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Melanoma: HELP
Articles by Aimilios Lallas
Based on 48 articles published since 2008
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Between 2008 and 2019, A. Lallas wrote the following 48 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Spitz/Reed nevi: proposal of management recommendations by the Dermoscopy Study Group of the Italian Society of Dermatology (SIDeMaST). 2014

Broganelli, P / Titli, S / Lallas, A / Alaibac M Annetta, A / Battarra, V / Brunetti, B / Castagno, I / Cavicchini, S / Ferrari, A / Ghigliotti, G / Landi, C / Manganoni, A / Moscarella, E / Pellacani, G / Pizzichetta, M A / Rosina, P / Rubegni, P / Satta, R / Scalvenzi, M / Stanganelli, I / Stinco, G / Zalaudek, I / Zampieri, P / Argenziano, G / Anonymous1410806. ·Department of Oncology and Hematology, Section of Dermatology, City of Health and Science Hospital of Turin, Turin, Italy - paolobroganelli@inwind.it. ·G Ital Dermatol Venereol · Pubmed #25213387.

ABSTRACT: -- No abstract --

2 Review A meta-analysis of nevus-associated melanoma: Prevalence and practical implications. 2017

Pampena, Riccardo / Kyrgidis, Athanassios / Lallas, Aimilios / Moscarella, Elvira / Argenziano, Giuseppe / Longo, Caterina. ·Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy. · First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece. · Dermatology Unit, University of Campania, Naples, Italy. · Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy; Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: longo.caterina@gmail.com. ·J Am Acad Dermatol · Pubmed #28864306.

ABSTRACT: The reported prevalence of nevus-associated melanoma varies substantially. We performed a systematic review and meta-analysis to determine the incidence and prevalence of this disease; we also performed subanalyses considering age, tumor thickness, and nevus-type classification. In 38 observational cohort and case-control studies, 29.1% of melanomas likely arose from a preexisting nevus and 70.9% de novo. Any given melanoma was 64% less likely to be nevus-associated than de novo (risk ratio 0.36, 95% confidence interval [CI] 0.29-0.44; P < .001; I

3 Review Dermoscopy of Malignant Skin Tumours: What's New? 2017

Russo, Teresa / Piccolo, Vincenzo / Lallas, Aimilios / Giacomel, Jason / Moscarella, Elvira / Alfano, Roberto / Argenziano, Giuseppe. ·Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy. ·Dermatology · Pubmed #28486238.

ABSTRACT: Dermoscopy represents a new and effective tool that assists dermatologists in improving the accuracy of clinical diagnosis in onco-dermatology. The aim of this article is to provide an overview of the latest and important dermoscopic progress and observations in this ever-evolving field of dermatology.

4 Review MELTUMP: how to manage these lesions in the clinical routine. 2017

Piccolo, Vincenzo / Moscarella, Elvira / Lallas, Aimilios / Alfano, Roberto / Ferrara, Gerardo / Argenziano, Giuseppe. ·Dermatology Unit, L. Vanvitelli University, Naples, Italy - piccolo.vincenzo@gmail.com. · Dermatology Unit, L. Vanvitelli University, Naples, Italy. · Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova Institute for Research and Care, Reggio Emilia, Italy. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · Department of Anesthesiology, Surgery and Emergency, L. Vanvitelli University, Naples, Italy. · Anatomic Pathology Unit, General Hospital of Macerata, Macerata, Italy. ·G Ital Dermatol Venereol · Pubmed #28195450.

ABSTRACT: Although most melanocytic lesions can be diagnosed by histopathologists as benign or malignant with high confidence, a subset of morphologically ambiguous lesions does exist and still represents a significant problem for pathologists. These lesions have been defined as MELTUMP, i.e. melanocytic tumors of uncertain malignant potential. MELTUMP could be considered as a large cauldron in which melanocytic lesions with equivocal morphologic features fall into, including most benign lesions and a minority of melanomas, unfortunately recognizable only a posteriori for their unfavorable outcome. As a consequence of the lack of uniformity in the biologic behavior of melanocytic lesions belonging to the heterogeneous subset of MELTUMP, confusion and lack of agreement in the management of these difficult lesions is increasingly growing up. As most MELTUMP have a favorable prognosis we recommend a conservative approach, avoiding over treatment for this group of lesions.

5 Review Melanoma: clinical and dermoscopic diagnosis. 2017

Brancaccio, Gabriella / Russo, Teresa / Lallas, Aimilios / Moscarella, Elvira / Agozzino, Marina / Argenziano, Giuseppe. ·Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy. · Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy - russo.teresa87@gmail.com. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. ·G Ital Dermatol Venereol · Pubmed #28121084.

ABSTRACT: Missing the diagnosis of a melanoma is the worst dermatologist nightmare, especially when melanomas have a non-alarming clinical appearance and imitate a completely benign lesion. The use of dermoscopy has provided an effective tool to facilitate the differential diagnosis and to increasingly allow an early diagnosis of melanoma. The aim of this article was to summarize the most recent and important clinical and dermoscopic pearls to recognize melanoma at the earliest stages of its development.

