Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Melanoma: HELP
Articles by Harold S. Rabinovitz
Based on 47 articles published since 2008
||||

Between 2008 and 2019, H. Rabinovitz wrote the following 47 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Assessing Skin Cancer Using Epidermal Genetic Information Retrieved by Adhesive Patch Skin Surface Sampling. 2017

Lee, Nayoung / Scope, Alon / Rabinovitz, Harold. ·Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Avenue, Miami, FL 33136, USA. · Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Hashomer 5262000, Israel. · Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Avenue, Miami, FL 33136, USA; Private Practice, Skin and Cancer Associates, Plantation, FL 33324, USA. Electronic address: harold@admcorp.com. ·Dermatol Clin · Pubmed #28886808.

ABSTRACT: The detection of melanoma can be challenging. Many patients have clinically equivocal lesions in cosmetically sensitive areas or have multiple suspicious lesions. Epidermal genetic information retrieval is a noninvasive diagnostic method involving the application of adhesive tape onto the skin's surface to recover genomic material from the epidermis. This genomic material can then be used in assays to determine gene expression profiles. Studies have shown the potential of this technology to aid clinicians in differentiating between melanomas and nevi. Although this technology is not meant to replace a biopsy, it can help guide the decision whether to biopsy.

2 Review Application of Handheld Confocal Microscopy for Skin Cancer Diagnosis: Advantages and Limitations Compared with the Wide-Probe Confocal. 2016

Que, Syril Keena T / Grant-Kels, Jane M / Rabinovitz, Harold S / Oliviero, Margaret / Scope, Alon. ·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. · Department of Dermatology, University of Miami School of Medicine, 1295 NW 14th St., University of Miami South Bldg., Suites K-M, Miami, FL 33125, USA. · Department of Dermatology, Sheba Medical Center, Tel Hashomer, Ramat Gan 5262000, Affiliated with the Sackler School of Medicine, Tel Aviv University, Ramat Gan 52621, Israel. ·Dermatol Clin · Pubmed #27692452.

ABSTRACT: The clinical diagnosis of tumors on the curved surfaces of the face, around the eyes, and on the mucosal surfaces can be difficult, while biopsies and excisions can have functional and aesthetic consequences. To avoid unnecessary surgery, clinicians have been aiming to attain accurate noninvasive diagnosis of lesions at these sites. However, acquisition of high-quality images with dermoscopy and with traditional wide-probe reflectance confocal microscopy (WP-RCM) have been hampered with technical difficulties. This article discusses the technical parameters of the handheld reflectance confocal microscope and discusses its advantages and limitations compared with the WP-RCM.

3 Review Through the looking glass: Basics and principles of reflectance confocal microscopy. 2015

Que, Syril Keena T / Fraga-Braghiroli, Naiara / Grant-Kels, Jane M / Rabinovitz, Harold S / Oliviero, Margaret / Scope, Alon. ·Department of Dermatology at the University of Connecticut Health Center, Farmington, Connecticut. Electronic address: keenaq@gmail.com. · Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida. · Department of Dermatology at the University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York. ·J Am Acad Dermatol · Pubmed #26051696.

ABSTRACT: Reflectance confocal microscopy (RCM) offers high-resolution, noninvasive skin imaging and can help avoid obtaining unnecessary biopsy specimens. It can also increase efficiency in the surgical setting by helping to delineate tumor margins. Diagnostic criteria and several RCM algorithms have been published for the differentiation of benign and malignant neoplasms. We provide an overview of the basic principles of RCM, characteristic RCM features of normal skin and cutaneous neoplasms, and the limitations and future directions of RCM.

4 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.

5 Review Dermoscopy research--an update. 2009

Braun, Ralph P / Rabinovitz, H / Tzu, J E / Marghoob, A A. ·Skin Cancer Diagnosis and Prevention Centre, Department of Dermatology, University Hospital, Zürich, Switzerland. Ralph.Braun@usc.ch ·Semin Cutan Med Surg · Pubmed #19782940.

ABSTRACT: Dermoscopy increases the clinician's diagnostic accuracy by as much as 30% over that of unaided visual clinical inspection alone and has been confirmed in 3 separate evidence-based publications using a meta-analysis of the literature. It can be viewed as an in vivo bridge between clinical morphology and histopathology. This "bridge" has provided clinician researchers with many new insights into morphology and tumor biology. In this article, we provide the reader with an overview of the different aspects of dermoscopy as a research tool. We cover different aspects, such as the new equipment, new structures, the importance of blood vessels, etc.

6 Review Dermoscopy of superficial spreading melanoma. 2009

Obieta, M P / Braun, R P / Scope, A / Rabinovitz, H / Marghoob, A A. ·Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA. ·G Ital Dermatol Venereol · Pubmed #19218911.

ABSTRACT: Knowledge and insights gained over the past few decades pertaining to the clinical and dermoscopic primary morphology of melanoma has greatly increased the authors' appreciation of the varied faces of this malignancy. This knowledge has improved their ability to detect early melanoma and may in part explain the observed increase in the percentage of thin melanomas being diagnosed today as compared to the past. The authors have previously published in this journal an article on the dermoscopic patterns of melanoma. In this review they will focus on specific dermoscopic structures that are frequently observed in the most common subtype of melanoma, the superficial spreading melanoma.

7 Clinical Trial The performance of MelaFind: a prospective multicenter study. 2011

Monheit, Gary / Cognetta, Armand B / Ferris, Laura / Rabinovitz, Harold / Gross, Kenneth / Martini, Mary / Grichnik, James M / Mihm, Martin / Prieto, Victor G / Googe, Paul / King, Roy / Toledano, Alicia / Kabelev, Nikolai / Wojton, Maciej / Gutkowicz-Krusin, Dina. ·Total Skin and Beauty Dermatology, Birmingham, Alabama, USA. ·Arch Dermatol · Pubmed #20956633.

