- Visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults. [Review]
- CDCochrane Database Syst Rev 2018 Dec 03; 12:CD011901
- CONCLUSIONS: Dermoscopy may be a valuable tool for the diagnosis of BCC as an adjunct to visual inspection of a suspicious skin lesion following a thorough history-taking including assessment of risk factors for keratinocyte cancer. The evidence primarily comes from secondary-care (referred) populations and populations with pigmented lesions or mixed lesion types. There is no clear evidence supporting the use of currently-available formal algorithms to assist dermoscopy diagnosis.
- Development of a Pigmented Facial Lesion Scale based on darkness and extent of lesions in older veterans. [Journal Article]
- JIJ Invest Dermatol 2018 Nov 30
- Pigmented skin lesions displaying regression features: dermoscopy and reflectance confocal microscopy criteria for diagnosis. [Journal Article]
- EDExp Dermatol 2018 Dec 02
- Melanomas and nevi displaying regression features can be difficult to differentiate. To describe reflectance confocal microscopy features in benign and malignant pigmented skin lesions characterized ...
Melanomas and nevi displaying regression features can be difficult to differentiate. To describe reflectance confocal microscopy features in benign and malignant pigmented skin lesions characterized by regression features in dermoscopy. Methods: Observational retrospective study. Inclusion criteria were presence of dermoscopic features of regression; availability of clinical, dermoscopic and RCM imaging; definite histopathologic diagnosis. The study sample comprised 217 lesions; 108 (49.8%) melanomas and 109 were benign lesions, of which 102 (47.0%) nevi and 7 (3.2%) lichen planus like keratosis (lplk). Patients with melanoma were significantly older than those with benign lesions (61.9±15.4 vs. 46.1±14.8; p<0.001) and a higher proportion of melanomas displayed dermoscopic regression structures in more than 50% of lesion surface (n=83/108; 76.9%; p<0.001). On RCM examination, pagetoid cells were significantly more reported in melanoma group, than in benign lesions (86.1% vs. 59.6%; p<0.001) and were more frequently widespread distributed (65.6% vs. 20.0%; p<0.001) and both dendritic and roundish (36.6% vs. 15.4%; p<0.001) in shape. Aspecific architecture at the dermo-epidermal junction (DEJ) was more commonly seen among melanomas than benign lesions (23.1% vs. 11.9%; p=0.002) with higher presence of dendritic and both dendritic and roundish atypical cells at the DEJ (28.7% vs. 18.3% and 19.4% vs. 3.7%; p<0.001, respectively). Focal pagetoid infiltration and ringed or clod patterns were more commonly seen in benign lesion. In conclusion, the correct interpretation of regressing lesions remains a challenge, assessing carefully the extent and characteristics of architectural and cytologic atypia on RCM is an additional piece of the complex puzzle of melanoma diagnosis. This article is protected by copyright. All rights reserved.
- A Deep Learning Approach to Vascular Structure Segmentation in Dermoscopy Colour Images. [Journal Article]
- BRBiomed Res Int 2018; 2018:5049390
- CONCLUSIONS: Vascular structures due to small size and similarity to other local structures create enormous difficulties during the segmentation and assessment process. The use of advanced segmentation methods like deep learning, especially convolutional neural networks, has the potential to improve the accuracy of advanced local structure detection.
- Carney complex: Two case reports and review of literature. [Journal Article]
- WJWorld J Clin Cases 2018 Nov 26; 6(14):800-806
- Carney complex (CNC) is an extremely rare genetic syndrome of pigmented skin lesions, endocrine hyperfunction and myxoma. Given its diverse clinical manifestations, CNC is often misdiagnosed. Recogni...
Carney complex (CNC) is an extremely rare genetic syndrome of pigmented skin lesions, endocrine hyperfunction and myxoma. Given its diverse clinical manifestations, CNC is often misdiagnosed. Recognition of some special clinical manifestations and imaging features may help with the diagnosis. Early diagnosis of CNC would alert ongoing surveillance of tumors and complications; the prognosis of CNC may thus be improved by early treatment. Herein, we report two cases of CNC with bone lesions.
