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Melanoma: HELP
Articles by Giovanni Pellacani
Based on 146 articles published since 2010
(Why 146 articles?)
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Between 2010 and 2020, G. Pellacani wrote the following 146 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
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 / Anonymous1420806. ·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 Computational neural network in melanocytic lesions diagnosis: artificial intelligence to improve diagnosis in dermatology? 2019

Aractingi, Selim / Pellacani, Giovanni. ·Université Paris 5 Descartes, AP-HP and Inserm Institut Cochin 2f016, Hôpital Cochin, Department of Dermatology, Paris, France. · Facolta di Medicina et Chirugia, UNIMORE Iniversita Degli Studi di Modena e Reggio Emilia, Modena, Italy. ·Eur J Dermatol · Pubmed #31017580.

ABSTRACT: Diagnosis in dermatology is largely based on contextual factors going far beyond the visual and dermoscopic inspection of a lesion. Diagnostic tools such as the different types of dermoscopy, confocal microscopy and optical coherence tomography (OCT) are available and all of these have shown their importance in improving the dermatologist's ability, especially in the diagnosis of skin cancer. Their use, however, remains limited and time consuming, and optimizing their practice appears to be difficult, requiring extensive pre-processing, lesion segmentation and extraction of domain-specific visual features before classification. Over the last two decades, image recognition has been a matter of interest in a large part of our society and in industry, leading to the development of several techniques such as convolutional processing combined with artificial intelligence or neural networks (CNN/ANN). The aim of the present manuscript is to provide a short overview of the most recent data about CNN in the field of dermatology, mainly in skin cancer detection and its diagnosis.

3 Review Reflectance confocal microscopy in the diagnosis of pigmented macules of the face: differential diagnosis and margin definition. 2019

Farnetani, Francesca / Manfredini, Marco / Chester, Johanna / Ciardo, Silvana / Gonzalez, Salvador / Pellacani, Giovanni. ·Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, Dermatology Unit, University of Modena & Reggio Emilia, Modena, Italy. manfredini07@gmail.com. ·Photochem Photobiol Sci · Pubmed #30938378.

ABSTRACT: In vivo reflectance confocal microscopy (RCM) is a noninvasive high-resolution skin imaging tool that has become an important adjunct to clinical exam, dermoscopy and histopathology assessment, in the diagnosis and management of pigmented macules of the face. The diagnosis of early stage lentigo maligna (LM) and lentigo maligna melanoma (LMM) is challenging and RCM improves the diagnostic accuracy in the differential diagnosis of LM with other macules of the face such as solar lentigo (SL), pigmented actinic keratosis (PAK), seborrheic keratosis (SK) and lichen planus-like keratosis (LPLK). Here we review the state-of-the-art of RCM morphologic descriptors, standardized terminology, and diagnostic algorithms for the RCM assessment of pigmented macules of the face including melanocytic, and nonmelanocytic lesions. Clinical applications of RCM are broad and include diagnosis, assessment of large lesions on cosmetically sensitive areas, directing areas to biopsy, delineating margins prior to surgery, detecting response to treatment and assessing recurrence. The present review is intended to summarize the application of RCM for the correct diagnosis of challenging pigmented facial macules and to evaluate its application in LM margin mapping during the pre surgical phase.

4 Review Role of In Vivo Reflectance Confocal Microscopy in the Analysis of Melanocytic Lesions. 2018

Serban, Elena-Daniela / Farnetani, Francesca / Pellacani, Giovanni / Constantin, Maria Magdalena. ·Elena-Daniela Serban, MD, Department of Medical Oncology, University of Bologna, 40138 Bologna; Italy. ·Acta Dermatovenerol Croat · Pubmed #29782304.