6 Review Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society. 2017

Lallas, A / Apalla, Z / Ioannides, D / Lazaridou, E / Kyrgidis, A / Broganelli, P / Alfano, R / Zalaudek, I / Argenziano, G / Anonymous4790894. ·First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. · City of Health and Science University, Turin, Italy. · Department of Anaesthesiology, Surgery and Emergency Medicine, Second University of Naples, Naples, Italy. · Department of Dermatology and Venereology, Nonmelanoma Skin Cancer Unit, Medical University of Graz, Austria. · Dermatology Unit, Second University of Naples, Naples, Italy. ·Br J Dermatol · Pubmed #28118479.

ABSTRACT: Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical recognition, biological behaviour and management strategies. Although Spitz naevi are considered benign tumours, their clinical and dermoscopic morphological overlap with spitzoid melanoma renders the management of spitzoid lesions particularly difficult. The controversy deepens because of the existence of tumours that cannot be safely histopathologically diagnosed as naevi or melanomas (atypical Spitz tumours). The dual objective of the present study was to provide an updated classification on dermoscopy of Spitz naevi, and management recommendations of spitzoid-looking lesions based on a consensus among experts in the field. After a detailed search of the literature for eligible studies, a data synthesis was performed from 15 studies on dermoscopy of Spitz naevi. Dermoscopically, Spitz naevi are typified by three main patterns: starburst pattern (51%), a pattern of regularly distributed dotted vessels (19%) and globular pattern with reticular depigmentation (17%). A consensus-based algorithm for the management of spitzoid lesions is proposed. According to it, dermoscopically asymmetric lesions with spitzoid features (both flat/raised and nodular) should be excised to rule out melanoma. Dermoscopically symmetric spitzoid nodules should also be excised or closely monitored, irrespective of age, to rule out atypical Spitz tumours. Dermoscopically symmetric, flat spitzoid lesions should be managed according to the age of the patient. Finally, the histopathological diagnosis of atypical Spitz tumour should warrant wide excision but not a sentinel lymph-node biopsy.

7 Review Contemporary and potential future molecular diagnosis of melanoma. 2016

Gandolfi, G / Dallaglio, K / Longo, C / Moscarella, E / Lallas, A / Alfano, R / Argenziano, G / Ciarrocchi, A. ·a Laboratory of Translational Research , Arcispedale S. Maria Nuova-IRCCS , Reggio Emilia , Italy. · b Skin Cancer Unit , Arcispedale Santa Maria Nuova-IRCCS , Reggio Emilia , Italy. · c Surgery and Emergency Unit , Second University of Naples , Naples , Italy. · d Dermatology Unit , Second University of Naples , Naples , Italy. ·Expert Rev Mol Diagn · Pubmed #27348706.

ABSTRACT: INTRODUCTION: The increasing incidence of cutaneous melanoma and the still limited effective treatments available for this disease represent a major health problem and a great challenge for research. The raise of the "omics" era and the development of new techniques to explore phenotypic heterogeneity are helping to decipher the mechanisms at the basis of melanoma heterogeneity. AREAS COVERED: We reviewed the most recent publications about the biology of cutaneous melanoma, to provide an overview of the most recent insights into the complexity of this tumor and their potential impact in the clinical settings. Expert commentary: Starting from the first attempts to provide a molecular classification of melanoma, it has been evident that this tumor represents a widely heterogeneous disease. This complexity and the multivariate nature of melanoma represent a major obstacle in developing the best management strategies for patients.

8 Review Dermoscopy of melanoma and non-melanoma skin cancer. 2015

Babino, G / Lallas, A / Longo, C / Moscarella, E / Alfano, R / Argenziano, G. ·Department of Dermatology, University of Rome Tor Vergata, Rome, Italy - g.argenziano@gmail.com. ·G Ital Dermatol Venereol · Pubmed #26184795.

ABSTRACT: Skin cancer is a major health problem because of its high incidence in white populations, as well as its related potential morbidity and mortality. Dermoscopy is a noninvasive tool that allows the identification of specific morphological features in different skin tumors, improving significantly the early diagnosis of melanoma and non-melanoma skin cancer (NMSC). This tool has also gained increased interest in the management of NMSC therapy and in the post-treatment follow-up. In this article, we provide a review of the dermoscopic patterns and criteria for the diagnosis of melanoma and NMSC described until now in the literature.

9 Review Sentinel lymph node biopsy followed by lymph node dissection for localised primary cutaneous melanoma. 2015

Kyrgidis, Athanassios / Tzellos, Thrasivoulos / Mocellin, Simone / Apalla, Zoe / Lallas, Aimilios / Pilati, Pierluigi / Stratigos, Alexander. ·Division of Evidence Based Dermatology, Dessau Medical Center, Dessau, Germany. ·Cochrane Database Syst Rev · Pubmed #25978975.

