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Melanoma: HELP
Articles by Fergal J. Moloney
Based on 6 articles published since 2008
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Between 2008 and 2019, F. J. Moloney wrote the following 6 articles about Melanoma.
 
+ Citations + Abstracts
1 Review Key points in the dermoscopic diagnosis of hypomelanotic melanoma and nodular melanoma. 2011

Moloney, Fergal J / Menzies, Scott W. ·Discipline of Dermatology, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. fergal.moloney@sydney.edu.au ·J Dermatol · Pubmed #21175750.

ABSTRACT: Nodular melanoma (NM) and amelanotic/hypomelanotic melanoma (AHM) often present a challenge to the diagnosing clinician. A significant proportion of AHM are nodular in nature. Such tumors may lack features of asymmetry and altered peripheral pigmentation routinely observed in other melanoma subtypes. This lack of distinguishing clinical features can potentially result in delayed diagnosis or inappropriate treatment. This review highlights the key points in evaluating the range of lesions where AHM or NM are considered in the differential diagnosis and summarizes current evidence in relation to pigmented and vascular dermoscopic diagnostic criteria for both.

2 Article Detection of primary melanoma in individuals at extreme high risk: a prospective 5-year follow-up study. 2014

Moloney, Fergal J / Guitera, Pascale / Coates, Elliot / Haass, Nikolas K / Ho, Kenneth / Khoury, Ritta / O'Connell, Rachel L / Raudonikis, Leo / Schmid, Helen / Mann, Graham J / Menzies, Scott W. ·Discipline of Dermatology, University of Sydney at the Sydney Cancer Centre, Sydney, New South Wales, Australia2Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia3Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Sydney, New South. · Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia3Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Sydney, New South Wales, Australia. · National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia. · Raudonikis Database Services, Mount Colah, New South Wales, Australia. · University of Sydney at the Westmead Millennium Institute, Westmead, New South Wales, Australia9Melanoma Institute Australia, Westmead, New South Wales, Australia. ·JAMA Dermatol · Pubmed #24964862.

ABSTRACT: IMPORTANCE: The clinical phenotype and certain predisposing genetic mutations that confer increased melanoma risk are established; however, no consensus exists regarding optimal screening for such individuals. Early identification remains the most important intervention in reducing melanoma mortality. OBJECTIVE: To evaluate the impact of full-body examinations every 6 months supported by dermoscopy and total-body photography (TBP) on all patients and sequential digital dermoscopy imaging (SDDI), when indicated, on detecting primary melanoma in an extreme-risk population. DESIGN, SETTING, AND PARTICIPANTS: Prospective observational study from February 2006 to February 2011, with patients recruited from Sydney Melanoma Diagnostic Centre and Melanoma Institute Australia who had a history of invasive melanoma and dysplastic nevus syndrome, history of invasive melanoma and at least 3 first-degree or second-degree relatives with prior melanoma, history of at least 2 primary invasive melanomas, or a CDKN2A or CDK4 gene mutation. EXPOSURES: Six-month full-body examination compared with TBP. For equivocal lesions, SDDI short term (approximately 3 months) or long term (≥6 months), following established criteria, was performed. Atypical lesions were excised. MAIN OUTCOMES AND MEASURES: New primary melanoma numbers, characteristics, and cumulative incidence in each patient subgroup; effect of diagnostic aids on new melanoma identification. RESULTS: In 311 patients with a median (interquartile range [IQR]) follow-up of 3.5 (2.4-4.2) years, 75 primary melanomas were detected, 14 at baseline visit. Median (IQR) Breslow thickness of postbaseline incident melanomas was in situ (in situ to 0.60 mm). Thirty-eight percent were detected using TBP and 39% with SDDI. Five melanomas were greater than 1 mm Breslow thickness, 3 of which were histologically desmoplastic; the other 2 had nodular components. The benign to malignant excision ratio was 1.6:1 for all lesions excised and 4.4:1 for melanocytic lesions. Cumulative risk of developing a novel primary melanoma was 12.7% by year 2, with new primary melanoma incidence during the final 3 years of follow-up half of that observed during the first 2 years (incidence density ratio, 0.43 [95% CI, 0.25-0.74]; P = .002). CONCLUSIONS AND RELEVANCE: Monitoring patients at extreme risk with TBP and SDDI assisted with early diagnosis of primary melanoma. Hypervigilance for difficult-to-detect thick melanoma subtypes is crucial.