ABSTRACT: OBJECTIVE: To demonstrate the safety and effectiveness of MelaFind, a noninvasive and objective computer-vision system designed to aid in detection of early pigmented cutaneous melanoma. DESIGN: A prospective, multicenter, blinded study. The diagnostic performance of MelaFind and of study clinicians was evaluated using the histologic reference standard. Standard images and patient information for a subset of 50 randomly selected lesions (25 melanomas) were used in a reader study of 39 independent dermatologists to estimate clinicians' biopsy sensitivity to melanoma. SETTING: Three academic and 4 community practices in the United States with expertise in management of pigmented skin lesions. PATIENTS: A total of 1383 patients with 1831 lesions enrolled from January 2007 to July 2008; 1632 lesions (including 127 melanomas-45% in situ-with median Breslow thickness of invasive lesions, 0.36 mm) were eligible and evaluable for the study end points. MAIN OUTCOME MEASURES: Sensitivity of MelaFind; specificities and biopsy ratios for MelaFind and the study investigators; and biopsy sensitivities of independent dermatologists in the reader study. RESULTS: The measured sensitivity of MelaFind was 98.4% (125 of 127 melanomas) with a 95% lower confidence bound at 95.6% and a biopsy ratio of 10.8:1; the average biopsy sensitivity of dermatologists was 78% in the reader study. Including borderline lesions (high-grade dysplastic nevi, atypical melanocytic proliferations, or hyperplasias), MelaFind's sensitivity was 98.3% (172 of 175), with a biopsy ratio of 7.6:1. On lesions biopsied mostly to rule out melanoma, MelaFind's average specificity (9.9%) was superior to that of clinicians (3.7%) (P=.02). CONCLUSION: MelaFind is a safe and effective tool to assist in the evaluation of pigmented skin lesions. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00434057.

8 Clinical Trial Accuracy of teledermatology for pigmented neoplasms. 2009

Warshaw, Erin M / Lederle, Frank A / Grill, Joseph P / Gravely, Amy A / Bangerter, Ann K / Fortier, Lawrence A / Bohjanen, Kimberly A / Chen, Karen / Lee, Peter K / Rabinovitz, Harold S / Johr, Robert H / Kaye, Valda N / Bowers, Sacharitha / Wenner, Rachel / Askari, Sharone K / Kedrowski, Deborah A / Nelson, David B. ·Minneapolis Veterans Affairs Medical Center, Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota, USA. erin.warshaw@med.va.gov ·J Am Acad Dermatol · Pubmed #19679375.

ABSTRACT: BACKGROUND: Accurate diagnosis and management of pigmented lesions is critical because of the morbidity and mortality associated with melanoma. OBJECTIVE: We sought to compare accuracy of store-and-forward teledermatology for pigmented neoplasms with standard, in-person clinic dermatology. METHODS: We conducted a repeated measures equivalence trial involving veterans with pigmented skin neoplasms. Each lesion was evaluated by a clinic dermatologist and a teledermatologist; both generated a primary diagnosis, up to two differential diagnoses, and a management plan. The primary outcome was aggregated diagnostic accuracy (match of any chosen diagnosis with histopathology). We also compared the severity of inappropriately managed lesions and, for teledermatology, evaluated the incremental change in accuracy when polarized light dermatoscopy or contact immersion dermatoscopy images were viewed. RESULTS: We enrolled 542 patients with pigmented lesions, most were male (96%) and Caucasian (97%). The aggregated diagnostic accuracy rates for teledermatology (macro images, polarized light dermatoscopy, and contact immersion dermatoscopy) were not equivalent (95% confidence interval for difference within +/-10%) and were inferior (95% confidence interval lower bound <10%) to clinic dermatology. In general, the addition of dermatoscopic images did not significantly change teledermatology diagnostic accuracy rates. In contrast to diagnostic accuracy, rates of appropriate management plans for teledermatology were superior and/or equivalent to clinic dermatology (all image types: all lesions, and benign lesions). However, for the subgroup of malignant lesions (n = 124), the rate of appropriate management was significantly worse for teledermatology than for clinic dermatology (all image types). Up to 7 of 36 index melanomas would have been mismanaged via teledermatology. LIMITATIONS: Nondiverse study population and relatively small number of melanomas were limitations. CONCLUSIONS: In general, the diagnostic accuracy of teledermatology was inferior whereas management was equivalent to clinic dermatology. However, for the important subgroup of malignant pigmented lesions, both diagnostic and management accuracy of teledermatology was generally inferior to clinic dermatology and up to 7 of 36 index melanomas would have been mismanaged via teledermatology. Teledermatology and teledermatoscopy should be used with caution for patients with suspected malignant pigmented lesions.

9 Article Reflectance confocal microscopy features of melanomas on the body and non-glabrous chronically sun-damaged skin. 2018

Shahriari, Neda / Grant-Kels, Jane M / Rabinovitz, Harold / Oliviero, Margaret / Scope, Alon. ·Department of Internal Medicine, St. Mary's Hospital, Waterbury, Connecticut. · Department of Dermatology, UCONN Health Center, Farmington, Connecticut. · Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida. · Sheba Medical Center and Sackler Faculty of Medicine, Medical Screening Institute, Tel Aviv University, Tel Aviv, Israel. ·J Cutan Pathol · Pubmed #29971811.