ABSTRACT: BACKGROUND: Melanoma is the leading cause of skin cancer-associated mortality. The vast majority of newly diagnosed melanomas are confined to the primary cutaneous site. Surgery represents the mainstay of melanoma treatment. Treatment strategies include wide excision of the primary tumour and sentinel lymph node biopsy (SLNB) to assess the status of the regional nodal basin(s). SLNB has become an important component of initial melanoma management providing accurate disease staging. OBJECTIVES: To assess the effects and safety of SLNB followed by completion lymph node dissection (CLND) for the treatment of localised primary cutaneous melanoma. SEARCH METHODS: We searched the following databases up to February 2015: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2015, Issue 1), MEDLINE (from 1946), EMBASE (from 1974), and LILACS ((Latin American and Caribbean Health Science Information database, from 1982). We also searched the following from inception: African Index Medicus, IndMED of India, Index Medicus for the South-East Asia Region, and six trials registers. We checked the reference lists of included and excluded studies for further references to relevant randomised controlled trials (RCTs). We searched ISI Web of Science Conference Proceedings from inception to February 2015, and we scanned the abstracts of major dermatology and oncology conference proceedings up to 2015. SELECTION CRITERIA: Two review authors independently assessed all RCTs comparing SLNB followed by CLND for the treatment of primary localised cutaneous melanoma for inclusion. Primary outcome measures were overall survival and rate of treatment complications and side effects. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted and analysed data on survival and recurrence, assessed risk of bias, and collected adverse effect information from included trials. MAIN RESULTS: We identified and included a single eligible trial comparing SLNB with observation and published in eight different reports (from 2005 to 2014) with 2001 participants. This did not report on our first primary outcome of overall survival. The study did report on the rate of treatment complications. Our secondary outcomes of disease-specific and disease-free survival, local recurrence and distant metastases were reported. There were 1347 participants in the intermediate-thickness melanoma group and 314 in the thick melanoma group.With regard to treatment complications, short-term surgical morbidity (30 days) in 1735 participants showed no difference between SLNB and observation (risk ratio [RR] 1.11; 95% confidence interval [CI] 0.9 to 1.37) for wide excision of the tumour site but favoured observation for complications related to the regional nodal basin (RR 14.36; 95% CI 6.74 to 30.59).The study did not report the actual 10-year melanoma-specific survival rate for all included participants. Instead, melanoma-specific survival rates for each group of participants: intermediate-thickness melanoma (defined as 1.2 to 3.5 mm) and thick melanomas (defined as 3.50 mm or more) was reported.In the intermediate-thickness melanoma group there was no statistically significant difference in disease-specific survival between study groups at 10 years (81.4 ± 1.5% versus 78.3 ± 2.0%, hazard ratio [HR] 0.84; 95% CI 0.65 to 1.09). In the thick melanoma group, again there was no statistically significant difference in disease-specific survival between study groups at 10 years (58.9.3 ± 4.1% versus 64.4 ± 4.6%, HR 1.12; 95% CI 0.77 to 1.64). Combining these groups there was some heterogeneity (I² = 34%) but the total HR was not statistically significant (HR 0.92; 95% CI 0.74 to 1.14). This study failed to show any difference for its stated primary outcome.The summary estimate for disease-free survival at 10 years favoured SLNB over observation in participants with intermediate-thickness and thick melanomas (HR 0.75; 95% CI 0.63 to 0.89).With regard to the rate of local and regional recurrence as the site of first recurrence, a benefit of SLNB uniformly existed in both groups of participants with intermediate-thickness and thick melanomas (RR 0.56; 95% CI 0.45 to 0.69). This is in contrast with a uniformly unfavourable effect of SLNB with regard to the rate of distant metastases as site of first recurrence, in both groups of participants with intermediate-thickness and thick melanomas (HR 1.33; 95% CI 1.03 to 1.72). AUTHORS' CONCLUSIONS: We contacted the trial authors querying the lack of data on overall survival which was the primary outcome of their important study. They stated "there are numerous additional analyses that have yet to be reported for the trial". We expect that overall survival data will be available in a future update of this review.Disease-free survival and rate of local and regional recurrence favoured SLNB in both groups of participants with intermediate-thickness and thick melanomas but short-term surgical morbidity was higher in the SLNB group, especially with regard to complications in the nodal basin.The evidence for the outcomes of interest in this review is of low quality due to the risk of bias and imprecision of the estimated effects. Further research may have an important impact on our estimate of the effectiveness of SLNB in managing primary localised cutaneous melanoma. Currently this evidence is not sufficient to document a benefit of SLNB when compared to observation in individuals with primary localised cutaneous melanoma.

10 Review Reflectance confocal microscopy in the diagnosis of solitary pink skin tumours: review of diagnostic clues. 2015

Longo, C / Moscarella, E / Argenziano, G / Lallas, A / Raucci, M / Pellacani, G / Scope, A. ·Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy. · Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy. · Department of Dermatology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. ·Br J Dermatol · Pubmed #25640416.

ABSTRACT: Reflectance confocal microscopy (RCM) is a noninvasive tool that can be helpful in the diagnosis of nonpigmented skin tumours. As RCM enables visualization of architectural and cytological structures at near-histological resolution, it can improve the diagnostic accuracy of dermoscopically equivocal solitary pink neoplasms. For management decisions, it is important to identify specific morphological clues that allow bedside classification of nonpigmented skin neoplasms into benign vs. malignant and melanocytic vs. nonmelanocytic. More specifically, the presence of a nested melanocytic proliferation at the dermoepidermal junction or dermis level permits the clinician to ascribe a given lesion as melanocytic; the identification of basaloid bright tumour islands is a key RCM feature for the diagnosis of basal cell carcinoma; and the presence of disarrayed epidermis along with small demarcated papillae is suggestive for the diagnosis of squamous cell carcinoma. The present review offers a comprehensive description of the main RCM diagnostic clues for solitary pink neoplasms that direct clinicians to the correct diagnosis and that may serve as groundwork for future prospective studies.

