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Melanoma: HELP
Articles by Elvira Moscarella
Based on 79 articles published since 2008
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Between 2008 and 2019, E. Moscarella wrote the following 79 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
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 Regression in cutaneous melanoma: a comprehensive review from diagnosis to prognosis. 2016

Ribero, S / Moscarella, E / Ferrara, G / Piana, S / Argenziano, G / Longo, C. ·Medical Sciences Department, Section of Dermatology, University of Turin, Turin, Italy. · Department off Twin research and Genetic Epidemiology, King's College London, London, UK. · Skin Cancer Unit, Arcispedale ASMN-IRCCS, Reggio Emilia, Italy. · Pathology Unit, Gaetano Rummo Hospital, Benevento, Italy. · Pathology Unit, Arcispedale ASMN-IRCCS, Reggio Emilia, Italy. · Dermatology Unit, Second University of Naples, Naples, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #27401335.

ABSTRACT: Histological regression in primary cutaneous melanoma occurs in 10-35% of cases. Although a large body of literature exists to suggest that histological regression serves very little purpose in predicting biologic behaviour with melanoma, recognizing the presence of regression at clinical and histological ground may still retain some value in grading melanoma aggressiveness. In the current review, a comprehensive overview of the main aspects of regression will be provided. Histologically, many classifications have been reported so far, but all of them only agreed on the presence of an infiltrate of lymphocytes admixed with pigment-laden macrophages underlying an atrophic epidermis with flattened rete ridges. Upon dermoscopy, regression is also named Blue White Scar-like areas and could be variably admixed with granularity or peppering. Almost fully regressed lesions represent a main diagnostic issue in dermoscopy, and thus, confocal microscopy can be of help to identify whether the tumour is melanocytic or not. The clinical utility of regression as a prognostic factor has been challenged recently. Nowadays, evidences showed that it is less likely associated to SLN metastases.

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 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.

10 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.

11 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.

12 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.

13 Review A clinico-dermoscopic approach for skin cancer screening: recommendations involving a survey of the International Dermoscopy Society. 2013

Argenziano, Giuseppe / Giacomel, Jason / Zalaudek, Iris / Blum, Andreas / Braun, Ralph P / Cabo, Horacio / Halpern, Allan / Hofmann-Wellenhof, Rainer / Malvehy, Josep / Marghoob, Ashfaq A / Menzies, Scott / Moscarella, Elvira / Pellacani, Giovanni / Puig, Susana / Rabinovitz, Harold / Saida, Toshiaki / Seidenari, Stefania / Soyer, H Peter / Stolz, Wilhelm / Thomas, Luc / Kittler, Harald. ·Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, Reggio Emilia 42100, Italy. Electronic address: g.argenziano@gmail.com. ·Dermatol Clin · Pubmed #24075542.

ABSTRACT: Dermoscopy is useful for skin cancer screening, but a detailed approach is required that integrates this tool into a rational clinical work flow. To investigate clinician perceptions and behavior in approaching patients with skin tumors, a survey was launched by electronic mail through the International Dermoscopy Society. After 4 months, the responses were analyzed and significant findings calculated. Considering the current approach of study participants in examining patients for skin cancer, an up-to-date system of triage is presented in this review, which aims to promote an improved diagnostic accuracy and more timely management of skin malignancy.

14 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.

15 Article Dermoscopy of Pigmented Actinic Keratosis of the Face: A Study of 232 Cases. 2017

Kelati, A / Baybay, H / Moscarella, E / Argenziano, G / Gallouj, S / Mernissi, F Z. ·Department of Dermatology, University Hospital Hassan II, Fez, Morocco. Electronic address: awatkelati@gmail.com. · Department of Dermatology, University Hospital Hassan II, Fez, Morocco. · Department of Dermatology, Second University of Naples, Naples, Italy. ·Actas Dermosifiliogr · Pubmed #28705516.

ABSTRACT: The diagnosis of pigmented actinic keratosis (PAK) is often challenging because of overlapping features with lentigo maligna. OBJECTIVE: To investigate dermoscopic patterns of PAK according to their different evolutionary stages, and to correlate the pattern with clinical characteristics of the patients. METHODS: Descriptive and analytical study of 232 PAK. Dermoscopic patterns were divided into two categories: the follicule surroundings' abnormalities (FSA) and follicular keratosis' abnormalities (FKA). RESULTS: FSA and FKA dermoscopic patterns were related to male gender, except for star-like appearance, double white clods and dermoscopic horn (p≤0.04). Rhomboidal, annular granular pattern, gray halo, white circle and double clods were dermoscopic pattern significantly related to xeroderma pigmentosum's type of skin. Based on the evolutionary stages of PAK, the jelly sign was significantly related to thin patches of PAK. Central crusts and scales were related to thick plaques and the star-like appearance to hypertrophic PAK. The presence of 2 or more dermoscopic signs in both FSA and FKA was noticed in 99.1% of lesions. CONCLUSIONS: The dermoscopic diagnosis of PAK vary according to the evolutionary stages of the disease, this will increase the diagnosis accuracy, with therapeutic implications.

