gianluca Nazzaro
- Department of Physiopathology and Transplantation, University of Milan, UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maite L Eliceche
- Dermatology Unit, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | | | | | | | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | | | - Mike Inskip
- Skin Patrol Skin Cancer Clinic, Melbourne, Victoria, Australia
| | - Cliff Rosendahl
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - John H Pyne
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Graeme Siggs
- SunDoctors Skin Cancer Clinic, Adelaide, South Australia, Australia
| | - Arzu K Toğral
- Faculty of Medicine, Department of Dermatology, Başkent University, Ankara, Turkey
| | - Horatio Cabo
- Dermatology Unit, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Lubomir Drlik
- Department of Dermatology, Šumperk Hospital, Šumperk, Czech Republic
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Caterina Longo
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.,Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
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2
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McNeill FE, Fisher M, Chettle DR, Inskip M, Healey N, Bray R, Webber CE, Manton WI, Marro L, Arbuckle TE. The decrease in population bone lead levels in Canada between 1993 and 2010 as assessed by in vivo XRF. Physiol Meas 2017; 39:015005. [PMID: 28967867 DOI: 10.1088/1361-6579/aa904f] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective and Approach: A study, conducted in Toronto, Canada, between 2009 and 2011, measured the bone lead concentrations of volunteers aged 1-82 years using in vivo x-ray fluorescence (XRF) technology. MAIN RESULTS Bone lead levels were lower compared to Ontario in vivo XRF studies from the early 1990s. In adults, the slope of tibia lead content versus age was reduced by 36-56%, i.e. bone lead levels for a given age group were approximately half compared to the same age group 17 years prior. Further, bone lead levels of individuals fell over that time period. In 2010, an average person aged 57 years had a bone lead level approximately 1/3 less than their bone lead level age 40 years in 1993. Using this data, the half-lives of lead in the tibia were estimated as 7-26 years. Tibia lead levels were found to be low in children. The reduction in bone tibia content in children was not significant (p = 0.07), but using data from additional north eastern US studies, there is evidence that childhood tibia stores are lower than in the 1990s. SIGNIFICANCE In vivo XRF analysis shows that there has been a reduction in the level of lead in bone in Canada over the last two decades. Public health measures have been very successful in reducing ongoing exposure to lead and in reducing bone lead stores.
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Affiliation(s)
- F E McNeill
- McMaster University, Hamilton, ON, Canada. Physics and Astronomy, Nuclear Research Building Room 230, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
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3
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Behinaein S, Chettle DR, Fisher M, Manton WI, Marro L, Fleming DEB, Healey N, Inskip M, Arbuckle TE, McNeill FE. Age and sex influence on bone and blood lead concentrations in a cohort of the general population living in Toronto. Physiol Meas 2017; 38:431-451. [PMID: 28067216 DOI: 10.1088/1361-6579/aa57b9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To study the age and sex influence on bone and blood lead concentrations in a cohort of the general population living in Toronto. APPROACH A 109Cd K x-ray fluorescence (KXRF) measurement system was used from 2009 to 2011 in a study that measured the bone lead (Pb) concentration of 263 environmentally exposed individuals residing in Toronto, Ontario, Canada. Tibia (cortical bone) and calcaneus (trabecular bone) lead contents were measured in 134 males and 129 females between 1 and 82 years of age. Whole blood Pb concentration was measured by TIMS (thermal ionization mass spectrometer). Tibia (Ti) and calcaneus (Cal) Pb were examined versus the age of participants, taking into account uncertainties in bone Pb measurement values. MAIN RESULTS No significant sex differences were observed in any of the age categories. Participants older than 50 years of age demonstrated the highest concentrations of Pb in their blood, tibia, and calcaneus bones. SIGNIFICANCE In most of the previous publications, uncertainty was not considered in the regression model of bone Pb and age. However, in this paper, we adjusted the bone Pb values for the uncertainty level. This had a significant influence in regression models of bone Pb and thus we recommend that uncertainty be considered in future studies.
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Inskip M, Longo C, Haddad A. Two adjacent individual fibroepithelioma of Pinkus of the umbilicus-one pink, one pigmented-a case report and review of the literature. Dermatol Pract Concept 2016; 6:17-20. [PMID: 27222767 PMCID: PMC4866622 DOI: 10.5826/dpc.0602a04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 02/03/2016] [Indexed: 11/11/2022] Open
Abstract
We present a unique case of separate and independent adjacent fibroepitheliomas of Pinkus (FeP) arising from the umbilicus in an 83-year-old man. Of further interest, one is pigmented and the other nonpigmented. Clinical, dermatoscopic and histopathological images are provided. A review of the published literature is undertaken to attempt to assess the incidence of pigmented versus nonpigmented FeP. Of 24 published FeP cases, 10 (41.7%) have been pigmented. Thus to date pigmented FeP comprise approaching one-half of all reported cases.