11 Review Blue lesions. 2013

Longo, Caterina / Scope, Alon / Lallas, Aimilios / Zalaudek, Iris / Moscarella, Elvira / Gardini, Stefano / Argenziano, Giuseppe / Pellacani, Giovanni. ·Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, Reggio Emilia 42100, Italy. Electronic address: longo.caterina@gmail.com. ·Dermatol Clin · Pubmed #24075551.

ABSTRACT: Blue color is found in a wide range of malignant and benign melanocytic and nonmelanocytic lesions and in lesions that result from penetration of exogenous materials, such as radiation or amalgam tattoo or traumatic penetration of particles. Discriminating between different diagnostic entities that display blue color relies on careful patient examination and lesion assessment. Dermoscopically, the extent, distribution, and patterns created by blue color can help diagnose lesions with specificity and differentiate between benign and malignant entities. This article provides an overview of the main diagnoses whereby blue color can be found, providing simple management rules for these lesions.

12 Review Problematic lesions in the elderly. 2013

Zalaudek, Iris / Lallas, Aimilios / Longo, Caterina / Moscarella, Elvira / Tiodorovic-Zivkovic, Danica / Ricci, Cinzia / Albertini, Giuseppe / Argenziano, Giuseppe. ·Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS, Viale Risorgimento 80, Reggio Emilia 42100, Italy; Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz 8036, Austria. Electronic address: iris.zalaudek@gmail.com. ·Dermatol Clin · Pubmed #24075544.

ABSTRACT: As the population continues to age, clinicians and dermatologists are increasingly faced with geriatric patients presenting with a range of dermatologic manifestations, including benign and malignant skin tumors. Knowledge of epidemiologic and morphologic features, including dermoscopy of common and benign melanocytic and nonmelanocytic skin tumors, provides the basis for a better understanding and management of problematic skin tumors in this age group. This article provides an overview of common and problematic skin lesions in elderly patients and addresses epidemiologic, clinical, and dermoscopic clues that aid the differential diagnosis and management of challenging skin lesions.

13 Review Problematic lesions in children. 2013

Moscarella, Elvira / Piccolo, Vincenzo / Argenziano, Giuseppe / Lallas, Aimilios / Longo, Caterina / Castagnetti, Fabio / Pizzigoni, Stefania / Zalaudek, Iris. ·Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Viale Risorgimento, 80, Reggio Emilia 42100, Italy. Electronic address: elvira.moscarella@gmail.com. ·Dermatol Clin · Pubmed #24075543.

ABSTRACT: Melanoma in childhood is rare, and appears more commonly either in association with a preexisting (congenital) nevus, or with spitzoid features than de novo. Thus, problematic melanocytic lesions in children are essentially represented by congenital nevi and Spitz nevi that can be regarded as melanoma precursors and melanoma simulators, respectively. As a consequence, clinical and dermoscopic features of melanoma in children differ from those in an adult population. Herein we describe common clinical and dermoscopic features of problematic lesions in children, focusing on congenital and Spitz/Reed nevi, and including other problematic lesions, such as atypical, blue, acral, and scalp nevi.

14 Article Accuracy of Dermoscopic Criteria for the Diagnosis of Melanoma In Situ. 2018

Lallas, Aimilios / Longo, Caterina / Manfredini, Marco / Benati, Elisa / Babino, Graziella / Chinazzo, Chiara / Apalla, Zoe / Papageorgiou, Chryssoula / Moscarella, Elvira / Kyrgidis, Athanassios / Argenziano, Giuseppe. ·First Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece. · Skin Cancer Unit, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy. · Department of Dermatology, University of Modena, Modena, Italy. · Department of Dermatology, University of Campania, Naples, Italy. ·JAMA Dermatol · Pubmed #29466542.

ABSTRACT: Importance: The accuracy of melanoma-specific dermoscopic criteria has been tested mainly in studies including invasive tumors. Scarce evidence exists on the usefulness of these criteria for the diagnosis of melanoma in situ (MIS). Objective: To investigate the diagnostic accuracy of dermoscopic criteria for the diagnosis of MIS. Design, Setting, and Participants: A diagnostic accuracy study with retrospective patient enrollment was conducted in 3 centers specializing in skin cancer diagnosis and management. A total of 1285 individuals with histopathologically diagnosed MIS or other flat, pigmented skin tumors that were histopathologically diagnosed or monitored for at least 1 year were included. Dermoscopic images of MIS and other flat, pigmented skin tumors were evaluated by 3 independent investigators for the presence of predefined criteria. Evaluators were blinded to the clinic dermoscopic and histopathologic diagnosis. Main Outcomes and Measures: Frequencies of dermoscopic criteria per diagnosis were calculated. Crude odds ratios, adjusted odds ratios, and corresponding 95% CIs were calculated by univariate and multivariate logistic regression, respectively. Results: A total of 1285 patients were included in the study (642 [50%] male); mean age was 45.9 years (range, 9-91 years). Of a total of 1285 lesions obtained from these patients, 325 (25.3%) were MIS; 574 (44.7%) were nevi (312 [24.3%] excised and 262 [20.4%] not excised); 67 (5.2%) were seborrheic keratoses, solar lentigines, or lichen planus-like keratoses; 91 (7.1%) were pigmented superficial basal cell carcinomas; 26 (2.0%) were pigmented intraepithelial carcinomas; 100 (7.8%) were Reed nevi; and 102 (7.9%) were invasive melanomas with a Breslow thickness less than 0.75 mm. The most frequent dermoscopic criteria for MIS were regression (302 [92.9%]), atypical network (278 [85.5%]), and irregular dots and/or globules (163 [50.2%]). The multivariate analysis revealed 5 main positive dermoscopic indicators of MIS: atypical network (3.7-fold; 95% CI, 2.5-5.4), regression (4.7-fold; 95% CI, 2.8-8.1), irregular hyperpigmented areas (5.4-fold; 95% CI, 3.7-8.0), prominent skin markings (3.4-fold; 95% CI, 1.9-6.1), and angulated lines (2.2-fold; 95% CI, 1.2-4.1). When compared only with excised nevi, 2 of these criteria remained potent MIS indicators, namely, irregular hyperpigmented areas (4.3-fold; 95% CI, 2.7-6.8) and prominent skin markings (2.7-fold; 95% CI, 1.3-5.7). Conclusions and Relevance: Clinicians should take into consideration the aforementioned dermoscopic indicators for the diagnosis of MIS.