16 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.

17 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.

18 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.

19 Article Acral melanoma. 2017

Persechino, Flavia / Longo, Caterina / Benati, Elisa / Borsari, Stefania / Lombardi, Mara / Piana, Simonetta / Argenziano, Giuseppe / Moscarella, Elvira. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · 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, Second University of Naples, Naples, Italy. · Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy. Electronic address: elvira.moscarella@gmail.com. ·J Am Acad Dermatol · Pubmed #28087024.

ABSTRACT: -- No abstract --

20 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.

21 Article Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study. 2017

Benati, E / Ribero, S / Longo, C / Piana, S / Puig, S / Carrera, C / Cicero, F / Kittler, H / Deinlein, T / Zalaudek, I / Stolz, W / Scope, A / Pellacani, G / Moscarella, E / Piraccini, B M / Starace, M / Argenziano, G. ·Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. · Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy. · Pathology Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. · Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain. · CIBER of Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain. · Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria. · Non-Melanoma Skin Cancer Unit, Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria. · Clinic for Dermatology, Allergology, and Environmental Medicine, Klinik Thalkirchner Straße Städt, Klinikum München GmbH, Munich, Germany. · Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Department of Dermatology, University of Modena, Reggio Emilia, Italy. · Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. · Dermatology Unit, Second University of Naples, Naples, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #27696528.

ABSTRACT: BACKGROUND: Longitudinal melanonychia might be difficult to differentiate and the use of dermoscopy can be useful for the preoperative evaluation and management decision. OBJECTIVES: The aim of our study was to investigate clinical and dermoscopic criteria of acquired longitudinal melanonychia in adults to identify the best predictors of melanoma using a multivariate analysis and to explore eventual new dermoscopic criteria for nail melanoma diagnosis. METHODS: In this retrospective observational study, 82 histopathologically diagnosed, acquired nail pigmented bands were collected and examined. All variables were included in the analysis and examined as possible predictors of nail melanoma. Both univariate and multivariable analyses have been performed. RESULTS: Among 82 cases, 25 were diagnosed as nail melanoma and 57 as benign lesions (including 32 melanocytic nevi and 25 benign melanocytic hyperplasia). Melanoma cases were significantly associated with a width of the pigmented band higher than 2/3 of the nail plate, grey and black colours, irregularly pigmented lines, Hutchinson and micro-Hutchinson signs, and nail dystrophy. Granular pigmentation, a newly defined dermoscopic criterion, was found in 40% of melanomas and only in 3.51% of benign lesions. CONCLUSIONS: Dermoscopic examination of longitudinal melanonychia provides useful information that could help clinicians to improve melanoma recognition.

22 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.

23 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.

24 Article Unknown Primary Melanoma: Worldwide Survey on Clinical Management. 2016

Ribero, Simone / Pampena, Riccardo / Bataille, Veronique / Moscarella, Elvira / Thomas, Luc / Quaglino, Pietro / Potenza, Concetta / Van Akkooi, Alexander C J / Testori, Alessandro / Nathan, Paul / Puig, Susana / Zalaudek, Iris / Argenziano, Giuseppe / Longo, Caterina. ·Section of Dermatology, Medical Sciences Department, University of Turin, Turin, Italy. ·Dermatology · Pubmed #28052277.

ABSTRACT: BACKGROUND: How to deal with melanoma of unknown primary (MUP) origin is a debated topic in the literature. OBJECTIVE: We performed a worldwide survey to inquire what clinical and investigational workup is performed as well as the physicians' perception of this disease. METHODS: A questionnaire was sent via mail to clinicians involved in melanoma care from December 2015 to April 2016 using the International Dermoscopy Society website. RESULTS: 119 physicians from 47 different countries answered the questionnaire. The most reported examination was skin examination followed by CT and/or PET scans. All the participants declared asking about previous excisions of skin lesions with 81% of them asking for a histopathological slide review of previous biopsies. Half of the participants checked for a possible vitiligo phenomenon that may explain regression of the primary lesion. BRAF, cKIT, and GNAQ mutations were screened by 32% of participants. The majority of participants (76%) applied the same treatment protocols for MUP as patients with known primary melanomas of the same AJCC stage. CONCLUSION: Strong heterogeneity was found between physicians dealing with MUP. Thus, a consensus document should be strongly encouraged.

25 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.

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