ABSTRACT: Worldwide melanoma incidence and mortality are increasing (1). Despite the ongoing research, advanced melanoma is still incurable; therefore, the most appropriate solution seems to be early detection combined with complete surgical excision (2). Since the diagnostic protocol of suspicious lesions includes a complete excision with safety margins (2), the problem of unnecessary scarring is significant. The real challenge in this case is to have a properly formulated diagnosis before acquiring a biopsy. Currently available non-invasive techniques are coherence tomography, digital dermoscopy, and reflectance confocal microscopy. All these techniques allow for a presumptive diagnosis, but the most promising results are provided by reflectance confocal microscopy. Reflectance confocal microscopy (RCM) is an optical imaging technique that uses a laser diode as a source of coherent monochromatic light which penetrates the tissue and illuminates a single point. Light from the stimulated section is reflected and passes through a filter, thereby forming the image on the detector. This filter enables selective excitation of a particular point on which focus is achieved and rejects reflection from the out-of-focus area, thus obtaining a "confocal" image. Contrast is the result of differences in the refractive index of the cell organelles and microstructures, resulting in white structures on a black background. This technique allows, as opposed to conventional light microscopy, the analysis of sections obtained at a bi- or tri-dimensional level and controlling the depth of the field, permitting out-of-focus artifacts to be eliminated. In dermatology, this technique is useful for both clinical and research purposes. It is the only technique that allows horizontal viewing of the skin up to the superficial dermis (approximately 300 mm, at a cellular level resolution (0.5-1.0 μm in the lateral dimension and 4.0-5.0 μm in the axial dimension) (3). It allows both in vivo and ex vivo diagnosis, while providing the possibility for long-term monitoring. It has proved to be especially valuable for in vivo examinations of melanocytic lesions, whereas melanin and melanosomes are a powerful source of contrast, allowing the individualization of melanocytic cells (4). We report the case of a 65-year-old Caucasian woman who presented to the Dermatology Department of University of Modena and Reggio Emilia, Italy, for the examination of an atypical lesion, of unknown history, localized in the right preauricular area. The patient's personal and family histories were negative for skin malignancies and for other significant medical history. The clinical presentation was highly indicative of malignancy, as it met all the ABCD clinical criteria: an asymmetric papule composed of two areas, one pigmented and another one hypopigmented, with ill-defined borders and a diameter of approximately 2 cm. The dermatoscopic examination revealed an asymmetric multicomponent pattern with atypical network, structureless areas, peripheral irregular globules, and a blue-white veil. Because clinical and dermatoscopic features pointed towards a suspicious lesion which was situated on the face, where unnecessary scarring is unwanted, reflectance confocal microscopy (RCM) examination was proposed and performed (VivaScope 3000; MAVIG GmBH, Munich, Germany) (5). It revealed the following features: the epidermis presented a disarranged pattern; the dermo-epidermal junction and superficial dermis presented a meshwork pattern with edged AND non-edged papillae, non-homogenous junctional clusters, dense nests, dense AND sparse nests, and atypical cells in a sparse distribution (Figure 1). Figure 1. (A) Clinical examination of an atypical melanocytic lesion situated at the right preauricular area. (B) Dermatoscopic examination. (C) Confocal examination of dermo-epidermal junction and superficial dermis which reveals a meshwork pattern (yellow circle) with edged AND non-edged papillae, non-homogenous junctional clusters (yellow star), dense nests, dense AND sparse nests (red star) and atypical cells in a sparse distribution (arrow). The clinical and confocal data indicated a malignant melanocytic tumor, so an excisional biopsy with safety margins was performed. The histopathological report indicated superficial spreading melanoma with a Breslow of 0.55 mm and 0 mitosis/mm2. This case illustrates the important role confocal microscopy examination has in the management of melanocytic lesions situated in special areas like the face. Reflectance confocal microscopy is an imaging technique that allows viewing the layers of the skin up to the superficial dermis and therefore turns out to be extremely useful in obtaining a pertinent diagnosis before acquiring a biopsy. According to the data available so far, it was established that reflectance confocal microscopy increases the diagnostic accuracy for melanocytic lesions in both pigmented and hypopigmented lesions. In a study conducted by Borsari et al., reflectance confocal microscopy proved to have a sensibility and specificity of 95.3% and 83.9%, respectively (6). By improving the accuracy of clinical and dermatoscopic diagnosis, the reflectance confocal microscopy technique contributes to increasing the confidence of the clinical and dermatoscopic diagnosis (7). In this regard, confocal reflectance microscopy reduces unnecessary excisions, particularly in cases of damage to cosmetically important areas, such as the face or the neck, simultaneously detecting the malignant lesions that require a surgical approach, as seen in the case presented, where confirmation of the diagnosis by confocal microscopy allowed for a safe excision. In fact, the head and neck are the most appropriate body location for reflectance confocal examination, especially because RCM showed a high diagnostic accuracy for lesions located on sun-damaged skin, as these two areas frequently are (adjusted odds ratio (aOR), 2.13; 95% confidence interval (CI), 1.37-3.30; P=.001) (6). Reflectance confocal microscopy is very helpful in the management of special lesions, like facial lentigo maligna melanoma. This type of lesion is considered to be a real challenge for the dermatologist because of its clinical and morphological features that are similar to other lesions such as solar lentigines and pigmented actinic keratoses. In this case, reflectance confocal excels at specificity of the diagnosis, but also at to the ability to define the margins more accurately, permitting a pre-surgical mapping and for possibility of identifying the optimal site for biopsy (8,9). By improving diagnostic ability, reflectance confocal microscopy technique may contribute to the selection of lesions that may be eligible for non-surgical treatment. Facial pigmented non-melanocytic macules like solar lentigo, flat seborrheic keratosis, lichen planus-like keratosis, and pigmented actinic keratosis can mimic a lentigo maligna, or even a lentigo maligna melanoma, but with the help of the RCM, an accurate diagnosis can be established, sparing the patient can be from unwanted facial scars using a non-surgical approach (laser, cryotherapy, imiquimod) (10,11). Furthermore, reflectance confocal microscopy can be a valuable method for the monitoring of a skin lesion over time, especially melanocytic nevi, reducing unnecessary surgical excision, such as for patients with multiple atypical nevi that undergo multiple biopsies (12,13). Like all other diagnostic methods, RCM has its limitations: palmoplantar lesions (due to thickened epidermis), ulcers or crusts on a large lesion, lesions localized in inaccessible regions such as interdigital space, nasal wing (3). To summarize, reflectance confocal microscopy can improve clinical and dermatoscopic diagnosis of melanocytic lesions, detecting the lesions that need an invasive approach and preventing unnecessary excision. It has proven to be very helpful in the management of lentigo maligna and lentigo maligna melanoma, achieving high specificity in the diagnosis and simultaneously allowing an optimal approach. This technique can be a reliable bridge between dermoscopy and histopathology, being able to provide an alternative to histopathological examination. Special mention must be made of the factors that may change the result to a false negative such as hyperkeratosis, ulceration, or bleeding, so any results should be integrated with the rest of the patient's data.