ABSTRACT: BACKGROUND: Melanoma remains a challenge to diagnose, especially when appearing on the background of chronically sun-damaged skin (CSDS). Our goal was to identify and quantify the reflectance confocal microscopy (RCM) features of melanoma on non-facial CSDS. METHODS: Included lesions were biopsy-proven melanomas, from anatomic sites other than the face, neck, scalp and acral skin, with histopathologic finding of solar elastosis in the underlying dermis. All included lesions underwent clinical, dermoscopic and RCM imaging, obtained in a standardized fashion, prior to biopsy. All images were retrospectively analyzed by four observers. RESULTS: We identified 33 melanomas from 33 patients with 63.6% male patients and overall mean age of 72.8 years. The salient RCM features included an atypical honeycomb or disarranged epidermal pattern (81.8%), pagetoid infiltration of the epidermis by both round and/or dendritic melanocytes (100%), focal proliferation of predominantly dendritic melanocytes as sheets (78.8%), foci with non-edged papillae (84.8%), junctional thickening (60.6%), areas of irregular ring or meshwork pattern (78.8%), and underlying thickened collagen bundles (51.5%). CONCLUSION: Non-facial CSDS melanomas share features similar to other melanoma types including pagetoid cells and non-edged papillae. The focal proliferation of dendritic pagetoid cells in sheets is similar to that seen in facial CSDS melanomas.

10 Article Validity and Reliability of Dermoscopic Criteria Used to Differentiate Nevi From Melanoma: A Web-Based International Dermoscopy Society Study. 2016

Carrera, Cristina / Marchetti, Michael A / Dusza, Stephen W / Argenziano, Giuseppe / Braun, Ralph P / Halpern, Allan C / Jaimes, Natalia / Kittler, Harald J / Malvehy, Josep / Menzies, Scott W / Pellacani, Giovanni / Puig, Susana / Rabinovitz, Harold S / Scope, Alon / Soyer, H Peter / Stolz, Wilhelm / Hofmann-Wellenhof, Rainer / Zalaudek, Iris / Marghoob, Ashfaq A. ·Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York2Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatology Unit, Second University of Naples, Naples, Italy. · Department of Dermatology, University Hospital Zürich, Zürich, Switzerland. · Dermatology Service, Aurora Skin Cancer Center, Universidad Pontificia Bolivariana, Medellín, Colombia. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. · Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Centro de Investigacion Biomedica en red de enfermedades raras, Barcelona, Spain. · Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Australia8Discipline of Dermatology, The University of Sydney, New South Wales, Australia. · Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Skin and Cancer Associates, Plantation, Florida. · Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Dermatology Research Centre, The University of Queensland, Brisbane, Queensland, Australia13School of Medicine, Translational Research Institute, Brisbane, Queensland, Australia. · Clinic for Dermatology, Allergology, and Environmental Medicine, Klinik Thalkirchner Straße Städt, Klinikum München GmbH, Munich, Germany. · Department of Dermatology, Medical University of Graz, Graz, Austria. ·JAMA Dermatol · Pubmed #27074267.

ABSTRACT: IMPORTANCE: The comparative diagnostic performance of dermoscopic algorithms and their individual criteria are not well studied. OBJECTIVES: To analyze the discriminatory power and reliability of dermoscopic criteria used in melanoma detection and compare the diagnostic accuracy of existing algorithms. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, observational study of 477 lesions (119 melanomas [24.9%] and 358 nevi [75.1%]), which were divided into 12 image sets that consisted of 39 or 40 images per set. A link on the International Dermoscopy Society website from January 1, 2011, through December 31, 2011, directed participants to the study website. Data analysis was performed from June 1, 2013, through May 31, 2015. Participants included physicians, residents, and medical students, and there were no specialty-type or experience-level restrictions. Participants were randomly assigned to evaluate 1 of the 12 image sets. MAIN OUTCOMES AND MEASURES: Associations with melanoma and intraclass correlation coefficients (ICCs) were evaluated for the presence of dermoscopic criteria. Diagnostic accuracy measures were estimated for the following algorithms: the ABCD rule, the Menzies method, the 7-point checklist, the 3-point checklist, chaos and clues, and CASH (color, architecture, symmetry, and homogeneity). RESULTS: A total of 240 participants registered, and 103 (42.9%) evaluated all images. The 110 participants (45.8%) who evaluated fewer than 20 lesions were excluded, resulting in data from 130 participants (54.2%), 121 (93.1%) of whom were regular dermoscopy users. Criteria associated with melanoma included marked architectural disorder (odds ratio [OR], 6.6; 95% CI, 5.6-7.8), pattern asymmetry (OR, 4.9; 95% CI, 4.1-5.8), nonorganized pattern (OR, 3.3; 95% CI, 2.9-3.7), border score of 6 (OR, 3.3; 95% CI, 2.5-4.3), and contour asymmetry (OR, 3.2; 95% CI, 2.7-3.7) (P < .001 for all). Most dermoscopic criteria had poor to fair interobserver agreement. Criteria that reached moderate levels of agreement included comma vessels (ICC, 0.44; 95% CI, 0.40-0.49), absence of vessels (ICC, 0.46; 95% CI, 0.42-0.51), dark brown color (ICC, 0.40; 95% CI, 0.35-0.44), and architectural disorder (ICC, 0.43; 95% CI, 0.39-0.48). The Menzies method had the highest sensitivity for melanoma diagnosis (95.1%) but the lowest specificity (24.8%) compared with any other method (P < .001). The ABCD rule had the highest specificity (59.4%). All methods had similar areas under the receiver operating characteristic curves. CONCLUSIONS AND RELEVANCE: Important dermoscopic criteria for melanoma recognition were revalidated by participants with varied experience. Six algorithms tested had similar but modest levels of diagnostic accuracy, and the interobserver agreement of most individual criteria was poor.

