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Melanoma: HELP
Articles by Gabriele Cevenini
Based on 10 articles published since 2008
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Between 2008 and 2019, G. Cevenini wrote the following 10 articles about Melanoma.
 
+ Citations + Abstracts
1 Article An integrated clinical-dermoscopic risk scoring system for the differentiation between early melanoma and atypical nevi: the iDScore. 2018

Tognetti, L / Cevenini, G / Moscarella, E / Cinotti, E / Farnetani, F / Mahlvey, J / Perrot, J L / Longo, C / Pellacani, G / Argenziano, G / Fimiani, M / Rubegni, P. ·Dermatology Unit, Department of Medical, Surgical and NeuroSciences, University of Siena, Siena, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. · Dermatology Unit, University of Campania, Naples, Italy. · Skin Cancer Unit Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain. · Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France. ·J Eur Acad Dermatol Venereol · Pubmed #29888421.

ABSTRACT: BACKGROUND: Dermoscopy revealed to be extremely useful in the diagnosis of early melanoma, the most important limitation being its subjectivity in giving a final diagnosis. To overcome this problem, several algorithms and checklists have been proposed. However, they generally demonstrated modest level of diagnostic accuracy, unsatisfactory concordance between dermoscopists and/or poor specificity. OBJECTIVE: To test a new methodological approach for the differentiation between early melanoma and atypical nevi, based on an integrated clinical-anamnestic dermoscopic risk scoring system (iDScore). METHODS: We selected a total of 435 standardized dermoscopic images of clinically atypical melanocytic skin lesion (MSL) excised in the suspect of malignancy (i.e. 134 early melanomas - MM - and 301 atypical nevi). Data concerning patient age and sex and lesion dimension and site were collected. A scoring classifier was designed based on this data set integrated with the dermoscopic evaluations performed by three experts blinded to histological diagnosis. RESULTS: A total of seven dermoscopic structures, three age groups (30-40 years, 41-60 years and >60 years), two maximum diameter categories (5-10 mm and >10 mm) and three body areas (i.e. frequently, chronically and seldom photoexposed sites) were selected by the scoring classifier as interdependently significant variables. The total risk score (S) of a lesion resulted from the simple sum of partial scores assigned to each selected variable. The iDScore-aided diagnosis showed an high accuracy (receiver operating characteristic-area under the curve = 0.903; IC: 95% = 0.887-0.918). A risk-based criticality scale corresponding to different S ranges was proposed. CONCLUSION: The iDScore checklist is proposed as a feasible and efficient tool to support dermatologists in non-invasive differentiation between atypical nevi and early MM on the basis of few selected clinical-anamnestic data and standardized dermoscopic features.

2 Article A risk scoring system for the differentiation between melanoma with regression and regressing nevi. 2016

Rubegni, P / Tognetti, L / Argenziano, G / Nami, N / Brancaccio, G / Cinotti, E / Miracco, C / Fimiani, M / Cevenini, G. ·Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy. · Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy. Electronic address: linda.tognetti@gmail.com. · Dermatology Unit, Department of Mental and Physic Health and Preventive Medicine, Second University of Naples, Naples, Italy. · Dermatology Department-University Hospital of Saint-Etienne, Saint-Etienne, France. · Section of Human Patology, University of Siena, Siena, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. ·J Dermatol Sci · Pubmed #27157925.