5 Review Imaging Blood Vessel Morphology in Skin: Dynamic Optical Coherence Tomography as a Novel Potential Diagnostic Tool in Dermatology. 2017

Schuh, Sandra / Holmes, Jon / Ulrich, Martina / Themstrup, Lotte / Jemec, Gregor B E / De Carvalho, Nathalie / Pellacani, Giovanni / Welzel, Julia. ·Department of Dermatology, General Hospital Augsburg, Augsburg, Germany. · Michelson Diagnostics Ltd., Maidstone, UK. · CMB Collegium Medicum Berlin, Berlin, Germany. · Department of Dermatology, Zealand University Hospital, Roskilde, Denmark. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Department of Dermatology, General Hospital Augsburg, Augsburg, Germany. Julia.Welzel@klinikum-augsburg.de. ·Dermatol Ther (Heidelb) · Pubmed #28258554.

ABSTRACT: Conventional optical coherence tomography (OCT) enables the visualization of morphological changes of skin cancer. The use of OCT in the diagnostic investigation and in the therapy decision of non-melanoma skin cancer and other skin changes is already established, and has found its way into routine practice. With the development of speckle-variance OCT, also named dynamic OCT (D-OCT), the vascular architecture and the blood flow of the skin can be displayed in vivo and in 3D. This novel angiographic variant of OCT offers the ability to visualize and measure vessel morphology providing a new insight into healthy, inflammatory and neoplastic skin lesions such as malignant melanoma. This review focuses on the possibilities of using D-OCT on healthy and diseased skin. We suggest and illustrate key diagnostic characteristics by analyzing the initial publications and preliminary unpublished data on vessel morphology and distribution. The potential of D-OCT as a diagnostic tool in dermatology is examined and may give rise to future studies on D-OCT, which are needed to confirm the aforementioned features.

6 Review In Vivo and Ex Vivo Confocal Microscopy for Dermatologic and Mohs Surgeons. 2016

Longo, Caterina / Ragazzi, Moira / Rajadhyaksha, Milind / Nehal, Kishwer / Bennassar, Antoni / Pellacani, Giovanni / Malvehy Guilera, Josep. ·Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, viale Risorgimento 80, Reggio Emilia 42100, Italy. Electronic address: longo.caterina@gmail.com. · Pathology Unit, Arcispedale Santa Maria Nuova-IRCCS, viale Risorgimento 80, Reggio Emilia 42100, Italy. · Dermatology Service, Memorial Sloan Kettering Cancer Center, 160 East 53rd Street, New York, NY 10022, USA. · Melanoma Unit, Dermatology Department, Hospital Clinic and Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. · Dermatology Unit, UniMore, Modena, Italy. ·Dermatol Clin · Pubmed #27692455.

ABSTRACT: Confocal microscopy is a modern imaging device that has been extensively applied in skin oncology. More specifically, for tumor margin assessment, it has been used in two modalities: reflectance mode (in vivo on skin patient) and fluorescence mode (on freshly excised specimen). Although in vivo reflectance confocal microscopy is an add-on tool for lentigo maligna mapping, fluorescence confocal microscopy is far superior for basal cell carcinoma and squamous cell carcinoma margin assessment in the Mohs setting. This article provides a comprehensive overview of the use of confocal microscopy for skin cancer margin evaluation.

7 Review Melanomas. 2016

Longo, Caterina / Pellacani, Giovanni. ·Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Viale Risorgimento, 80, Reggio Emilia 42100, Italy. Electronic address: longo.caterina@gmail.com. · Dermatology Unit, UniMore, via del Pozzo, 71, Modena 41121, Italy. ·Dermatol Clin · Pubmed #27692447.

ABSTRACT: Melanomas are a wide range of tumors that differ in their epidemiology, morphology, genetic profile, and biological behavior. They can be grouped as superficial spreading melanoma, lentigo maligna, and nodular melanoma. Reflectance confocal microscopy is useful for the evaluation of skin lesions that are dermoscopically doubtful by increasing diagnostic accuracy and specificity. This article provides a comprehensive overview of the different confocal main morphologies of distinct melanoma types as a function of the anatomic location of the tumor.

8 Review Basics of Confocal Microscopy and the Complexity of Diagnosing Skin Tumors: New Imaging Tools in Clinical Practice, Diagnostic Workflows, Cost-Estimate, and New Trends. 2016

Que, Syril Keena T / Grant-Kels, Jane M / Longo, Caterina / Pellacani, Giovanni. ·Department of Dermatology, University of Connecticut Health Center, 263 Farmington Avenue, MC 6231, Farmington, CT 06030-6231, USA. Electronic address: keenaq@gmail.com. · Department of Dermatology, University of Connecticut Health Center, 263 Farmington Avenue, MC 6231, Farmington, CT 06030-6231, USA. · Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, viale risorgimento, 80, 42100 Reggio Emilia, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, via del Pozzo 71, Modena 41124, Italy. ·Dermatol Clin · Pubmed #27692444.