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Affiliation(s)
- Mike Inskip
- Skin Patrol Skin Cancer Clinic, Berwick, Victoria, Australia
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Afaf Haddad
- Dorevitch Pathology, Heidelberg, Victoria, Australia
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5
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MacMillan JW, Behinaein S, Chettle DR, Inskip M, McNeill FE, Manton WI, Healey N, Fisher M, Arbuckle TE, Fleming DEB. Physiologically based modeling of lead kinetics: a pilot study using data from a Canadian population. Environ Sci Process Impacts 2015; 17:2122-2133. [PMID: 26565959 DOI: 10.1039/c5em00517e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Canadian population is currently subject to low, chronic lead exposure and an understanding of its effects is of great significance to the population's health. Such low exposure is difficult to measure directly; approximation by physiologically based modeling may provide a preferable approach to population analysis. The O'Flaherty model of lead kinetics is based on an age-dependent approach to human growth and development and devotes special attention to bone turnover rates. Because lead is a bone-seeking element, the model was deemed ideal for such an analysis. Sample from 263 individuals of various ages from the Greater Toronto Area were selected to evaluate the applicability of the current version of the O'Flaherty model to populations with low lead exposure. For each individual, the input value of lead exposure was calibrated to match the output value of cortical bone lead to the individual's measured tibia lead concentration; the outputs for trabecular bone, blood, and plasma lead concentrations obtained from these calibrations were then compared with the subjects' measured calcaneus, blood, and serum lead concentrations, respectively. This indicated a need for revision of the model parameters; those for lead binding in blood and lead clearance from blood to bone were adjusted and new outputs were obtained in the same fashion as before. Model predictions of trabecular lead concentration did not agree with measurements in the calcaneus. The outputs for blood and plasma lead concentrations were highly scattered and, on an individual level, inconsistent with corresponding measurements; however, the general trends of the outputs matched those of the measurements reasonably well, which indicates that the revised blood lead binding and lead clearance parameters may be useful in future studies. Overall, the analysis showed that with the revisions to the model discussed here, the model should be a useful tool in the analysis of human lead kinetics and body burden in populations characterized by low, chronic exposure to lead from the general environment.
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Affiliation(s)
- John W MacMillan
- Physics Department, Mount Allison University, Sackville, New Brunswick E4L 1E6, Canada.
| | | | | | - Mike Inskip
- McMaster University, Hamilton, Ontario, Canada
| | | | | | - Norm Healey
- Azimuth Consulting Group, Vancouver, British Columbia, Canada
| | | | | | - David E B Fleming
- Physics Department, Mount Allison University, Sackville, New Brunswick E4L 1E6, Canada.
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Inskip M, James N, Magee J, Rosendahl C. Pigmented primary cutaneous balloon cell melanoma demonstrating balloon cells in the dermoepidermal junction: a brief case report with dermatoscopy and histopathology. Int J Dermatol 2015; 55:e110-2. [DOI: 10.1111/ijd.13028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 02/16/2015] [Accepted: 03/01/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Cancer Clinic; Berwick Vic. Australia
| | - Nisha James
- Sun Patrol Skin Cancer Clinic; Berwick Vic. Australia
| | - Jill Magee
- Dorevitch Pathology; Heidelberg Vic. Australia
| | - Cliff Rosendahl
- School of Medicine; The University of Queensland; Brisbane Qld Australia
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7
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Inskip M, Magee J. Evolving clonal nevus-case report with serial digital dermatoscopy and dermatopathology. Dermatol Pract Concept 2015; 5:55-7. [PMID: 25692084 PMCID: PMC4325693 DOI: 10.5826/dpc.0501a10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We present a case of a clonal nevus arising from a previously banal melanocytic nevus over a 15-month period on the central back of a 30-year-old woman in a primary care skin cancer practice in Melbourne, Australia. Clinical, dermatoscopic and dermatopathologic images are presented. A search of the literature has discovered no previously published dermatoscopy images of an evolving clonal nevus.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Care Cancer Clinic, Berwick, Australia
| | - Jill Magee
- Dorevitch Pathology, Heidelberg, Australia
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8
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Inskip M, Magee J. Microcystic adnexal carcinoma of the cheek-a case report with dermatoscopy and dermatopathology. Dermatol Pract Concept 2015; 5:43-6. [PMID: 25692080 PMCID: PMC4325690 DOI: 10.5826/dpc.0501a07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 10/15/2014] [Indexed: 11/09/2022] Open
Abstract