15 Article Does pregnancy influence melanoma prognosis? A meta-analysis. 2017

Kyrgidis, Athanassios / Lallas, Aimilios / Moscarella, Elvira / Longo, Caterina / Alfano, Roberto / Argenziano, Giuseppe. ·aSkin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia bDepartment of Anesthesiology, Surgery and Emergency cDermatology Unit, Second University of Naples, Naples, Italy. ·Melanoma Res · Pubmed #28430756.

ABSTRACT: The literature has not been able to conclude whether pregnancy influences the prognosis of melanoma. The aim of this study was to explore the prognosis of melanoma diagnosed during pregnancy or post partum [pregnancy-associated melanoma (PAM)] compared with melanoma in female patients who were not pregnant. We systematically searched for studies of female patients with melanoma that reported outcomes related to survival. Fifteen eligible studies were found. Overall, PAM was associated with a 17% higher mortality compared with melanoma diagnosed in female patients who were not pregnant (hazard ratio=1.17, 95% confidence interval: 1.03-1.33, P=0.02). The heterogeneity associated with this test was moderate (P=0.07; I=38%). PAM was also associated with a 50% higher recurrence rate compared with melanoma not associated with pregnancy (hazard ratio=1.50, 95% confidence interval: 1.19-1.90, P<0.001). The heterogeneity associated with this test was low (P=0.69; I=0%). A limitation of this meta-analysis is the definition of PAM, which is not unanimous among the studies included. Our results indicate that PAM is associated with a worse prognosis than melanoma not related to pregnancy, both in terms of overall survival and disease-free survival. On the basis of our data, we anticipate that the survival difference we report here will be further amplified with the addition of future well-carried out studies. We suggest that detection of PAM requires particular awareness by healthcare professionals.

16 Article Dermoscopic features predicting the presence of mitoses in thin melanoma. 2017

Ribero, S / Argenziano, G / Lallas, A / Moscarella, E / Benati, E / Raucci, M / Piana, S / Longo, C. ·Dermatology Department, University of Turin, Turin, Italy. Electronic address: simone.ribero@unito.it. · Dermatology Unit, Second University of Naples, Italy; Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. · Pathology Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. ·J Dermatol Sci · Pubmed #28196618.

ABSTRACT: BACKGROUND: The latest AJCC classification has included the number of mitoses as a factor for upstaging thin melanomas. Meanwhile, while dermoscopy has often been used to predict melanoma thickness, its value in predicting number of mitoses remains unknown. OBJECTIVE: Our aim is to evaluate the correlation between dermoscopic features and the presence of mitoses in a consecutive cohort of thin melanomas. METHODS: A case control study has been performed to identify specific dermoscopic parameters that could differentiate thin melanomas with 1 or more mitoses per mm2 from those without mitoses. RESULTS: Of 177 melanomas equal to or thinner than 1mm, 131 (74%) lesions had no mitoses and 46 (36%) lesions had at least 1 mitosis×mm2. Dermoscopic features associated with the presence of 1 or more mitoses were the following: peripheral streaks (OR 4.11; 95% CI 1.94-8.71) and black colour (OR 4.70; 95% CI; 2.28-9.68). In contrast, atypical pigment network (OR (0.30; 95% CI 0.15-0.61)) and brown colour (OR 0.36; 95% CI 0.18-0.75) were associated to melanomas without mitoses. The same variables were also associated to the increasing number of mitoses at linear regression. CONCLUSION: Black colour and peripheral streaks can predict the presence of mitoses in thin melanoma, while atypical pigment network and brown colour are associated to thin melanoma without mitoses.

17 Article Lymph nodes' capsular naevi are associated with high naevus count in melanoma patients: a case-control study. 2017

Ribero, Simone / Longo, Caterina / Specchio, Francesca / Piana, Simonetta / Castagnetti, Fabio / Moscarella, Elvira / Lallas, Aimilios / Alfano, Roberto / Argenziano, Giuseppe. ·aDermatologic Unit, Department of Medical Sciences, University of Turin, Turin bSkin Cancer Unit cPathology Unit dBreast Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia eDepartment of Anesthesiology, Surgery and Emergency fDermatology Unit, Second University of Naples, Italy gFirst Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece. ·Melanoma Res · Pubmed #28151776.