ABSTRACT: The use of reflectance confocal microscopy (RCM) and other noninvasive imaging devices can potentially streamline clinical care, leading to more precise and efficient management of skin cancer. This article explores the potential role of RCM in cutaneous oncology, as an adjunct to more established techniques of detecting and monitoring for skin cancer, such as dermoscopy and total body photography. Discussed are current barriers to the adoption of RCM, diagnostic workflows and standards of care in the United States and Europe, and medicolegal issues. The potential role of RCM and other similar technological innovations in the enhancement of dermatologic care is evaluated.

9 Review Advances in noninvasive imaging of melanoma. 2016

Menge, Tyler D / Pellacani, Giovanni. ·University of Michigan Medical School, Ann Arbor, Michigan, USA. tmenge@umich.edu. · University of Modena and Reggio Emilia, Modena, Italy. pellacani.giovanni@gmail.com. ·Semin Cutan Med Surg · Pubmed #26963113.

ABSTRACT: Melanoma is the most dangerous type of skin cancer and its incidence has risen sharply in recent decades. Early detection of disease is critical for improving patient outcomes. Any pigmented lesion that is clinically concerning must be removed by biopsy for morphologic investigation on histology. However, biopsies are invasive and can cause significant morbidity, and their accuracy in detecting melanoma may be limited by sampling error. The advent of noninvasive imaging devices has allowed for assessment of intact skin, thereby minimizing the need for biopsy; and these technologies are increasingly being used in the diagnosis and management of melanoma. Reflectance confocal microscopy, optical coherence tomography, ultrasonography, and multispectral imaging are noninvasive imaging techniques that have emerged as diagnostic aids to physical exam and/or conventional dermoscopy. This review summarizes the current knowledge about these techniques and discusses their practical applications and limitations.

10 Review Methods of Melanoma Detection. 2016

Leachman, Sancy A / Cassidy, Pamela B / Chen, Suephy C / Curiel, Clara / Geller, Alan / Gareau, Daniel / Pellacani, Giovanni / Grichnik, James M / Malvehy, Josep / North, Jeffrey / Jacques, Steven L / Petrie, Tracy / Puig, Susana / Swetter, Susan M / Tofte, Susan / Weinstock, Martin A. ·Department of Dermatology and Knight Cancer Institute, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR, 97239, USA. leachmas@ohsu.edu. · Department of Dermatology and Knight Cancer Institute, Oregon Health and Science University, 3125 SW Sam Jackson Park Road, L468R, Portland, OR, 97239, USA. cassidyp@ohsu.edu. · Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road NE, 1st Floor, Atlanta, GA, 30322, USA. schen2@emory.edu. · Department of Dermatology and Arizona Cancer Center, University of Arizona, 1515 N Campbell Avenue, Tucson, AZ, 85721, USA. ccuriel@email.arizona.edu. · Department of Dermatology, Harvard School of Public Health and Massachusetts General Hospital, Landmark Center, 401 Park Drive, 3rd Floor East, Boston, MA, 02215, USA. ageller@hsph.harvard.edu. · Laboratory of Investigative Dermatology, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA. daniel.gareau@rockefeller.edu. · Department of Dermatology, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, Italy. giovanni.pellacani@unimore.it. · Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Room 912, BRB (R-125), 1501 NW 10th Avenue, Miami, FL, 33136, USA. grichnik@miami.edu. · Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. jmalvehy@clinic.ub.es. · University of California, San Francisco, 1701 Divisadero Street, Suite 280, San Francisco, CA, 94115, USA. jeffrey.north@ucsf.edu. · Department of Biomedical Engineering and Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH13B, Portland, OR, 97239, USA. jacquess@ohsu.edu. · Department of Biomedical Engineering, Oregon Health and Science University, 3303 SW Bond Avenue, CH13B, Portland, OR, 97239, USA. petrie@ohsu.edu. · Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. spuig@clinic.ub.es. · Department of Dermatology/Cutaneous Oncology, Stanford University, 900 Blake Wilbur Drive, W3045, Stanford, CA, 94305, USA. sswetter@stanford.edu. · Department of Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR, 97239, USA. toftes@ohsu.edu. · Departments of Dermatology and Epidemiology, Brown University, V A Medical Center 111D, 830 Chalkstone Avenue, Providence, RI, 02908, USA. maw@brown.edu. ·Cancer Treat Res · Pubmed #26601859.

ABSTRACT: Detection and removal of melanoma, before it has metastasized, dramatically improves prognosis and survival. The purpose of this chapter is to (1) summarize current methods of melanoma detection and (2) review state-of-the-art detection methods and technologies that have the potential to reduce melanoma mortality. Current strategies for the detection of melanoma range from population-based educational campaigns and screening to the use of algorithm-driven imaging technologies and performance of assays that identify markers of transformation. This chapter will begin by describing state-of-the-art methods for educating and increasing awareness of at-risk individuals and for performing comprehensive screening examinations. Standard and advanced photographic methods designed to improve reliability and reproducibility of the clinical examination will also be reviewed. Devices that magnify and/or enhance malignant features of individual melanocytic lesions (and algorithms that are available to interpret the results obtained from these devices) will be compared and contrasted. In vivo confocal microscopy and other cellular-level in vivo technologies will be compared to traditional tissue biopsy, and the role of a noninvasive "optical biopsy" in the clinical setting will be discussed. Finally, cellular and molecular methods that have been applied to the diagnosis of melanoma, such as comparative genomic hybridization (CGH), fluorescent in situ hybridization (FISH), and quantitative reverse transcriptase polymerase chain reaction (qRT-PCR), will be discussed.