We present a case report of a microcystic adnexal carcinoma on the cheek of a 67-year-old man. Clinical, dermatoscopic and dermatopathologic images are presented. A search of the literature has not discovered any previously published dermatoscopy images of microcystic adenexal carcinoma.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Care Cancer Clinic, Berwick, Australia
| | - Jill Magee
- Dorevitch Pathology, Heidelberg, Australia
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9
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Behinaein S, Chettle DR, Marro L, Malowany M, Fisher M, Fleming DEB, Healey N, Inskip M, Arbuckle TE, McNeill FE. Factors influencing uncertainties of in vivo bone lead measurement using a (109)Cd K X-ray fluorescence clover leaf geometry detector system. Environ Sci Process Impacts 2014; 16:2742-2751. [PMID: 25322174 DOI: 10.1039/c4em00446a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A (109)Cd K X-ray fluorescence (KXRF) measurement system consisting of four detectors in clover-leaf geometry is a non-invasive, low-radiation-dose method of measuring bone lead concentration. Its high precision in estimating the bone lead content makes it a promising tool for the determination of the low levels of lead currently found in the general population. After developing the clover-leaf geometry system, the system was used for the first time in a major survey in 2008 to measure the lead levels of 497 smelter employees (an occupationally exposed group with high lead levels). Since the delivered effective dose of the bone lead system in clover-leaf geometry is small (on the order of nSv), the technique can be used to measure the bone lead of sensitive populations such as the elderly and children. This detector system was used from 2009 to 2011, in a pilot study that measured the bone lead concentration of 263 environmentally exposed individuals (termed the EG group) residing in Toronto, Ontario, Canada. In this paper, the factors that influence uncertainties in lead content in tibia (cortical bone) and calcaneus (trabecular bone) are discussed based on gender, age, and body mass index (BMI) by using analysis of variance (ANOVA) and multiple linear regression models. Results from the two study groups (the EG group versus the occupationally exposed smelter employees) are compared where appropriate (i.e. for males older than 20). Results from univariate analyses showed that females have higher tibia uncertainty compared to males. We observed significant differences for both calcaneus and tibia uncertainty measures (p < 0.0005) among different age groups, where the uncertainties were highest in the lowest age group (<11 years). Lastly, and perhaps most significantly, we found that the product of source activity and measurement time influenced the precision of measurements greatly, and that this factor alone could account for the higher uncertainties observed for the male cohort of the EG group versus the smelter employees.
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Affiliation(s)
- Sepideh Behinaein
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S4L8, Canada.
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10
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Inskip M, Magee J, Weedon D, Rosendahl C. Atypical fibroxanthoma of the cheek-case report with dermatoscopy and dermatopathology. Dermatol Pract Concept 2014; 4:77-80. [PMID: 24855581 PMCID: PMC4029261 DOI: 10.5826/dpc.0402a16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/25/2013] [Indexed: 12/31/2022] Open
Abstract
We present a case report of an atypical fibroxanthoma on the cheek of a 73-year-old man. Clinical, dermatoscopic and dermatopathologic images are presented.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Cancer Clinic, Berwick, Australia
| | - Jill Magee
- Dorevitch Pathology, Heidelberg, Australia
| | - David Weedon
- Sullivan Nicolaides Pathology, Brisbane, Australia
| | - Cliff Rosendahl
- School of Medicine, The University of Queensland, Brisbane, Australia
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Matysiak W, Atanackovic J, Katalmohseni H, Byun S, Inskip M, Prestwich W, Priest N, Chin K, Cowan D, Chettle D. In-Vivo Neutron Activation Analysis for Aluminium in Bone: System Upgrade and Improve Data Analysis. ACTA ACUST UNITED AC 2013. [DOI: 10.12943/anr.2013.00015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An existing NaI(Tl) multidetector array at McMaster University used for in vivo measurement of aluminum by means of neutron activation has been recently upgraded with an in-house built pulse processing system. The new system is capable of collecting spectra in coincidence and anticoincidence modes which allows for better discrimination between the 1.78 MeV 28Al peak and the interfering 38Cl peak. The system is interfaced with Matlab and controlled using a custom graphical user interface, which provides periodic spectral data storage during the acquisition. This feature makes it possible to validate the acquired data and the spectral fitting routines through half-life analysis of the radionuclides. A new set of calibration phantoms spanning a narrower range of aluminum concentrations than employed in the previous study, has also been developed. The combined effect of the new improvements resulted in the minimum detectable level of aluminum in aqueous solutions containing Na, Cl, and Ca in physiological levels, equal to approximately 3 µgAl/gCa.