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

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

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

12 Article Skin Cancer Diagnosis With Reflectance Confocal Microscopy: Reproducibility of Feature Recognition and Accuracy of Diagnosis. 2015

Farnetani, Francesca / Scope, Alon / Braun, Ralph P / Gonzalez, Salvador / Guitera, Pascale / Malvehy, Josep / Manfredini, Marco / Marghoob, Ashfaq A / Moscarella, Elvira / Oliviero, Margaret / Puig, Susana / Rabinovitz, Harold S / Stanganelli, Ignazio / Longo, Caterina / Malagoli, Carlotta / Vinceti, Marco / Pellacani, Giovanni. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Sheba Medical Center, Department of Dermatology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel3Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. · Internal Medicine Department, Alcala University, Madrid, Spain. · Melanoma Institute Australia, The University of Sydney, Sydney7Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, Australia. · Melanoma Unit, Dermatology Department, Hospital Clinic and University of Barcelona, Institut de Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain9Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III. · Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova-Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy. · Department of Dermatology and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida. · Skin Cancer Unit-Istituto di Ricovero e Cura a Carattere Scientifico Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Forlì-Cesena, Italy. · Center for Environmental, Genetic, and Nutritional Epidemiology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy. ·JAMA Dermatol · Pubmed #25993262.

ABSTRACT: IMPORTANCE: Reflectance confocal microscopy (RCM) studies have been performed to identify criteria for diagnosis of skin neoplasms. However, RCM-based diagnosis is operator dependent. Hence, reproducibility of RCM criteria needs to be tested. OBJECTIVE: To test interobserver reproducibility of recognition of previously published RCM descriptors and accuracy of RCM-based skin cancer diagnosis. DESIGN, SETTING, AND PARTICIPANTS: Observational retrospective web-based study of a set of RCM images collected at a tertiary academic medical center. Nine dermatologists (6 of whom had ≥3 years of RCM experience) from 6 countries evaluated an RCM study set from 100 biopsy-proven lesions, including 55 melanocytic nevi, 20 melanomas, 15 basal cell carcinomas, 7 solar lentigines or seborrheic keratoses, and 3 actinic keratoses. Between June 15, 2010, and October 21, 2010, participanting dermatologists, blinded to histopathological diagnosis, evaluated 3 RCM mosaic images per lesion for the presence of predefined RCM descriptors. MAIN OUTCOMES AND MEASURES: The main outcome was identification of RCM descriptors with fair to good interrater agreement (κ statistic, ≥0.3) and independent correlation with malignant vs benign diagnosis on discriminant analysis. Additional measures included sensitivity and specificity for diagnosis of malignant vs benign for each evaluator, for majority diagnosis (rendered by ≥5 of 9 evaluators), and for experienced vs recent RCM users. RESULTS: Eight RCM descriptors showed fair to good reproducibility and were independently associated with a specific diagnosis. Of these, the presence of pagetoid cells, atypical cells at the dermal-epidermal junction, and irregular epidermal architecture were associated with melanoma. Aspecific junctional pattern, basaloid cords, and ulceration were associated with basal cell carcinomas. Ringed junctional pattern and dermal nests were associated with nevi. The mean sensitivity for the group of evaluators was 88.9% (range, 82.9%-100%), and the mean specificity was 79.3% (range, 69.2%-90.8%). Majority diagnosis showed sensitivity of 100% and specificity of 80.0%. Sensitivity was higher for experienced vs recent RCM users (91.0% vs. 84.8%), but specificity was similar (80.0% vs. 77.9%). CONCLUSIONS AND RELEVANCE: The study highlights key RCM diagnostic criteria for melanoma and basal cell carcinoma that are reproducibly recognized among RCM users. Diagnostic accuracy increases with experience. The higher accuracy of majority diagnosis suggests that there is intrinsically more diagnostic information in RCM images than is currently used by individual evaluators.

13 Article Clinical and dermoscopic characteristics of melanomas on nonfacial chronically sun-damaged skin. 2015

Jaimes, Natalia / Marghoob, Ashfaq A / Rabinovitz, Harold / Braun, Ralph P / Cameron, Alan / Rosendahl, Cliff / Canning, Greg / Keir, Jeffrey. ·Dermatology Service, Aurora Skin Cancer Center and Universidad Pontificia Bolivariana, Medellín, Colombia. · Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York. · Skin and Cancer Associates, Plantation, Florida. · Department of Dermatology, University Hospital Zürich, Zürich, Switzerland. · School of Medicine, The University of Queensland, Brisbane, Australia. · Hermit Park Clinic and Skin Cancer Care, Townsville, Australia. · Northern Rivers Skin Cancer Clinic, Ballina, Australia. Electronic address: jkballina@gmail.com. ·J Am Acad Dermatol · Pubmed #25824275.