11 Review Update on the use of confocal microscopy in melanoma and non-melanoma skin cancer. 2015

Guida, S / Longo, C / Casari, A / Ciardo, S / Manfredini, M / Reggiani, C / Pellacani, G / Farnetani, F. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy - stefania.guida@alice.it. ·G Ital Dermatol Venereol · Pubmed #26140397.

ABSTRACT: Reflectance confocal microscopy (RCM) is a new technique enabling the visualization of the skin at a quasi-histological resolution, allowing the identification of clues for the diagnosis of skin diseases. The aim of this analysis was to provide new insights into the role of RCM in the diagnosis of skin cancers. Data comes from the most recent literature, taking into account previous essential reported information in this field. The study eligibility criteria were: studies providing update information, focusing on RCM findings in melanoma and non-melanoma skin cancers (NMSC), without restrictions for age, sex, ethnicity. Duplicated studies and single case report were excluded from this study. A search concerning the role of RCM in melanoma and NMSC was performed on the Medline. RCM clues were analyzed for different skin cancers, in particular melanoma and NMSC, in association with clinical, dermoscopic and histopathologic findings. Diagnostic accuracy, sensibility and specificity of the technique were reviewed. Furthermore, some new findings have been described and recent applications have been discussed. The selection of articles was limited in order to provide an up-to-date revision. In conclusion, several RCM features were implemented for the diagnosis of melanoma and NMSC, leading to a confocal-based classification in most cases.

12 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.

13 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.

14 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.

15 Review Early diagnosis of melanoma: what is the impact of dermoscopy? 2012

Argenziano, Giuseppe / Albertini, Giuseppe / Castagnetti, Fabio / De Pace, Barbara / Di Lernia, Vito / Longo, Caterina / Pellacani, Giovanni / Piana, Simonetta / Ricci, Cinzia / Zalaudek, Iris. ·Dermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. g.argenziano@gmail.com ·Dermatol Ther · Pubmed #23046019.

ABSTRACT: There are three possible explanations for the improved melanoma recognition when a clinician uses dermoscopy: first, the presence of early dermoscopy signs that become visible in melanoma much before the appearance of the classical clinical features; second, an increased attitude of clinicians to check more closely clinically banal-looking lesions; and third, an improved attitude of clinicians to monitor their patients. In this review, the light and the dark sides of melanoma screening are briefly discussed, including the need to find better strategies to decrease the number of unnecessary excision of benign lesions on one hand, and to finally decrease melanoma mortality rates on the other.

16 Review New directions in dermatopathology: in vivo confocal microscopy in clinical practice. 2012

Longo, Caterina / Zalaudek, Iris / Argenziano, Giuseppe / Pellacani, Giovanni. ·Dermatology and Skin Care Unit, Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42100 Reggio Emilia, Italy. ·Dermatol Clin · Pubmed #23021059.

ABSTRACT: In vivo confocal microscopy represents a new device that generates a virtual skin biopsy at cytologic resolution. This article describes the most relevant confocal findings and their histopathologic correlates in skin oncology and inflammatory diseases. The light and dark of confocal microscopy are briefly discussed in relation with its clinical applications.

17 Review Improving triage and management of patients with skin cancer: challenges and considerations for the future. 2012

Argenziano, Giuseppe / Giacomel, Jason / Abramavicus, Alexandre / Pellacani, Giovanni / Longo, Caterina / De Pace, Barbara / Albertini, Giuseppe / Cristofolini, Mario / Zalaudek, Iris. ·Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, Reggio Emilia, Italy. g.argenziano@gmail.com ·Expert Rev Anticancer Ther · Pubmed #22594896.

ABSTRACT: Skin cancer is the most common malignancy in humans, thus representing a major health concern. Because of the increasing attention to skin cancer prevention, there has been a growing workload for dermatology clinics, with patients referred from primary care requiring assessment of suspicious skin tumors. This places a strain on limited specialist resources and can create a paradoxical situation wherein an early diagnosis becomes increasingly difficult for those patients who actually do suffer from skin cancer. The aim of these recommendations is to propose an updated, rational system of triage, involving improved accuracy of diagnosis and more timely management of skin cancer by both general practitioners and dermatologists.

18 Clinical Trial The somatic affairs of BRAF: tailored therapies for advanced malignant melanoma and orphan non-V600E (V600R-M) mutations. 2013

Ponti, Giovanni / Pellacani, Giovanni / Tomasi, Aldo / Gelsomino, Fabio / Spallanzani, Andrea / Depenni, Roberta / Al Jalbout, Samer / Simi, Lisa / Garagnani, Lorella / Borsari, Stefania / Conti, Andrea / Ruini, Cristel / Fontana, Annalisa / Luppi, Gabriele. ·Department of Clinical and Diagnostic Medicine and Public Health, University Hospital of Modena and Reggio Emilia, Modena, Italy. giovanni.ponti@unimore.it ·J Clin Pathol · Pubmed #23463675.