ABSTRACT: Capsular naevi (CNs) in lymph nodes (LNs) are relatively common, occurring in 3-22% of patients who undergo LN surgery for melanoma. Naevus count is one of the principal risk factors for melanoma, as well as a prognostic factor in melanoma patients. However, little is known about the occurrence of CN in melanoma patients on the basis of their naevus count. A case-control study was performed, to look at the naevus count differences between CN-positive and CN-negative melanoma patients. Cases (CN positive) were matched for age, sex and Breslow thickness with controls (CN negative). Total naevus count was recorded at diagnosis and compared between the two groups. This study was conducted in a tertiary referral academic centre for skin cancer. Twenty-two positive CN patients were matched with 22 negative CN patients. The mean Breslow thickness was 2.66 mm (range: 0.6-9). Positive CN patients were significantly associated with an increasing naevus count on their skin (P=0.02). Patients with more than 100 naevi reported an odds ratio of 7.78 on having a CN compared with patients with fewer than 50 naevi on their skin (P=0.02). An increased melanocytic migration to LNs might be the reason for the association between CNs and a high number of melanocitic naevi on the skin. This could shed some light on the physiology of melanocytes and could be an easy way to predict patients at greater risk of having CNs.

18 Article Association between dermoscopic and reflectance confocal microscopy features of cutaneous melanoma with BRAF mutational status. 2017

Bombonato, C / Ribero, S / Pozzobon, F C / Puig-Butille, J A / Badenas, C / Carrera, C / Malvehy, J / Moscarella, E / Lallas, A / Piana, S / Puig, S / Argenziano, G / Longo, C. ·Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. · Dermatology Department, University of Turin, Turin, Italy. · Dermatology Department or Biochemical and Molecular Genetics Service, Melanoma Unit, Hospital Clinic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona, Barcelona, Spain. · Centro de Investigación Biomédica en Red de enfermedades raras (CIBER ER), Instituto de Salud Carlos III, Valencia, Spain. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · Pathology Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy. · Dermatology Department, Second University of Naples, Naples, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #27790766.

ABSTRACT: BACKGROUND: Melanomas harbouring common genetic mutations might share certain morphological features detectable with dermoscopy and reflectance confocal microscopy. BRAF mutational status is crucial for the management of metastatic melanoma. OBJECTIVES: To correlate the dermoscopic characteristics of primary cutaneous melanomas with BRAF mutational status. Furthermore, a subset of tumours has also been analysed for the presence of possible confocal features that might be linked with BRAF status. METHODS: Retrospectively acquired dermoscopic and confocal images of patients with melanoma in tertiary referral academic centres: Skin Cancer Unit in Reggio Emilia and at the Melanoma Unit in Barcelona. Kruskal-Wallis test, logistic regressions, univariate and multivariate analyses have been performed to find dermoscopic and confocal features significantly correlated with BRAF mutational status. RESULTS: Dermoscopically, the presence of irregular peripheral streaks and ulceration were positive predictors of BRAF-mutated melanomas with a statistically significance value, while dotted vessels were more represented in wild-type melanomas. None of the evaluated reflectance confocal microscopy features were correlated with genetic profiling. CONCLUSIONS: Ulceration and irregular peripheral streaks represent dermoscopic feature indicative for BRAF-mutated melanoma, while dotted vessels are suggestive for wild-type melanoma.

19 Article Both short-term and long-term dermoscopy monitoring is useful in detecting melanoma in patients with multiple atypical nevi. 2017

Moscarella, E / Tion, I / Zalaudek, I / Lallas, A / Kyrgidis, A / Longo, C / Lombardi, M / Raucci, M / Satta, R / Alfano, R / Argenziano, G. ·Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. · Unit of Dermatology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy. · Department of Dermatology, Medical University of Graz, Graz, Austria. · Department of Anesthesiology, Surgery and Emergency, Second University of Naples, Naples, Italy. · Dermatology Unit, Second University of Naples, Naples, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #27422807.

ABSTRACT: BACKGROUND: Digital dermoscopy monitoring (DDM) is an effective strategy for melanoma detection. Two methods are currently employed. Short-term follow-up (STFU) for the evaluation of single, atypical lesions to detect subtle changes over a short period of time (3-6 months). Long-term follow-up (LTFU) is recommended for patients with multiple nevi. Although a study demonstrated that STFU improves the patients' compliance for DDM, little remains known about the impact and reliability of STFU in this setting. OBJECTIVES: The aim of this retrospective, observational study was to evaluate the impact and reliability of a schedule combining STFU and LTFU in patients with multiple atypical nevi. METHODS: We searched our database for all cases of patients with multiple atypical nevi occurring between 2006 and 2014. RESULTS: A total of 3823 lesions in 541 patients were dermoscopically monitored (mean number = 7 lesions per patient; median = 6 lesions; range, 2-51). In all, 264 (6.9%) lesions in 184 (34.4%) patients were excised (mean of 0.5 lesions per patient). In total, 197 (74.6%) lesions were excised at follow-up, with melanomas representing 30.5% of lesions excised after follow-up. A total of 30 (33.3%) melanomas were excised at baseline, 23 (25.6%) after STFU and 37 (41.1%) after LTFU. There was no difference in the number of in situ melanomas detected at baseline with those detected after follow-up. The mean Breslow thickness of melanomas detected at baseline was higher than those detected after STFU (P = 0.038) and LTFU (P = 0.055). CONCLUSIONS: Our study confirm that digital dermoscopy follow-up is a valid management strategy for patients with multiple atypical nevi, with short-term monitoring playing an effective role also in this setting of patients.