ABSTRACT: BACKGROUND: Melanomas on chronically sun-damaged skin (CSDS) can be difficult to identify and often manifest morphologic features that overlap with benign lesions. OBJECTIVE: We describe and analyze the clinical and dermoscopic characteristics of melanomas on nonfacial CSDS. METHODS: Melanoma cases on nonfacial CSDS were retrospectively identified from the biopsy specimen logs of 6 melanoma clinics. Clinical and dermoscopic images were combined into 1 database. Demographics, clinical, dermoscopic, and histopathologic information were analyzed. Descriptive frequencies were calculated. RESULTS: One hundred eighty-six cases met the inclusion criteria: 142 melanomas in situ (76%) and 39 invasive (21%; mean thickness, 0.49 mm). Lentigo maligna was the most common histopathologic subtype (n = 76; 40.9%). The most frequent dermoscopic structures were granularity (n = 126; 67.7%) and angulated lines (n = 82; 44%). Vascular structures were more frequent in invasive melanomas (56% vs 12% of in situ melanomas). Most manifested 1 of 3 dermoscopic patterns: patchy peripheral pigmented islands, angulated lines, and tan structureless with granularity pattern. LIMITATIONS: This was a retrospective study, and evaluators were not blinded to the diagnosis. In addition, interobserver concordance and sensitivity and specificity for dermoscopic structures were not evaluated. CONCLUSION: Outlier lesions manifesting dermoscopic structures, such as granularity, angulated lines, or vessels and any of the 3 described dermoscopic patterns should raise suspicion for melanoma.

14 Article Age, gender, and topography influence the clinical and dermoscopic appearance of lentigo maligna. 2015

Tiodorovic-Zivkovic, Danica / Argenziano, Giuseppe / Lallas, Aimilios / Thomas, Luc / Ignjatovic, Aleksandra / Rabinovitz, Harold / Moscarella, Elvira / Longo, Caterina / Hofmann-Wellenhof, Rainer / Zalaudek, Iris. ·Clinic of Dermatovenereology, Clinical Center of Nis Medical Faculty, University of Nis, Nis, Serbia. · Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico), Reggio Emilia, Italy. · Lyon 1 University, Dermatology Department, Centre Hospitalier Lyon Sud, Lyon, France. · Department of Medical Statistics, Faculty of Medicine, University of Nis, Nis, Serbia. · Skin and Cancer Associates, Plantation, Florida. · Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria. · Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria. Electronic address: iris.zalaudek@gmail.com. ·J Am Acad Dermatol · Pubmed #25774013.

ABSTRACT: BACKGROUND: Little is known about the frequency of clinical and dermoscopic patterns of lentigo maligna (LM) in relation to specific anatomic subsites and patients characteristics. OBJECTIVE: We sought to assess the frequency of clinical and dermoscopic features of LM and to correlate them to specific anatomic subsites, and patients' age and gender. METHODS: This was a retrospective analysis of clinical and dermoscopic images of a series of consecutive, histopathologically diagnosed, facial and extrafacial LM. RESULTS: A total of 201 cases from 200 patients (mean age 69.51 ± 12.26 years) including 120 women were collected. Most cases were located on the face (n = 192, 95.5%). In 102 cases, LM presented as clinically solitary facial macule (s/LM), whereas it was associated with multiple surrounding freckles in the remaining cases. s/LM were significantly smaller (<10 vs >10 mm; P = .020) and associated with younger age compared with LM associated with multiple surrounding freckles (mean age 67.73 ± 12.68 years vs 71.34 ± 11.59 years, respectively; P = .036). Dermoscopically, gray color irrespective of a specific pattern was the most prevalent finding seen in 178 (88.6%) cases. LIMITATIONS: This was a retrospective study. CONCLUSIONS: The knowledge about patient age, patient gender, and site-related clinical features of LM associated with gray color upon dermoscopy may enhance the clinical recognition of LM.

15 Article Accuracy of in vivo confocal microscopy for diagnosis of basal cell carcinoma: a comparative study between handheld and wide-probe confocal imaging. 2015

Castro, R P / Stephens, A / Fraga-Braghiroli, N A / Oliviero, M C / Rezze, G G / Rabinovitz, H / Scope, A. ·Department of Cutaneous Oncology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil. · Skin and Cancer Associations, Plantation, FL, USA. · Dermatology Department, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel. · Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. ·J Eur Acad Dermatol Venereol · Pubmed #25338750.

ABSTRACT: BACKGROUND: Reflectance confocal microscopy (RCM) increases specificity of identification of basal cell carcinoma (BCC). A smaller-diameter handheld RCM (HH-RCM) allows better access to limited anatomic locations. OBJECTIVE: To compare accuracy of HH-RCM in identification of BCC to that of traditional wide-probe RCM (TWP-RCM). METHODS: Patients presenting at least one lesion clinically and dermoscopically suspicious for BCC, were recruited from two dermatology skin cancer clinics. Prior to excision, we attempted to image all lesions with HH-RCM and TWP-RCM using a standardized protocol. RCM images were retrospectively evaluated, jointly by two blinded readers. For purposes of comparative RCM, sensitivity and specificity analysis, we used a threshold of ≥3 RCM criteria to identify BCC, whereby at least one criterion had to be presence of 'dark silhouettes' or 'bright tumor islands'. RESULTS: Among 54 lesions imaged with both RCM devices, 45 were biopsy-proven BCCs. Comparison between TWP-RCM vs. HH-RCM was as follows: sensitivity (100% vs. 93%), specificity (78% for both probes), positive predictive value (96% vs. 95%), and negative predictive value (100% vs. 70%) respectively. Notably, both TWP-RCM and HH-RCM demonstrated the presence of 'dark silhouettes' or 'bright tumor islands' in all 45 BCCs. CONCLUSION: Both RCM probes demonstrate high PPV. TWP-RCM shows higher NPV, since its broader field-of-view probably allows more exhaustive search for BCC criteria. The RCM criteria threshold for BCC identification should be further tested.