ABSTRACT: BRAF V600R-M-D are uncommon mutations, not included in the experimental protocols of BRAF selective inhibitors. We report the evaluation of correlations among different types of BRAF somatic mutations in melanoma and their management with BRAF inhibitors. 21 patients with BRAF mutated metastatic melanoma were enrolled in the protocol with BRAF inhibitors for compassionate use at the University of Modena. Hot spot V600E mutations were found in 19 patients. V600R mutation and double (V600E -V600M) mutation were identified in two melanomas. In one case, V600K mutation was found. Two screening failures were noted. Mean progression free survival at follow-up of to 8 weeks, was 7.6 months. Five patients had a very short follow-up and the experimental protocol is still ongoing, so we cannot provide complete follow-up data. However, all of them are still under treatment and disease progression free. An objective response with few side effects was observed in all patients. in vitro studies with the aim of testing drug sensitivity.

19 Article The presence of eccentric hyperpigmentation should raise the suspicion of melanoma. 2020

Borsari, S / Peccerillo, F / Pampena, R / Lai, M / Spadafora, M / Moscarella, E / Lallas, A / Pizzichetta, M A / Zalaudek, I / Del Regno, L / Peris, K / Pellacani, G / Longo, C. ·Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Dermatology Unit, Second University of Naples, Naples, Italy. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · Department of Dermatology, University Hospital of Trieste, Trieste, Italy. · Division of Medical Oncology - Preventive Oncology, National Cancer Institute, Aviano, Italy. · Institute of Dermatology, Catholic University of Rome and Fondazione Policlinico Universitario A. Gemelli, Rome, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #32402129.

ABSTRACT: BACKGROUND: Melanocytic lesions with eccentric hyperpigmentation (EH), even though without other dermatoscopic features of melanoma, are often excised. OBJECTIVE: Aiming to understand if the EH in a pigmented lesion is an accurate criterion of malignancy, we evaluated the capability of two evaluators, with different expertise, to correctly diagnose a melanoma when analyzing a given lesion in toto versus a partial analysis, with only the EH or the non-hyperpigmented portion (non-EH) visible. METHODS: Dermatoscopic images of 240 lesions (107 melanomas and 133 nevi) typified by EH were selected. Facial, acral, mucosal lesions, as well as lesions showing clear-cut features of melanoma (except for atypical network) were excluded. Clinical and dermoscopic features (main pattern and numbers of colors) were described for all cases. Each image was split in two through a software so that only the EH or the non-EH was visible. Two blinded evaluators examined three sets of images, two with customized images and one with the non-modified ones: they were asked to give a dichotomous diagnosis (melanoma or nevus) for each image. RESULTS: Melanomas were significantly more frequently typified by color variegation (3 colors in 44.8% and 4 colors in 41.1% of cases) and atypical network (88.1% in the EH). No significant differences in diagnostic accuracy emerged between the two evaluators. Sensitivity improved in the evaluation of the whole lesions (mean sensitivity 89.7%) in comparison to the evaluation of EH or non-EH alone (72.7-62.6%). Specificity increased when evaluating the EH (54.1%). Positive predictive value (PPV) and likelihood ratio (LR+) of EH resulted 52.3% and 1.4, meaning that in one case out of two with EH is a melanoma. CONCLUSIONS: Lesions with EH are challenging, regardless of dermoscopic experience. The EH is a robust criterion for malignancy, since the evaluation of the whole lesion, through an intralesional comparative approach, increases sensitivity.

20 Article European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics - Update 2019. 2020

Garbe, Claus / Amaral, Teresa / Peris, Ketty / Hauschild, Axel / Arenberger, Petr / Bastholt, Lars / Bataille, Veronique / Del Marmol, Veronique / Dréno, Brigitte / Fargnoli, Maria Concetta / Grob, Jean-Jacques / Höller, Christoph / Kaufmann, Roland / Lallas, Aimilios / Lebbé, Celeste / Malvehy, Josep / Middleton, Mark / Moreno-Ramirez, David / Pellacani, Giovanni / Saiag, Philippe / Stratigos, Alexander J / Vieira, Ricardo / Zalaudek, Iris / Eggermont, Alexander M M / Anonymous9471072. ·Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany. Electronic address: claus.garbe@med.uni-tuebingen.de. · Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany; Portuguese Air Force Health Care Direction, Lisbon, Portugal. · Institute of Dermatology, Università Cattolica, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy. · Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany. · Department of Dermatovenerology, Third Faculty of Medicine, Charles University of Prague, Prague, Czech Republic. · Department of Oncology, Odense University Hospital, Denmark. · Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London, SE1 7EH, UK. · Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. · Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France. · Department of Dermatology, University of L'Aquila, Italy. · University Department of Dermatology, Marseille, France. · Department of Dermatology, Medical University of Vienna, Austria. · Department of Dermatology, Venerology and Allergology, Frankfurt University Hospital, Frankfurt, Germany. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · APHP Department of Dermatology, INSERM U976, University Paris 7 Diderot, Saint-Louis University Hospital, Paris, France. · Melanoma Unit, Department of Dermatology, Hospital Clinic, IDIBAPS, Barcelona, Spain. · NIHR Biomedical Research Center, University of Oxford, UK. · Medical-&-Surgical Dermatology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain. · Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy. · University Department of Dermatology, Université de Versailles-Saint Quentin en Yvelines, APHP, Boulogne, France. · 1st Department of Dermatology, University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece. · Department of Dermatology and Venereology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal. · Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy. · Princess Máxima Center, 3584 CS, Utrecht, the Netherlands. ·Eur J Cancer · Pubmed #31928887.