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Affiliation(s)
- W. Matysiak
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
| | - J. Atanackovic
- Atomic Energy of Canada Limited, Chalk River Laboratories, Chalk, River, ON Canada K0J 1J0
| | - H. Katalmohseni
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
| | - S.H. Byun
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
| | - M. Inskip
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
| | - W.V. Prestwich
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
| | - N. Priest
- Atomic Energy of Canada Limited, Chalk River Laboratories, Chalk, River, ON Canada K0J 1J0
| | - K. Chin
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
| | - D. Cowan
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
| | - D.R. Chettle
- McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8
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Abstract
A case of balloon cell melanoma encountered in a primary care skin cancer practice in Melbourne, Australia is presented. The presenting lesion was 6 mm in diameter, ulcerated, non-pigmented and without any algorithmic clues to melanoma. However the presence of terminal hairs caused the clinician to suspect that it was melanocytic. The lesion was reported as a balloon cell melanoma, Clark level 4, Breslow thickness 2 mm with a mitotic index of 4 per square mm. This is an extremely rare melanoma subtype. Author DW has encountered only two cases in a career involving in excess of one million signed out dermatopathology reports. A search of the literature has not discovered any previously published dermatoscopy images of a balloon cell melanoma.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Cancer Clinic, Berwick, Australia
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13
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Inskip M, Magee J, Barksdale S, Weedon D, Rosendahl C. Balloon cell melanoma in primary care practice: a case report. Dermatol Pract Concept 2013; 3:25-9. [PMID: 24106659 PMCID: PMC3791969 DOI: 10.5826/dpc.0303a08] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 06/01/2013] [Indexed: 11/15/2022] Open
Abstract
A case of balloon cell melanoma encountered in a primary care skin cancer practice in Melbourne, Australia is presented. The presenting lesion was 6 mm in diameter, ulcerated, non-pigmented and without any algorithmic clues to melanoma. However the presence of terminal hairs caused the clinician to suspect that it was melanocytic. The lesion was reported as a balloon cell melanoma, Clark level 4, Breslow thickness 2 mm with a mitotic index of 4 per square mm. This is an extremely rare melanoma subtype. Author DW has encountered only two cases in a career involving in excess of one million signed out dermatopathology reports. A search of the literature has not discovered any previously published dermatoscopy images of a balloon cell melanoma.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Cancer Clinic, Berwick, Australia
| | - Jill Magee
- Dorevitch Pathology, Heidelberg, Australia
| | | | - David Weedon
- Sullivan Nicolaides Pathology, Brisbane, Australia
| | - Cliff Rosendahl
- School of Medicine, The University of Queensland, Brisbane, Australia
- Corresponding author: Cliff Rosendahl, MBBS, Ph.D., PO Box 734, Capalaba, Queensland, 4157, Australia. Tel. +61 7 3245 3011; Fax. +61 7 3245 3022.
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14
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Inskip M, Magee J, Weedon D, Rosendahl C. When algorithms falter: a case report of a very small melanoma excised due to the dermatoscopic "ugly duckling" sign. Dermatol Pract Concept 2013; 3:59-62. [PMID: 23785647 PMCID: PMC3663390 DOI: 10.5826/dpc.0302a09] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/01/2013] [Indexed: 12/02/2022] Open
Abstract
We present a case report of a 3.5 mm diameter superficial spreading melanoma on the upper back of a 27-year-old woman, signed out as Clark level 2, Breslow thickness 0.2 mm with regression to 0.45 mm. The patient, with Fitzpatrick type 1 skin and minimal actinic damage, had presented for a routine skin check with no previous history of skin cancers. At the age of 17 she had received chemotherapy and radiotherapy for Ewing’s sarcoma of the right hip with pulmonary metastases. The skin lesion was assessed as dermatoscopically symmetrical and was not predicted as a melanoma by any algorithmic method. The provisional diagnosis of melanoma was made on the basis that this lesion was completely different in dermatoscopic pattern to her other nevi, a dermatoscopic “ugly duckling” lesion. We draw attention to the recently established link between defects in the STAG2 gene and Ewing’s sarcoma, glioblastoma and melanoma.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Cancer Clinic, Berwick, Australia
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15
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Mostafaei F, McNeill FE, Chettle DR, Prestwich WV, Inskip M. Design of a phantom equivalent to measure bone-fluorine in a human's hand via delayed neutron activation analysis. Physiol Meas 2013; 34:503-12. [DOI: 10.1088/0967-3334/34/5/503] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Liang J, Inskip M, Newhook D, Messier C. Neurobehavioral effect of chronic and bolus doses of methylmercury following prenatal exposure in C57BL/6 weanling mice. Neurotoxicol Teratol 2009; 31:372-81. [DOI: 10.1016/j.ntt.2009.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Revised: 07/10/2009] [Accepted: 08/16/2009] [Indexed: 11/28/2022]
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17
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Fitzgerald J, Wilson D, Bruce J, Grant A, Inskip M, Kaminski E, Middleton D, Roberts D, Williams F, Urbaniak S. HLA genes in Shetland Islanders: An anthropological study. Hum Immunol 1996. [DOI: 10.1016/0198-8859(96)84966-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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