16 Article Clinical performance of the Nevisense system in cutaneous melanoma detection: an international, multicentre, prospective and blinded clinical trial on efficacy and safety. 2014

Malvehy, J / Hauschild, A / Curiel-Lewandrowski, C / Mohr, P / Hofmann-Wellenhof, R / Motley, R / Berking, C / Grossman, D / Paoli, J / Loquai, C / Olah, J / Reinhold, U / Wenger, H / Dirschka, T / Davis, S / Henderson, C / Rabinovitz, H / Welzel, J / Schadendorf, D / Birgersson, U. ·Department of Dermatology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain. ·Br J Dermatol · Pubmed #24841846.

ABSTRACT: BACKGROUND: Even though progress has been made, the detection of melanoma still poses a challenge. In light of this situation, the Nevisense electrical impedance spectroscopy (EIS) system (SciBase AB, Stockholm, Sweden) was designed and shown to have the potential to be used as an adjunct diagnostic tool for melanoma detection. OBJECTIVES: To assess the effectiveness and safety of the Nevisense system in the distinction of benign lesions of the skin from melanoma with electrical impedance spectroscopy. METHODS: This multicentre, prospective, and blinded clinical study was conducted at five American and 17 European investigational sites. All eligible skin lesions in the study were examined with the EIS-based Nevisense system, photographed, removed by excisional biopsy and subjected to histopathological evaluation. A postprocedure clinical follow-up was conducted at 7 ± 3 days from the initial measurement. A total of 1951 patients with 2416 lesions were enrolled into the study; 1943 lesions were eligible and evaluable for the primary efficacy end point, including 265 melanomas - 112 in situ and 153 invasive melanomas with a median Breslow thickness of 0·57 mm [48 basal cell carcinomas (BCCs) and seven squamous cell carcinomas (SCCs)]. RESULTS: The observed sensitivity of Nevisense was 96·6% (256 of 265 melanomas) with an exact one-sided 95% lower confidence bound estimated at 94·2% and an observed specificity of 34·4%, and an exact two-sided 95% confidence bound estimated at 32·0-36·9%. The positive and negative predictive values of Nevisense were 21·1% and 98·2%, respectively. The observed sensitivity for nonmelanoma skin cancer was 100% (55 of 48 BCCs and seven SCCs) with an exact two-sided 95% confidence bound estimated at 93·5-100·0%. CONCLUSIONS: Nevisense is an accurate and safe device to support clinicians in the detection of cutaneous melanoma.

17 Article Fuzzy logic color detection: Blue areas in melanoma dermoscopy images. 2014

Lingala, Mounika / Stanley, R Joe / Rader, Ryan K / Hagerty, Jason / Rabinovitz, Harold S / Oliviero, Margaret / Choudhry, Iqra / Stoecker, William V. ·Department of Electrical and Computer Engineering, Missouri University of Science and Technology, G20 Emerson Electric Company Hall, 301 West 16th Street, Rolla, MO 65409-0040, United States. Electronic address: ml427@mst.edu. · Department of Electrical and Computer Engineering, Missouri University of Science and Technology, 127 Emerson Electric Company Hall, 301 West 16th Street, Rolla, MO 65409-0040, United States. Electronic address: stanleyj@mst.edu. · Stoecker & Associates, LLC 10101 Stoltz Drive Rolla, MO 65401-7714, United States. Electronic address: rkrc5b@health.missouri.edu. · Stoecker & Associates, LLC 10101 Stoltz Drive Rolla, MO 65401-7714, United States. Electronic address: hagerty.jason@gmail.com. · Skin & Cancer Associates, 201 NW 82nd Avenue, Suite 501, Plantation, FL 33324, United States. Electronic address: harold@admcorp.com. · Skin & Cancer Associates, 201 NW 82nd Avenue, Suite 501, Plantation, FL 33324, United States. Electronic address: maggie@admcorp.com. · Stoecker & Associates, LLC 10101 Stoltz Drive Rolla, MO 65401-7714, United States. Electronic address: iqrachowder@live.com. · Stoecker & Associates, LLC 10101 Stoltz Drive Rolla, MO 65401-7714, United States. Electronic address: wvs@mst.edu. ·Comput Med Imaging Graph · Pubmed #24786720.

ABSTRACT: Fuzzy logic image analysis techniques were used to analyze three shades of blue (lavender blue, light blue, and dark blue) in dermoscopic images for melanoma detection. A logistic regression model provided up to 82.7% accuracy for melanoma discrimination for 866 images. With a support vector machines (SVM) classifier, lower accuracy was obtained for individual shades (79.9-80.1%) compared with up to 81.4% accuracy with multiple shades. All fuzzy blue logic alpha cuts scored higher than the crisp case. Fuzzy logic techniques applied to multiple shades of blue can assist in melanoma detection. These vector-based fuzzy logic techniques can be extended to other image analysis problems involving multiple colors or color shades.

18 Article Dark homogeneous streak dermoscopic pattern correlating with specific KIT mutations in melanoma. 2014

Sanchez, Margaret I / Rabinovitz, Harold S / Oliviero, Margaret C / Elgart, George W / Perez, Carmen / Puig, Susana / Malvehy, Josep / Grichnik, James M. ·Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida. · Melanoma Unit, Dermatology Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain3CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain. ·JAMA Dermatol · Pubmed #24695820.