20 Article Intralesional (incision) biopsy for melanoma diagnosis: the rules and the exception. 2017

Moscarella, Elvira / Argenziano, Giuseppe / Moreno, Claudia / Piana, Simonetta / Lallas, Aimilios / Lombardi, Mara / Longo, Caterina / Ferrara, Gerardo. ·Unit of Dermatology and Skin Cancer - elvira.moscarella@gmail.com. · st Medical Department, Arcispedale Santa Maria Nuova Institute for Research and Care, Reggio Emilia, Italy. · Department of Dermatology, Second University of Naples, Naples, Italy. · Department of Dermatology, Clinical Hospital University of Chile, Santiago, Chile. · Unit of Dermatology and Skin Cancer. · Department of Dermatopathology, Arcispedale Santa Maria Nuova Institute for Research and Care, Reggio Emilia, Italy. ·G Ital Dermatol Venereol · Pubmed #27096540.

ABSTRACT: Intralesional (incision) biopsy for melanoma diagnosis can be warranted for large lesions or for those lesions whose in-toto excision leads to cosmetic and/or functional impairment. However, this diagnostic approach carries a risk of underdiagnosis, if a clinicopathologic diagnostic approach is not implemented. As a rule, in large pigmented lesions from special body areas (scalp and acral skin), clinicodermoscopic differential diagnosis of melanoma includes non-melanocytic skin lesions, traumatic skin changes, and nevi. The unique indication to incision biopsy for the differential diagnosis between nevus and melanoma is a relatively small nodular proliferation developing within a medium-large congenital nevus.

21 Article Clinical Indications for Use of Reflectance Confocal Microscopy for Skin Cancer Diagnosis. 2016

Borsari, Stefania / Pampena, Riccardo / Lallas, Aimilios / Kyrgidis, Athanassios / Moscarella, Elvira / Benati, Elisa / Raucci, Margherita / Pellacani, Giovanni / Zalaudek, Iris / Argenziano, Giuseppe / Longo, Caterina. ·Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy. · Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy. · Nonmelanoma Skin Cancer Unit, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria. · Dermatology Unit, Second University of Naples, Naples, Italy. ·JAMA Dermatol · Pubmed #27580185.

ABSTRACT: Importance: Reflectance confocal microscopy (RCM) improves diagnostic accuracy in skin cancer detection when combined with dermoscopy; however, little evidence has been gathered regarding its real impact on routine clinical workflow, and, to our knowledge, no studies have defined the terms for its optimal application. Objective: To identify lesions on which RCM performs better in terms of diagnostic accuracy and consequently to outline the best indications for use of RCM. Design, Setting, and Participants: Prospectively acquired and evaluated RCM images from consecutive patients with at least 1 clinically and/or dermoscopically equivocal skin lesion referred to RCM imaging, from January 2012 to October 2014, carried out in a tertiary referral academic center. Main Outcomes and Measures: A total of 1279 equivocal skin lesions were sent for RCM imaging. Spearman correlation, univariate, and multivariate regression models were performed to find features significantly correlated with RCM outcome. Results: In a total of 1279 lesions in 1147 patients, RCM sensitivity and specificity were 95.3% and 83.9%, respectively. The number of lesions needed to excise to rule out a melanoma was 2.4. After univariate and multivariate regression analysis, head and neck resulted as the most appropriate body location for confocal examination; RCM showed a high diagnostic accuracy for lesions located on sun-damaged skin (adjusted odds ratio [aOR], 2.13; 95% CI, 1.37-3.30; P=.001) and typified by dermoscopic regression (aOR, 2.13; 95% CI, 1.31-3.47; P=.002) or basal-cell carcinoma specific criteria (aOR, 9.35; 95% CI, 1.28-68.58; P=.03). Conclusions and Relevance: Lesions located on the head and neck, damaged by chronic sun-exposure, and dermoscopically typified by regression represent best indications for the use of RCM.

22 Article Diagnostic accuracy of reflectance confocal microscopy for lesions typified by dermoscopic island. 2016

Figueroa-Silva, O / Cinotti, E / de Almeida Silva, T / Moscarella, E / Lallas, A / Ciardo, S / Argenziano, G / Pellacani, G / Piana, S / Longo, C. ·Department of Dermatology, Faculty of Medicine, University Hospital Complex, Santiago de Compostela, Spain. · Department of Dermatology, University Hospital of Saint Etienne, Saint Etienne, France. · Department of Dermatology, Regional Hospital of Asa Norte, Brasilia, Brazil. · Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Pathology Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #27109574.