ABSTRACT: BACKGROUND: Spontaneous regression of melanomas is relatively common, its prevalence ranging from 10 to 35%. However, regressing nevi can exhibit worrisome feature and simulate melanoma both clinically and dermoscopically. Thus, the presence of regression can represent a confounding factor. OBJECTIVE: To investigate the frequency of dermoscopic patterns of "regression" in a series of benign and malignant melanocytic skin lesions, and to design an integrated scoring system. Scoring classifiers are very effective in selecting the significant parameters for discriminating two clinical conditions, thus can rapidly calculate a patient's risk for a given disease. METHODS: We selected a series of 95 regressing melanocytic lesions, including 50 regressing nevi and 45 melanomas with regression. For each lesion, 12 dermoscopic variables (i.e. five types of regression structures, five atypical pigmentation structures, atypical vascular pattern and pink areas) were examined by three expert in dermoscopy (blinded to the histological diagnosis). The dermoscopic evaluation was then combined with patient age, gender, body site and the maximum diameter of lesion. Concordance analysis with Cohen's kappa was performed between the three clinicians. A risk scoring system was designed by the leave-one-out cross-validation procedure to ensure model prediction power. RESULTS: The predictive score model revealed a sensitivity of 97.8% and a specificity of 75.5% in discriminating nevi and melanomas with regression. Using the score model, the diagnostic performance of the examiners increased by an average of 23.7% in sensitivity and 5.9% in specificity, compared with standard dermoscopic pattern analysis. CONCLUSIONS: We assessed the validity of an integrated risk scoring model as a new methodological approach that could help the dermatologist in the differentiation between melanoma with regression and regressing nevus. Future studies could test the setting up of a score model over an even more complex pool of data obtained from different skin lesions with various diagnostic devices.

3 Article Computer-assisted melanoma diagnosis: a new integrated system. 2015

Rubegni, Pietro / Feci, Luca / Nami, Niccolò / Burroni, Marco / Taddeucci, Paolo / Miracco, Clelia / Munezero Butorano, Marie A G / Fimiani, Michele / Cevenini, Gabriele. ·aDepartment of Medical, Surgical and Neurological Science, Dermatology Section, Siena University Hospital bDepartment of Medicine, Surgery and Neurosurgery, Section of Pathological Anatomy, Policlinico Santa Maria alle Scotte cDepartment of Medical Biotechnologies, University of Siena, Siena, Italy. ·Melanoma Res · Pubmed #26426763.

ABSTRACT: In dermatology, attempts at synergy between man and machine have mainly been made to improve melanoma diagnosis. The aim of the present study was to test an 'integrated digital dermoscopy analysis' (i-DDA) system with a series of melanocytic lesions that were benign and malignant in nature, and to evaluate its discriminating power with respect to histological diagnosis. In a retrospective study we used an i-DDA system to evaluate a series of 856 excised, clinically atypical pigmented skin lesions (584 benign and 272 malignant). The system evaluated 48 parameters to be studied as possible discriminant variables, grouped into four categories (geometries, colours, textures and islands of colour) integrated with three personal metadata items (sex, age and site of lesion) and presence/absence of three dermoscopic patterns (regression structures, blue-white veil and polymorphic vascular structures). Stepwise multivariate logistic regression of i-DDA data selected nine variables with the highest possible discriminant power. At the end of the stepwise procedure the percentage of cases correctly classified by i-DDA was 89.2% (100% sensitivity and 40.8% specificity). The limitations of the study included those associated with a retrospective design and the 'a priori' exclusion of nonmelanocytic skin lesions. By incorporating numerical digital features with personal data and some dermoscopic patterns into the learning process, the proposed i-DDA improved the performance of assisted melanoma diagnosis, with the advantage that our results can be objectively repeated in any other clinical setting.

4 Article Dermoscopy and digital dermoscopy analysis of palmoplantar 'equivocal' pigmented skin lesions in Caucasians. 2012

Rubegni, P / Cevenini, G / Nami, N / Argenziano, G / Saida, T / Burroni, M / Bono, R / Quaglino, P / Barbini, P / Miracco, C / Lamberti, A / Fimiani, M. ·Dermatology Section, Department of Clinical Medicine and Immunological Science, University of Siena, Siena, Italy. rubegni@unisi.it ·Dermatology · Pubmed #23182753.

ABSTRACT: BACKGROUND/AIM: The diagnosis of palmoplantar melanoma is often delayed and misdiagnosis is common, due to frequently unusual clinical presentation. We used a digital dermoscopy analyzer with a series of palmoplantar pigmented skin lesions (PP-PSL), and we compared sensitivity, specificity and diagnostic accuracy obtained with digital dermoscopy analysis (DDA) and classical dermoscopy. METHODS: Digital dermoscopy images of 107 PP-PSL were retrospectively obtained from the database of images of 3 Italian centers. The lesions (25 melanomas and 82 nevi) were all removed because of the presence of clinical and/or dermoscopic suspicious features. All digital images were analyzed using appropriate algorithms, and the diagnostic accuracy of the model was calculated. For comparison, dermoscopic images were clinically evaluated by two dermatologists and the Cohen ĸ concordance with DDA was calculated. RESULTS: The stepwise logistic regression analysis selected only 5 parameters out of 49. The logistic model achieved a sensitivity of 96% and a specificity of 87.8%. The Cohen ĸ concordance, evaluated by the Landis and Koch scale, supplied a substantial agreement between dermoscopy and DDA. CONCLUSIONS: DDA might be a useful diagnostic instrument in the evaluation of preselected PP-PSL. However, these findings should be confirmed in a formal clinical trial.