ABSTRACT: IMPORTANCE: Mutations driving melanoma growth have diagnostic, prognostic, and therapeutic implications. Traditional classification systems do not correlate optimally with underlying melanoma growth-promoting mutations. Our objective was to determine whether unique dermoscopic growth patterns directly correlate with driving mutations. OBSERVATIONS: We evaluated common driving mutations in 4 different dermoscopic patterns (rhomboidal, negative pigmented network, polygonal, and dark homogeneous streaks) of primary cutaneous melanomas; 3 melanomas per pattern were tested. Three of the 4 patterns lacked common mutations in BRAF, NRAS, KIT, GNAQ, and HRAS. One pattern, the dark homogeneous streaks pattern, had unique KIT mutations in the second catalytic domain of KIT in exon 17 for all 3 samples tested. Two tumors with the dark homogeneous streaks pattern turned out to be different primary melanomas from the same patient and had different sequence mutations but had an impact on the same KIT domain. CONCLUSIONS AND RELEVANCE: While future study is required, these results have multiple implications. (1) The underlying melanoma-driving mutations may give rise to specific dermoscopic growth patterns, (2) BRAF/NRAS mutations in early melanomas may not be as common as previously thought, and (3) patients may be predisposed to developing specific driving mutations giving rise to melanomas or nevi of similar growth patterns.

19 Article Dermoscopy of acral melanoma: a multicenter study on behalf of the international dermoscopy society. 2013

Braun, Ralph P / Thomas, L / Dusza, S W / Gaide, O / Menzies, S / Dalle, S / Blum, A / Argenziano, G / Zalaudek, I / Kopf, A / Rabinovitz, H / Oliviero, M / Perrinaud, A / Cabo, H / Pizzichetta, M / Pozo, L / Langford, D / Tanaka, M / Saida, T / Perusquia Ortiz, A M / Kreusch, J / De Giorgi, V / Piccolo, D / Grichnik, J M / Kittler, H / Puig, S / Malvehy, J / Seidenari, S / Stanganelli, I / French, L / Marghoob, A A. ·Department of Dermatology, University Hospital Zürich, Zürich, Switzerland. ·Dermatology · Pubmed #24296632.

ABSTRACT: BACKGROUND: Most studies on dermoscopy of acral lesions were conducted in Asian populations. In this study, we analyzed these features in a predominantly Caucasian population. OBJECTIVE: Estimate the prevalence of dermoscopic features in acral lesions, and assess their level of agreement between observers. METHODS: In this retrospective multicenter study, 167 acral lesions (66 melanomas) were evaluated for 13 dermoscopic patterns by 26 physicians, via a secured Internet platform. RESULTS: Parallel furrow pattern, bizarre pattern, and diffuse pigmentation with variable shades of brown had the highest prevalence. The agreement for lesion patterns between physicians was variable. Agreement was dependent on the level of diagnostic difficulty. CONCLUSION: Lesions with a diameter >1 cm were more likely to be melanoma. We found as well that a benign pattern can be seen in parts of melanomas. For this reason one should evaluate an acral lesion for the presence of malignant patterns first.

20 Article Dermoscopic evaluation of nodular melanoma. 2013

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

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

21 Article Multiple primary melanomas: do they look the same? 2013

Moscarella, E / Rabinovitz, H / Puig, S / Zalaudek, I / Oliviero, M C / Brown, L / Alarcon, I / Malvehy, J / Longo, C / Formisano, D / Carrera, C / Badenas, C / Piana, S / Albertini, G / Pellacani, G / Argenziano, G. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. ·Br J Dermatol · Pubmed #23374221.

ABSTRACT: BACKGROUND: A series of studies has investigated epidemiological, clinical and genetic characteristics of patients with multiple primary melanoma (MPM). However, comparison of the clinical and dermoscopic features of MPM within a given individual has been described only in case reports. OBJECTIVES: To describe the dermoscopic features of MPM for each given patient, and to evaluate the characteristics eventually associated with similar or dissimilar appearance. METHODS: From the databases of three skin-lesion clinics in the U.S.A., Italy and Spain we collected the dermoscopic images of melanomas in patients diagnosed with MPM. RESULTS: Among 58 patients with MPM, we found that 53% of patients had dermoscopically similar melanomas and 47% of patients had dermoscopically different melanomas. In older patients 59% of melanomas were dermoscopically similar vs. 47% in younger patients (P=0·377). Similar thickness was associated with the occurrence of dermoscopically similar melanomas (19/30 cases, 63%; P=0·039). Most (65%) of the synchronous lesions were similar, compared with 36% of nonsynchronous lesions (P=0·029), and most (69%) of the melanomas on sun-damaged skin were similar, vs. 37% of melanomas on nonsun-damaged skin (P=0·015; odds ratio 3·88, 95% confidence interval 1·11-13·98). The percentage of dermoscopically different melanomas was higher in patients with a family history of melanoma (67% vs. 48%). CONCLUSIONS: MPMs in a given patient have almost the same chance of looking dermoscopically similar or different. However, a subset of elderly patients with sun-damaged skin may present multiple, similar, thin melanomas characterized by pigment-network and regression structures.

22 Article Negative pigment network: an additional dermoscopic feature for the diagnosis of melanoma. 2013

Pizzichetta, Maria A / Talamini, Renato / Marghoob, Ash A / Soyer, H Peter / Argenziano, Giuseppe / Bono, Riccardo / Corradin, M Teresa / De Giorgi, Vincenzo / Gonzalez, Marian A / Kolm, Isabel / Kopf, Andrew W / Malvehy, Joseph / Nami, Niccolò / Oliviero, Margaret / Pellacani, Giovanni / Puig, Susana / Rabinovitz, Harold / Rubegni, Pietro / Seidenari, Stefania / Stanganelli, Ignazio / Veronesi, Andrea / Zalaudek, Iris / Zampieri, Pierfrancesco / Menzies, Scott W. ·Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy. Electronic address: pizzichetta@cro.it. · Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy. · Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatology Research Center, University of Queensland, School of Medicine, Princess Alexandra Hospital, Brisbane, Australia. · Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS), Reggio Emilia, Italy. · Istituto Dermopatico Immacolata, IRCCS, Rome, Italy. · Division of Dermatology, Pordenone Hospital, Pordenone, Italy. · Department of Dermatology, University of Florence, Florence, Italy. · Division of Dermatology, Merano Hospital, Merano, Italy. · Department of Dermatology, University of Miami, Miami, Florida. · New York University School of Medicine, New York, New York. · Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain. · Department of Dermatology, University of Siena, Siena, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy. · Skin Cancer Unit, Istituto Tumori Romagna, Meldola, Italy. · Medical University of Graz, Graz, Austria. · Sydney Melanoma Diagnostic Center, Royal Prince Alfred Hospital and Discipline of Dermatology, University of Sydney, Sydney, Australia. ·J Am Acad Dermatol · Pubmed #23062610.