ABSTRACT: Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed through dermatoscopy. If a melanoma is suspected, a histopathological examination is required. Sequential digital dermatoscopy and full-body photography can be used in risk persons to detect the development of melanomas at an earlier stage. Where available, confocal reflectance microscopy can improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the AJCC classification. Thin melanomas up to 0.8 mm tumor thickness does not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC whole-body examinations with CT or PET-CT in combination with brain MRI are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to support the frequency and extent of examinations. A stage-based follow-up scheme is proposed, which, according to the experience of the guideline group, covers the minimum requirements; further studies may be considered. This guideline is valid until the end of 2021.

21 Article European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2019. 2020

Garbe, Claus / Amaral, Teresa / Peris, Ketty / Hauschild, Axel / Arenberger, Petr / Bastholt, Lars / Bataille, Veronique / Del Marmol, Veronique / Dréno, Brigitte / Fargnoli, Maria Concetta / Grob, Jean-Jacques / Höller, Christoph / Kaufmann, Roland / Lallas, Aimilios / Lebbé, Celeste / Malvehy, Josep / Middleton, Mark / Moreno-Ramirez, David / Pellacani, Giovanni / Saiag, Philippe / Stratigos, Alexander J / Vieira, Ricardo / Zalaudek, Iris / Eggermont, Alexander M M / Anonymous9311072. ·Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany. Electronic address: claus.garbe@med.uni-tuebingen.de. · Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany; Portuguese Air Force Health Care Direction, Lisbon, Portugal. · Institute of Dermatology, Università Cattolica, Rome, Italy; Fondazione Policlinico Universitario A, Gemelli - IRCCS, Rome, Italy. · Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany. · Department of Dermatovenerology, Third Faculty of Medicine, Charles University of Prague, Prague, Czech Republic. · Department of Oncology, Odense University Hospital, Denmark. · Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London, SE1 7EH, UK. · Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. · Dermatology Department, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France. · Department of Dermatology, University of L'Aquila, Italy. · University Department of Dermatology, Marseille, France. · Department of Dermatology, Medical University of Vienna, Austria. · Department of Dermatology, Venerology and Allergology, Frankfurt University Hospital, Frankfurt, Germany. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · APHP Department of Dermatology, INSERM U976, University Paris 7 Diderot, Saint-Louis University Hospital, Paris, France. · Melanoma Unit, Department of Dermatology, Hospital Clinic, IDIBAPS, Barcelona, Spain. · NIHR Biomedical Research Centre, University of Oxford, UK. · Medical-&-Surgical Dermatology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain. · Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy. · University Department of Dermatology, Université de Versailles-Saint Quentin en Yvelines, APHP, Boulogne, France. · 1st Department of Dermatology, University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece. · Department of Dermatology and Venereology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal. · Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy. · Princess Máxima Center, 3584, CS Utrecht, the Netherlands. ·Eur J Cancer · Pubmed #31866016.

ABSTRACT: A unique collaboration of multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with 1- to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumour thickness ≥1.0 mm or ≥0.8 mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team ("Tumor Board"). Adjuvant therapies in stage III/IV patients are primarily anti-PD-1, independent of mutational status, or dabrafenib plus trametinib for BRAF-mutant patients. In distant metastasis, either resected or not, systemic treatment is indicated. For first-line treatment, particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In particular scenarios for patients with stage IV melanoma and a BRAF-V600 E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harbouring a BRAF-V600 E/K mutation, this therapy shall be offered in second-line. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future.

22 Article Immunohistochemical mismatch repair proteins expression as a tool to predict the melanoma immunotherapy response. 2020

Ponti, Giovanni / Pellacani, Giovanni / Tomasi, Aldo / Depenni, Roberta / Maccaferri, Monia / Maiorana, Antonio / Orsi, Giulia / Giusti, Francesca / Cascinu, Stefano / Manfredini, Marco. ·Division of Clinical Pathology, Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, I-41124 Modena, Italy. · Division of Dermatology, Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, I-41124 Modena, Italy. · Department of Oncology and Haematology, University of Modena and Reggio Emilia, I-41124 Modena, Italy. · Department of Pathology, University of Modena and Reggio Emilia, I-41124 Modena, Italy. ·Mol Clin Oncol · Pubmed #31814971.

ABSTRACT: In difference to other solid malignancies, the identification of biomarkers for the prediction of malignant melanoma (MM) response to immunotherapy is limited. The aim of the current study was to evaluate the immunohistochemical (IHC) expression of MMR proteins in a cohort of MM metastatic patients receiving anti PD-1 treatments. The therapeutic response of patients was also retrospectively assessed. The cohort of the current study included 14 patients with advanced MM that had received anti PD-1 from January 2014 to December 2016 (12 males, 2 females; average age, 71 years; age range, 47-88 years). IHC analysis of MLH1, PMS2, MSH2 and MSH6 proteins was performed on paraffin-embedded primary tumor samples from each patient and on the 23 available metastasis specimens obtained from the Division of Pathology (University of Modena and Reggio Emilia). The results revealed that 7% of the primary melanoma tissue obtained from the patient cohort exhibited the loss of expression of at least one MMR protein. Three samples from one patient, including one primary melanoma and two metastases, exhibited no MSH6 expression and had the most successful response to anti PD-1 treatment, with a progression-free survival and overall survival of 956 and 2,546 days, respectively. In conclusion, the assessment of MMR protein expression represents a potential predictive marker that may have critical importance for patients with primary and metastatic MM, primarily as criterion for the adoption of immunotherapy treatments.