ABSTRACT: INTRODUCTION: Dermoscopic island (DI) is a dermoscopic clue for the diagnosis of thin melanoma (MM). However, its positive predictive value is about 50% and several naevi with DI are unnecessarily excised. Reflectance confocal microscopy (RCM) is a second level non-invasive imaging tool that increases diagnostic accuracy for MM. OBJECTIVE: To evaluate diagnostic RCM features of pigmented lesions typified by the presence of DI and calculate RCM diagnostic accuracy for MM diagnosis. METHODS: All lesions with DI were retrieved from a database of 1964 cases. RCM diagnoses were given without being aware of the histopathological diagnoses. The number of MMs among lesions presenting with DI and the sensitivity and specificity of RCM for MM were assessed. The frequencies of dermoscopic and RCM features were calculated to evaluate significant differences in naevi and MMs showing DI (Chi-square test). Independently significant RCM criteria for MM were identified by discriminant analysis. RESULTS: Sixty-three (3.2%) out of 1964 lesions presented DI. Among them, 30.2% were in situ MMs and 12.7% invasive MMs. Sensitivity and specificity of RCM for the diagnosis of MM in case of DI was 88.9%. Pagetoid cells (Wilks' lambda .804, P < 0.001) and atypical cells at dermo-epidermal junction (Wilks' lambda .762, P < 0.001) were identified to differentiate MM from naevi. CONCLUSION: Our study confirmed that DI could be a sign of early MMs and underlined that RCM could be a good tool to discriminate MMs and naevi in the presence of DI because it can identify the presence of cytological atypia.

23 Article Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis. 2016

Lallas, A / Tschandl, P / Kyrgidis, A / Stolz, W / Rabinovitz, H / Cameron, A / Gourhant, J Y / Giacomel, J / Kittler, H / Muir, J / Argenziano, G / Hofmann-Wellenhof, R / Zalaudek, I. ·Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. · Department of Dermatology, Allergology and Environmental Medicine II, Hospital Thalkirchner Straße, Städtisches Klinikum Munich, Munich, Germany. · Skin and Cancer Associates, Plantation, FL, U.S.A. · School of Medicine, University of Queensland, Brisbane, Qld, Australia. · Dermatology Practice, Nemours, France. · Skin Spectrum Medical Services, Como, WA, Australia. · School of Medicine, The University of Queensland, Brisbane, Qld, Australia. · Dermatology Unit, Second University of Naples, Naples, Italy. · Department of Dermatology and Venerology, Non-Melanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria. ·Br J Dermatol · Pubmed #26784739.

ABSTRACT: BACKGROUND: Dermoscopy is limited in differentiating accurately between pigmented lentigo maligna (LM) and pigmented actinic keratosis (PAK). This might be related to the fact that most studies have focused on pigmented criteria only, without considering additional recognizable features. OBJECTIVES: To investigate the diagnostic accuracy of established dermoscopic criteria for pigmented LM and PAK, but including in the evaluation features previously associated with nonpigmented facial actinic keratosis. METHODS: Retrospectively enrolled cases of histopathologically diagnosed LM, PAK and solar lentigo/early seborrhoeic keratosis (SL/SK) were dermoscopically evaluated for the presence of predefined criteria. Univariate and multivariate regression analyses were performed and receiver operating characteristic curves were used. RESULTS: The study sample consisted of 70 LMs, 56 PAKs and 18 SL/SKs. In a multivariate analysis, the most potent predictors of LM were grey rhomboids (sixfold increased probability of LM), nonevident follicles (fourfold) and intense pigmentation (twofold). In contrast, white circles, scales and red colour were significantly correlated with PAK, posing a 14-fold, eightfold and fourfold probability for PAK, respectively. The absence of evident follicles also represented a frequent LM criterion, characterizing 71% of LMs. CONCLUSIONS: White and evident follicles, scales and red colour represent significant diagnostic clues for PAK. Conversely, intense pigmentation and grey rhomboidal lines appear highly suggestive of LM.

24 Article Twin melanomas. 2015

Cautela, Jennifer / Moscarella, Elvira / Lallas, Aimilios / Longo, Caterina / Piana, Simonetta / Argenziano, Giuseppe. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Dermatology and Skin Cancer Unit, Arcispedale S.Maria Nuova, IRCCS, Reggio Emilia, Italy. · Pathology Unit, Arcispedale S.Maria Nuova, IRCCS, Reggio Emilia, Italy. · Department of Dermatology, Second University of Naples, Naples, Italy. Electronic address: g.argenziano@gmail.com. ·J Am Acad Dermatol · Pubmed #26475556.

ABSTRACT: -- No abstract --

25 Article Routine Clinical-Pathologic Correlation of Pigmented Skin Tumors Can Influence Patient Management. 2015

Longo, Caterina / Piana, Simonetta / Lallas, Aimilios / Moscarella, Elvira / Lombardi, Mara / Raucci, Margherita / Pellacani, Giovanni / Argenziano, Giuseppe. ·Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy. · Pathology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy. · Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy. ·PLoS One · Pubmed #26325678.

ABSTRACT: BACKGROUND: Several studies have demonstrated the benefit of integrating clinical with pathologic information, to obtain a confident diagnosis for melanocytic tumors. However, all those studies were conducted retrospectively and no data are currently available about the role of a clinical-pathologic correlation approach on a daily basis in clinical practice. AIM OF THE STUDY: In our study, we evaluated the impact of a routine clinical-pathologic correlation approach for difficult skin tumors seen over 3 years in a tertiary referral center. RESULTS: Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing. Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se. CONCLUSION: In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.

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