ABSTRACT: BACKGROUND: The negative pigment network (NPN) is seen as a negative of the pigmented network and it is purported to be a melanoma-specific structure. OBJECTIVES: We sought to assess the frequency, sensitivity, specificity, and odds ratios (ORs) of NPN between melanoma cases and a group of control lesions. METHODS: Digitalized images of skin lesions from 679 patients with histopathological diagnosis of dermatofibroma (115), melanocytic nevus (220), Spitz nevus (139), and melanoma (205) were retrospectively collected and blindly evaluated to assess the presence/absence of NPN. RESULTS: The frequency of occurrence of NPN was higher in the melanoma group (34.6%) than in Spitz nevus (28.8%), melanocytic nevus (18.2%), and dermatofibroma (11.3%) groups. An OR of 1.8 emerged for the diagnosis of melanoma in the presence of NPN as compared with nonmelanoma diagnosis. Conversely, for melanocytic nevi and dermatofibromas the OR was very low (0.5 and 0.3, respectively). For Spitz nevi the OR of 1.1 was not statistically significant. When comparing melanoma with dermatofibroma, melanocytic nevus, and Spitz nevus, we observed a significantly higher frequency of multicomponent pattern (68.1%), asymmetric pigmentation (92.9%), irregularly distributed NPN (87.3%), and peripheral location of NPN (66.2%) in melanomas. LIMITATIONS: Further studies can provide the precise dermoscopic-histopathologic correlation of NPN in melanoma and other lesions. CONCLUSIONS: The overall morphologic pattern of NPN, such as the irregular distribution and the peripheral location of NPN, along with the multicomponent pattern and the asymmetric pigmentation could be used as additional features in distinguishing melanoma from Spitz nevus and other benign lesions.

23 Article Confocal microscopy of challenging dermoscopic diagnoses. 2012

Sanchez, Margaret I / Rabinovitz, Harold S / Oliverio, Margaret C / Elgart, George W / Grichnik, James M. ·University of Miami Miller School of Medicine, Miami, FL, USA. ·Arch Dermatol · Pubmed #23069979.

ABSTRACT: -- No abstract --

24 Article Agreement of dermatopathologists in the evaluation of clinically difficult melanocytic lesions: how golden is the 'gold standard'? 2012

Braun, R P / Gutkowicz-Krusin, D / Rabinovitz, H / Cognetta, A / Hofmann-Wellenhof, R / Ahlgrimm-Siess, V / Polsky, D / Oliviero, M / Kolm, I / Googe, P / King, R / Prieto, V G / French, L / Marghoob, A / Mihm, M. ·Department of Dermatology, University Hospital Zürich, Zürich, Switzerland. ralph.braun@usz.ch ·Dermatology · Pubmed #22433231.

ABSTRACT: BACKGROUND: The 'gold standard' for the diagnosis of melanocytic lesions is dermatopathology. Although most of the diagnostic criteria are clearly defined, the interpretation of histopathology slides may be subject to interobserver variability. OBJECTIVES: The aim of this study was to determine the variability among dermatopathologists in the interpretation of clinically difficult melanocytic lesions. METHODS: This study used the database of MelaFind®, a computer-vision system for the diagnosis of melanoma. All lesions were surgically removed and sent for independent evaluation by four dermatopathologists. Agreement was calculated using kappa statistics. RESULTS: A total of 1,249 pigmented melanocytic lesions were included. There was a substantial agreement among expert dermatopathologists: two-category kappa was 0.80 (melanoma vs. non-melanoma) and three-category kappa was 0.62 (malignant vs. borderline vs. benign melanocytic lesions). The agreement was significantly greater for patients ≥40 years (three-category kappa = 0.67) than for younger patients (kappa = 0.49). In addition, the agreement was significantly lower for patients with atypical mole syndrome (AMS) (kappa = 0.31) than for patients without AMS (kappa = 0.76). LIMITATIONS: The data were limited by the inclusion/exclusion criteria of the MelaFind® study. This might represent a selection bias. The agreement was evaluated using kappa statistics. This is a standard method for evaluating agreement among pathologists, but might be considered controversial by some statisticians. CONCLUSIONS: Expert dermatopathologists have a high level of agreement when diagnosing clinically difficult melanocytic lesions. However, even among expert dermatopathologists, the current 'gold standard' is not perfect. Our results indicate that lesions from younger patients and patients with AMS may be more problematic for the dermatopathologists, suggesting that improved diagnostic criteria are needed for such patients.

25 Article White shiny structures in melanoma and BCC. 2012

Liebman, Tracey N / Rabinovitz, Harold S / Balagula, Yevgeniy / Jaimes-Lopez, Natalia / Marghoob, Ashfaq A. · ·Arch Dermatol · Pubmed #22250261.

ABSTRACT: -- No abstract --

Next