23 Article Neck Melanoma: Clinical, Dermoscopic and Confocal Features. 2020

Borsari, Stefania / Pampena, Riccardo / Raucci, Margherita / Mirra, Marica / Piana, Simonetta / Pellacani, Giovanni / Longo, Caterina. ·Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy. · Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy, riccardopampena@gmail.com. · Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. ·Dermatology · Pubmed #31707398.

ABSTRACT: BACKGROUND: The head and neck are considered one single anatomical unit. No data on clinical, dermoscopic and confocal aspects of neck melanoma are currently available. OBJECTIVES: To identify clinical, dermoscopic and confocal diagnostic features of neck melanomas. METHODS: Consecutive malignant (cases) and benign (controls) melanocytic skin lesions located on the neck, excised as suspected of being melanoma from March 2011 to February 2018, were retrospectively retrieved. Dermoscopic criteria of the 7-point checklist, integrated by other melanoma features (such as grey colour and irregular hyperpigmented areas) were assessed. Reflectance confocal microscopy (RCM) images were examined when available. RESULTS: 282 lesions located to the head and neck area were biopsied to rule out melanoma. Thirty-one out of 282 (11%) lesions were located on the neck: 21 melanomas and 10 naevi. Melanoma patients were older than patients with naevi (mean age: 60.4 vs. 37.9 years, p < 0.001). Neck melanomas were more frequently located on sun-damaged skin compared to naevi (76.2 vs. 30%, p = 0.02). Dermoscopically, neck melanomas were characterized by irregular dots/globules, grey colour and regression (76.2, 81 and 46.7% of cases) and showed criteria of lentigo maligna melanoma (LMM) in 52.4% of cases. Regression, grey colour, irregular hyperpigmented areas and criteria of LMM typified melanomas on sun-damaged skin, whereas tumours located on non-sun-damaged areas were often characterized by irregular pigmentation (blotches). RCM, implemented to dermoscopy, correctly diagnosed 10/12 melanomas and 3/5 naevi. CONCLUSION: Neck melanoma has peculiar clinical and dermoscopic aspects that could help clinicians to distinguish it from naevi and to diagnose melanoma earlier.

24 Article Convolutional Neural Network Approach to Classify Skin Lesions Using Reflectance Confocal Microscopy. 2019

Wodzinski, Marek / Skalski, Andrzej / Witkowski, Alexander / Pellacani, Giovanni / Ludzik, Joanna. · ·Conf Proc IEEE Eng Med Biol Soc · Pubmed #31946924.

ABSTRACT: We propose an approach based on a convolutional neural network to classify skin lesions using the reflectance confocal microscopy (RCM) mosaics. Skin cancers are the most common type of cancers and a correct, early diagnosis significantly lowers both morbidity and mortality. RCM is an in-vivo non-invasive screening tool that produces virtual biopsies of skin lesions but its proficient and safe use requires hard to obtain expertise. Therefore, it may be useful to have an additional tool to aid diagnosis. The proposed network is based on the ResNet architecture. The dataset consists of 429 RCM mosaics and is divided into 3 classes: melanoma, basal cell carcinoma, and benign naevi with the ground-truth confirmed by a histopathological examination. The test set classification accuracy was 87%, higher than the accuracy achieved by medical, confocal users. The results show that the proposed classification system can be a useful tool to aid in early, noninvasive melanoma detection.

25 Article Consensus Recommendations for the Use of Non-Invasive Melanoma Detection Techniques Based on Results of an International DELPHI Process. 2019

Waldman, Reid A / Grant-Kels, Jane M / Curiel, Clara N / Curtis, Julia / Rodríguez, Salvador González / Hu, Shasa / Kerr, Philip / Marghoob, Ashfaq / Markowitz, Orit / Pellacani, Giovanni / Rabinovitz, Harold / Rao, Babar / Scope, Alon / Stein, Jennifer A / Swetter, Susan M. ·University of Connecticut Department of Dermatology, Farmington, CT 06032. · University of Connecticut Department of Dermatology, Farmington, CT 06032. Electronic address: grant@uchc.edu. · University of Arizona College of Medicine Department of Dermatology. · Department of Dermatology University of Utah School of Medicine. · Department of Medicine and Medical Specialties Alcalá University. · Department of Dermatology University of Miami Miller School of Medicine. · Department of Dermatology Memorial Sloan Kettering Cancer Center. · Department of Dermatology SUNY Downstate Medical Center. · Department of Dermatology University of Modena and Reggio Emilia. · Dermatology Associates. · Department of Dermatology Rutgers-Robert Wood Johnson Medical School. · The Kittner Skin Cancer Screening & Research Institute Sheba Medical Center and Sackler School of Medicine. · The Ronald O. Perelman Department of Dermatology New York University School of Medicine. · Department of Dermatology Stanford University Medical Center. ·J Am Acad Dermatol · Pubmed #31563644.

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