5 Article Objective melanoma progression. 2011

Rubegni, Pietro / Burroni, Marco / Nami, Niccolò / Cevenini, Gabriele / Bono, Riccardo / Sbano, Paolo / Fimiani, Michele. ·Department of Clinical Medicine and Immunological Science, Dermatology Section, University of Siena, Siena, Italy. rubegni@unisi.it ·Skin Res Technol · Pubmed #20923468.

ABSTRACT: BACKGROUND/PURPOSE: Many aspects of the natural history of malignant melanoma (MM) are still unclear, specifically its appearance at onset and particularly how it changes in time. The purpose of our study was to retrospectively determine objective changes in melanoma over a 3-24-month observation period. MATERIALS AND METHODS: Our study was carried out in two Italian dermatology centers. Digital dermoscopy analyzers (DB-Mips System) were used to retrospectively evaluate dermoscopic images of 59 MM (with no initial clinical aspects suggesting melanoma) under observation for 3-24 months. The analyzer evaluates 49 parameters grouped into four categories: geometries, colors, textures and islands of color. Multivariate analysis of variance for repeated measures was used to evaluate the statistical significance of the changes in the digital dermoscopy variables of melanomas. RESULTS: Within-lesion analysis indicated that melanomas increased in dimension (Area, Minimum, and Maximum Diameter), manifested greater disorganization of the internal components (Red, Green and Blue Multicomponent, Contrast, and Entropy) and increased in clusters of milky pink color (Light Red Area). CONCLUSION: Analysis of the parameters of our model and statistical analysis enabled us to interpret/identify the most significant factors of melanoma modification, providing quantitative insights into the natural history of this cutaneous malignancy.

6 Article Objective follow-up of atypical melanocytic skin lesions: a retrospective study. 2010

Rubegni, Pietro / Cevenini, Gabriele / Burroni, Marco / Bono, Riccardo / Sbano, Paolo / Biagioli, Maurizio / Risulo, Massimiliano / Nami, Niccolò / Perotti, Roberto / Miracco, Clelia / Fimiani, Michele. ·Department of Clinical Medicine and Immunological Science, Policlinico "Le Scotte", Siena, Italy. rubegni@unisi.it ·Arch Dermatol Res · Pubmed #20411393.

ABSTRACT: Various authors have suggested that information from longitudinal observation (follow-up) of dynamic changes in atypical melanocytic pigmented skin lesions (MPSL) could enable identification of early malignant melanoma escaping initial observation due to an absence of specific clinical and dermoscopic features. The aim of our retrospective study was to determine the existence of numerical variables regarding changes in MPSL that could be useful to differentiate early melanomas and atypical nevi. The study was carried out in two Italian dermatology Centres. Digital dermoscopy analyzers (DB-Mips System) were used to evaluate dermoscopic images of 94 equivocal pigmented skin lesions under observation for 6-12 months and then excised because of changes across time (29 melanomas and 65 nevi). The analyzer evaluates 49 parameters grouped into four categories: geometries, colours, textures and islands of colour. The ROC curve designed on the 49 digital dermoscopy analysis parameters showed good accuracy. At sensitivity (SE) = specificity (SP), it correctly classified 89.3% of cases. When objective pigmented skin lesion parameters were considered together with their objective changes over 6-12 months, a decisive increase in discrimination capacity was obtained. At SE = SP accuracy was 96.3%. Analysis of the parameters of our model and statistical analysis enabled us to interpret/identify the most significant factors of modification and differentiation of lesions, providing quantitative insights into the diagnosis of equivocal MPSL and demonstrating the utility of objective/numerical follow-up.