- Non-Invasive Analysis of High-Risk Driver Mutations and Gene Expression Profiles in Primary Cutaneous Melanoma. [Journal Article]
- JIJ Invest Dermatol 2018 Nov 27
- Tools that help reduce the number of surgical biopsies performed on benign lesions have the potential to improve patient care. The pigmented lesion assay (PLA) is a non-invasive tool validated agains...
Tools that help reduce the number of surgical biopsies performed on benign lesions have the potential to improve patient care. The pigmented lesion assay (PLA) is a non-invasive tool validated against histopathology that helps rule out melanoma and the need for surgical biopsies of atypical pigmented skin lesions. Genetic information is collected using adhesive patches and the expression of two genes, LINC00518 and PRAME, is measured. Using genetic material collected non-invasively and to further validate the PLA, somatic hotspot mutations in genes known to be drivers of early melanoma development (BRAF other than V600E, NRAS and the TERT promoter) can also be identified. The frequency of these hotspot mutations in samples of early melanoma was 77% and higher than the 14% found in non-melanoma samples (p<0.0001). TERT promoter mutations were the most prevalent mutation type in PLA positive melanomas. Eighty-two percent of PLA negative lesions had no mutations and 97% of histopathologically confirmed melanomas were PLA and/or mutation positive (cohort 1, n=103). Mutation frequencies were similar in prospectively collected real-world PLA samples (cohort 2, n=519), in which 88% of PLA negative samples had no mutations. Combining gene expression and mutation analyses enhances the ability to non-invasively detect early cutaneous melanoma.
- Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks. [Journal Article]
- JDJAMA Dermatol 2018 Nov 28
- CONCLUSIONS: Neural networks are able to classify dermoscopic and close-up images of nonpigmented lesions as accurately as human experts in an experimental setting.
- Assessing the efficacy of a 10-point referral tool in the triaging of pigmented lesions to a Dermatology clinic. [Letter]
- ABAn Bras Dermatol 2018 Nov/Dec; 93(6):932-933
- Descriptive dermoscopy terminology in Portuguese language in Brazil: a reproducibility analysis of the 3rd consensus of the International Dermoscopy Society. [Journal Article]
- ABAn Bras Dermatol 2018 Nov/Dec; 93(6):852-858
- CONCLUSIONS: Our study limitations include the small number of participants and limited regional representation (only 2 out of 5 Brazilian regions were represented).The descriptive English terminology proposed at the 3rd Consensus Conference of the International Dermoscopy Society revealed weak reproducibility and the morphology and arrangement of vascular structures presented moderate reproducibility in Brazilian Portuguese. Despite small regional differences, metaphoric terminology in dermoscopy seems to be the most useful and reproducible system to be adopted in Brazilian Portuguese.
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- Treatment of benign pigmented lesions using a novel Dermal Cooling System. [Journal Article]
- LSLasers Surg Med 2018 Nov 27
- Benign pigmented lesions are among the most common dermatologic diagnoses that patients seek treatments for. Treatment modalities range from cryotherapy to light and laser-based technologies. These t...
Benign pigmented lesions are among the most common dermatologic diagnoses that patients seek treatments for. Treatment modalities range from cryotherapy to light and laser-based technologies. These treatments have been shown to be effective, yet may lead to dyschromia or significant downtime. Therefore, we report the first clinical experience with a novel Dermal Cooling System that provides localized and controlled freezing to benign pigmented lesions. Twenty patients seeking treatment for benign pigmented lesions were treated with the Dermal Cooling System at the laser and cosmetic dermatology clinic at the University of California, San Diego. Photographs were captured at baseline and follow-up visits. Two blinded investigators reviewed and graded the photographs. Most patients experienced improvement after 1 month following the first treatment. Macular or slightly raised lesions responded best. Treatment side effects were transient, lasted a maximum of 3 days, and included erythema, swelling, itching, and darkening. There was no observed long-term dyschromia. The novel Dermal Cooling System shows promise in the treatment of flat to slightly raised benign pigmented lesions with little-to-no downtime. Further clinical experience is necessary to continue to optimize treatment parameters. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.