B Ferrari1, G Pupelli1, F Farnetani1, N T De Carvalho1, C Longo2, C Reggiani1, G Argenziano2, G Pellacani1. 1. Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. 2. Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS, Reggio Emilia, Italy.
Abstract
BACKGROUND: Early detection of melanoma is the main objective to ensure a high survival rate. In some cases melanoma diagnosis still remain difficult and this leads to unnecessary excisions. OBJECTIVE: The aim of this study was to detect the most relevant Reflectance confocal microscopy (RCM) features for the detection of dermoscopic difficult melanomas. METHOD: A total of 322 lesions were selected from database and were evaluated on dermoscopy according to the 7-point checklist score, in blind from histological diagnosis. We classified the lesions into three categories: (i) 'featureless' lesions with score ranging between 0 and 2; (ii) 'positive-borderline' moles with score between 3 and 4 and (iii) 'positive-clear cut' lesions with score from 5 to 10. We evaluated confocal features of the 'featureless' lesions and of the 'positive-borderline' lesions. Evaluated confocal features were as follows: presence of pagetoid cells, cell shape (roundish or dendritic) and number (< 5 or >5 cells per mm(2) ), overall architecture (ringed, meshwork, clods and non-specific pattern); architectural disorder, presence of cytological atypia (>5 cells per mm(2) ) and cells arranged in nests. RESULTS: Among 322 lesions 70 were melanomas and 252 were nevi. According to the classification based on the 7-point checklist score, 130 'featureless lesions' (score 0-2) including six melanomas, and 102 'positive-borderline' moles (score 3-4) including 17 melanomas, were identified. Round pagetoid cells >5 cells per mm(2) and/or architectural disorder on RCM were found in all of six melanomas with featureless dermoscopy. Round pagetoid infiltration and five or more atypical cells at the DEJ were found in 16 positive 'borderline melanomas'. CONCLUSIONS: RCM represents a rapid non-invasive technique that can aid early diagnosis of dermoscopic difficult melanomas. Use of RCM on lesions with clinical and/or dermoscopic suspect of malignancy may reduce the number of unnecessary excision increasing the rate of accurate diagnoses.
BACKGROUND: Early detection of melanoma is the main objective to ensure a high survival rate. In some cases melanoma diagnosis still remain difficult and this leads to unnecessary excisions. OBJECTIVE: The aim of this study was to detect the most relevant Reflectance confocal microscopy (RCM) features for the detection of dermoscopic difficult melanomas. METHOD: A total of 322 lesions were selected from database and were evaluated on dermoscopy according to the 7-point checklist score, in blind from histological diagnosis. We classified the lesions into three categories: (i) 'featureless' lesions with score ranging between 0 and 2; (ii) 'positive-borderline' moles with score between 3 and 4 and (iii) 'positive-clear cut' lesions with score from 5 to 10. We evaluated confocal features of the 'featureless' lesions and of the 'positive-borderline' lesions. Evaluated confocal features were as follows: presence of pagetoid cells, cell shape (roundish or dendritic) and number (< 5 or >5 cells per mm(2) ), overall architecture (ringed, meshwork, clods and non-specific pattern); architectural disorder, presence of cytological atypia (>5 cells per mm(2) ) and cells arranged in nests. RESULTS: Among 322 lesions 70 were melanomas and 252 were nevi. According to the classification based on the 7-point checklist score, 130 'featureless lesions' (score 0-2) including six melanomas, and 102 'positive-borderline' moles (score 3-4) including 17 melanomas, were identified. Round pagetoid cells >5 cells per mm(2) and/or architectural disorder on RCM were found in all of six melanomas with featureless dermoscopy. Round pagetoid infiltration and five or more atypical cells at the DEJ were found in 16 positive 'borderline melanomas'. CONCLUSIONS:RCM represents a rapid non-invasive technique that can aid early diagnosis of dermoscopic difficult melanomas. Use of RCM on lesions with clinical and/or dermoscopic suspect of malignancy may reduce the number of unnecessary excision increasing the rate of accurate diagnoses.
Authors: Milind Rajadhyaksha; Ashfaq Marghoob; Anthony Rossi; Allan C Halpern; Kishwer S Nehal Journal: Lasers Surg Med Date: 2016-10-27 Impact factor: 4.025
Authors: Cristian Navarrete-Dechent; Konstantinos Liopyris; Jilliana Monnier; Saud Aleissa; Lindsay M Boyce; Caterina Longo; Margaret Oliviero; Harold Rabinovitz; Ashfaq A Marghoob; Allan C Halpern; Giovanni Pellacani; Alon Scope; Manu Jain Journal: J Am Acad Dermatol Date: 2020-05-23 Impact factor: 11.527
Authors: Jacqueline Dinnes; Jonathan J Deeks; Naomi Chuchu; Rubeta N Matin; Kai Yuen Wong; Roger Benjamin Aldridge; Alana Durack; Abha Gulati; Sue Ann Chan; Louise Johnston; Susan E Bayliss; Jo Leonardi-Bee; Yemisi Takwoingi; Clare Davenport; Colette O'Sullivan; Hamid Tehrani; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04
Authors: Jacqueline Dinnes; Jonathan J Deeks; Naomi Chuchu; Lavinia Ferrante di Ruffano; Rubeta N Matin; David R Thomson; Kai Yuen Wong; Roger Benjamin Aldridge; Rachel Abbott; Monica Fawzy; Susan E Bayliss; Matthew J Grainge; Yemisi Takwoingi; Clare Davenport; Kathie Godfrey; Fiona M Walter; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04
Authors: A M Witkowski; J Łudzik; F Arginelli; S Bassoli; E Benati; A Casari; N De Carvalho; B De Pace; F Farnetani; A Losi; M Manfredini; C Reggiani; J Malvehy; G Pellacani Journal: PLoS One Date: 2017-11-09 Impact factor: 3.240