7 Article Evaluation of cutaneous melanoma thickness by digital dermoscopy analysis: a retrospective study. 2010

Rubegni, Pietro / Cevenini, Gabriele / Sbano, Paolo / Burroni, Marco / Zalaudek, Iris / Risulo, Massimiliano / Dell'Eva, Giordana / Nami, Niccolò / Martino, Antonia / Fimiani, Michele. ·Section of Dermatology, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy. rubegni@unisi.it ·Melanoma Res · Pubmed #20375922.

ABSTRACT: Digital dermoscopy analysis (DDA) exploits computerized analysis of digital images and offers the possibility of parametric analysis of morphological aspects of pigmented skin lesions by means of integration with dedicated software. We conducted a study by DDA in 141 melanomas, with the aim assessing whether the numerical variables extrapolated by univariate logistic analysis could be used in a system of multivariate analysis to predict melanoma thickness before surgery. Melanoma images were evaluated for 49 DDA parameters. Logistic analysis was conducted to identify statistically significant variables. The leave-one-out method was used to evaluate the predictive representations of rules for stepwise logistic classification. The percentage of correctly classified cases was calculated by a classification matrix. Melanomas less than 1 mm had a smaller area, faded borders and were more symmetrical than melanomas greater than 1 mm. The latter had a bluer colour and more random disposition of elements. The accuracy was 86.5%. Specifically, 97 of 108 thin melanomas (specificity 89.8%) and 25 of 33 thick melanomas (sensitivity 75.7%) were correctly classified. In conclusion, the predictive value of DDA for melanoma thickness was quite good. Moreover, DDA allowed us to know objectively those dermoscopic features important in the differentiation between thick and thin melanoma. However, further studies should be performed in a prospective setting before the clinical application.

8 Article Beclin 1 and LC3 autophagic gene expression in cutaneous melanocytic lesions. 2010

Miracco, Clelia / Cevenini, Gabriele / Franchi, Alessandro / Luzi, Pietro / Cosci, Elena / Mourmouras, Vasileios / Monciatti, Irene / Mannucci, Susanna / Biagioli, Maurizio / Toscano, Marzia / Moretti, Daniele / Lio, Roberto / Massi, Daniela. ·Department of Human Pathology and Oncology, University of Siena, 53100 Siena, Italy. miracco@unisi.it ·Hum Pathol · Pubmed #20004946.

ABSTRACT: Beclin 1 and LC3 autophagic genes are altered in several human cancer types. This study was designed to assess the expression of Beclin 1 and LC3 in cutaneous melanocytic lesions, in which they have not yet been investigated. In melanoma, we correlated their expression with conventional histopathologic prognostic factors. In 149 lesions, including benign nevi, dysplastic nevi, radial growth phase melanomas, vertical growth phase melanomas, and melanoma metastases, proteins were evaluated by immunohistochemistry, and, in representative cases of benign nevi, vertical growth phase melanomas and melanoma metastases were evaluated by Western blotting. In most lesions, messenger RNA level was also assessed by real-time reverse transcriptase polymerase chain reaction. Both genes were expressed in all the investigated conditions. Beclin 1 cytoplasmic protein and messenger RNA, as well as LC3 messenger RNA, significantly decreased with tumor progression (P < .05). The percentage of cases with high cytoplasmic expression of beclin 1 from 100% in benign nevi declined to 86.4% in dysplastic nevi, 54.5% in radial growth phase melanomas, 54.3% in vertical growth phase melanomas, and 26.7% in melanoma metastases. The lowest expression of LC3 II protein was observed in melanoma metastases (53.3% of cases) (P < .05); LC3 II protein overexpression was, however, found in several nonbenign lesions, with the highest percentage (45.5%) in radial growth phase melanomas. LC3 II protein expression was inversely correlated to thickness, ulceration, and mitotic rate. In a multivariate analysis, messenger RNAs for both genes discriminated between nonmalignant (benign and dysplastic nevi) and malignant (radial, vertical growth phase melanomas, and melanoma metastases) lesions. Our results, therefore, indicate that beclin 1 and LC3 II autophagic gene expression is altered also in melanocytic neoplasms.