3 Article Dermoscopic evaluation of nodular melanoma. 2013

Menzies, Scott W / Moloney, Fergal J / Byth, Karen / Avramidis, Michelle / Argenziano, Giuseppe / Zalaudek, Iris / Braun, Ralph P / Malvehy, Josep / Puig, Susana / Rabinovitz, Harold S / Oliviero, Margaret / Cabo, Horacio / Bono, Riccardo / Pizzichetta, Maria A / Claeson, Magdalena / Gaffney, Daniel C / Soyer, H Peter / Stanganelli, Ignazio / Scolyer, Richard A / Guitera, Pascale / Kelly, John / McCurdy, Olivia / Llambrich, Alex / Marghoob, Ashfaq A / Zaballos, Pedro / Kirchesch, Herbert M / Piccolo, Domenico / Bowling, Jonathan / Thomas, Luc / Terstappen, Karin / Tanaka, Masaru / Pellacani, Giovanni / Pagnanelli, Gianluca / Ghigliotti, Giovanni / Ortega, Blanca Carlos / Crafter, Greg / Ortiz, Ana María Perusquía / Tromme, Isabelle / Karaarslan, Isil Kilinc / Ozdemir, Fezal / Tam, Anthony / Landi, Christian / Norton, Peter / Kaçar, Nida / Rudnicka, Lidia / Slowinska, Monika / Simionescu, Olga / Di Stefani, Alessandro / Coates, Elliot / Kreusch, Juergen. ·Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia. scott.menzies@sswahs.nsw.gov.au ·JAMA Dermatol · Pubmed #23553375.

ABSTRACT: IMPORTANCE: Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical. OBJECTIVE: To determine the dermoscopy features of NM. DESIGN: Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/hypomelanotic or pigmented to assess outcomes. SETTING: Predominantly hospital-based clinics from 5 continents. MAIN OUTCOME MEASURES: Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma. RESULTS: Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, blue-white veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (>98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM. CONCLUSIONS AND RELEVANCE: When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.

4 Article Improving management and patient care in lentigo maligna by mapping with in vivo confocal microscopy. 2013

Guitera, Pascale / Moloney, Fergal J / Menzies, Scott W / Stretch, Jonathan R / Quinn, Michael J / Hong, Angela / Fogarty, Gerald / Scolyer, Richard A. ·Melanoma Institute Australia, The University of Sydney, Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW 2050, Australia. pascale.guitera@melanoma.org.au ·JAMA Dermatol · Pubmed #23553208.

ABSTRACT: IMPORTANCE: Lentigo maligna (LM) is a clinical, pathologic, and therapeutic challenge with a higher risk of local recurrence than other types of melanoma correctly treated and also carries the cosmetically sensitive localization of head and neck. OBJECTIVE: To determine whether in vivo reflectance confocal microscopy (RCM) mapping of difficult LM cases might alter patient care and management. DESIGN: Analysis of LM and LM melanoma (LMM) in a series of patients with large facial lesions requiring complex reconstructive surgery and/or recurrent or poorly delineated lesions at any body sites were investigated. SETTINGS: Two tertiary referral melanoma centers in Sydney, Australia. PARTICIPANTS: Thirty-seven patients with LM (including 5 with LMM) were mapped with RCM. Fifteen patients had a recurrent LM, including 9 with multiple prior recurrences. The LM was classified amelanotic in 10 patients, lightly pigmented in 9, and partially pigmented in 18. INTERVENTIONS: The RCM images were obtained in 4 radial directions (allowing for anatomic barriers) for LM margin delineation using an RCM LM score previously described by our research team. MAIN OUTCOME MEASURES: Differences in the margin of LM as determined by RCM vs dermoscopy vs histopathologic analysis. RESULTS: Seventeen of 29 patients (59%) with dermoscopically visible lesions had subclinical (RCM-identified) disease evident more than 5 mm beyond the dermoscopy margin (ie, beyond the excision margin recommended in published guidelines). The RCM mapping changed the management in 27 patients (73%): 11 patients had a major change in their surgical procedure, and 16 were offered radiotherapy or imiquimod treatment as a consequence of the RCM findings. Treatment was surgical in 17 of 37 patients. Surgical excision margins (based on the RCM mapping) were histopathologically involved in only 2 patients, each of whom had an LM lesion larger than 6 cm. CONCLUSIONS AND RELEVANCE: In vivo RCM can provide valuable information facilitating optimal patient care management.

5 Minor Segmental pityriasis rosea within the area of BRAF-mutated metastatic melanoma. 2016

Murad, A / Ralph, N / Mulligan, N / Moloney, F J. ·Department of Dermatology, The Mater Misericordiae University Hospital, Dublin, Ireland. aiz100@hotmail.com. · Department of Dermatology, The Mater Misericordiae University Hospital, Dublin, Ireland. · Department of Histopathology, The Mater Misericordiae University Hospital, Dublin, Ireland. ·J Eur Acad Dermatol Venereol · Pubmed #26446380.

ABSTRACT: -- No abstract --

6 Minor Multiple desmoplastic melanomas in Birt-Hogg-Dubé syndrome and a proposed signaling link between folliculin, the mTOR pathway, and melanoma susceptibility. 2010

Cocciolone, Raymond A / Crotty, Kerry A / Andrews, Lesley / Haass, Nikolas K / Moloney, Fergal J. · ·Arch Dermatol · Pubmed #21079084.

ABSTRACT: -- No abstract --