9 Article Nucleolin protein expression in cutaneous melanocytic lesions. 2009

Mourmouras, Vasileios / Cevenini, Gabriele / Cosci, Elena / Epistolato, Maria C / Biagioli, Maurizio / Barbagli, Letizia / Luzi, Pietro / Mannucci, Susanna / Miracco, Clelia. ·Department of Human Pathology and Oncology, Section of Pathological Anatomy, University of Siena, Siena, Italy. ·J Cutan Pathol · Pubmed #19515042.

ABSTRACT: BACKGROUND: Nucleolin is a major nucleolar argyrophilic protein involved in carcinogenesis. There are only few studies on its tissue expression in human cancer and none in melanoma. We aimed at exploring this protein and its prognostic impact in cutaneous melanocytic lesions. METHODS: We studied 193 cases including benign, dysplastic and malignant melanocytic lesions. Nuclear positivity was evaluated by immunohistochemistry and quantified by automated image analysis. RESULTS: Most dysplastic and malignant lesions showed high percentages of cells with abnormal patterns of nuclear positivity (Abn+N) consisting in multiple, irregular, positive dots (ID+) and a coarse, irregularly positive nucleoplasm (CNpl+) or both (ID+CNpl+). The patterns CNpl+ and/or ID+CNpl+ were never observed in benign lesions, in which ID+ were also virtually absent. Abn+N% was significantly lower in dysplastic nevi than in primary melanomas and metastases and in primary melanomas than in metastases (p < 0.05). Furthermore, Abn+N was the second powerful prognostic discriminator, after melanoma thickness, and a significantly lower survival was observed in vertical growth phase melanoma patients showing Abn+N in more than 50% of melanoma cells. CONCLUSION: An altered nuclear nucleolin expression seems to accompany melanoma progression. Further investigation on nucleolin functionality and subcellular trafficking could add information on its altered role in melanoma.

10 Article Sensitivity to ultraviolet B is a risk factor for cutaneous melanoma in a Mediterranean population: results from an Italian case-control study. 2009

Chiarugi, A / Ceroti, M / Palli, D / Cevenini, G / Guarrera, M / Carli, P. ·Department of Dermatology, University of Florence, Florence, Italy. alessandra.chiarugi@unifi.it ·Clin Exp Dermatol · Pubmed #19076789.

ABSTRACT: BACKGROUND: Sun sensitivity is one of the predictors of melanoma risk, together with other individual characteristics such as skin and eye colour and number of naevi. However, it is unclear how best to measure sun sensitivity in order to quantify the individual risk of melanoma. OBJECTIVES: In this case-control study, the relationship between minimal erythema dose (MED) and skin colour (both instrumentally assessed) was investigated, and their possible role as independent risk factors for melanoma in a Mediterranean population evaluated. METHODS: In total, 143 patients with cutaneous melanoma and 102 controls were enrolled in the study. Skin colour was assessed using a Minolta CR-200 chromameter. For MED calculation, a fluorescent lamp (Philips TL 4W/12) was used as a source of ultraviolet B light. MED was defined as the lowest dose that produced an increase of 2.5 in the redness value, expressed by the parameter a* of the Commission Internationale d'Eclairage (CIE) L*a*b* colour space (Deltaa* = 2.5). RESULTS: A significant excess of risk was associated with increasing L* values of skin colour (P < 0.05; OR = 1.12; 95% CI 1.01-1.24) for each unit of change. Low MED values were also associated with an increasing risk of melanoma, with an excess of risk of 18% (OR = 1.18, 95% CI 1.04-1.35) for every 10 mJ/cm(2) of MED reduction. Compared with the highest MED values (> 97.7 mJ/cm(2)), subjects with MED values 2-fold increased risk of melanoma (OR = 2.37, 95% CI 1.05-5.38). The effect of decreasing MED value as a melanoma risk factor persisted after adjustment for skin colour and atypical naevi in a multivariate model. CONCLUSIONS: In conclusion, both instrumentally assessed skin colour and MED are significant risk factors for malignant melanoma in a Mediterranean population. MED seems be an independent variable in establishing the subject's risk profile.