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Melanoma: HELP
Articles by Pietro Rubegni
Based on 42 articles published since 2010
(Why 42 articles?)
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Between 2010 and 2020, P. Rubegni wrote the following 42 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Spitz/Reed nevi: proposal of management recommendations by the Dermoscopy Study Group of the Italian Society of Dermatology (SIDeMaST). 2014

Broganelli, P / Titli, S / Lallas, A / Alaibac M Annetta, A / Battarra, V / Brunetti, B / Castagno, I / Cavicchini, S / Ferrari, A / Ghigliotti, G / Landi, C / Manganoni, A / Moscarella, E / Pellacani, G / Pizzichetta, M A / Rosina, P / Rubegni, P / Satta, R / Scalvenzi, M / Stanganelli, I / Stinco, G / Zalaudek, I / Zampieri, P / Argenziano, G / 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 Nipple and areola lesions: review of dermoscopy and reflectance confocal microscopy features. 2019

Cinotti, E / Galluccio, D / Tognetti, L / Habougit, C / Manganoni, A M / Venturini, M / Perrot, J L / Rubegni, P. ·Dermatology Section, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy. · Department of Pathology, University Hospital of St-Etienne, Saint-Etienne, France. · Department of Dermatology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy. · Department of Dermatology, University Hospital of St-Etienne, Saint-Etienne, France. ·J Eur Acad Dermatol Venereol · Pubmed #31166040.

ABSTRACT: The differential diagnosis of nipple and areola complex (NAC) lesions encompasses a large spectrum of conditions from benign tumours to inflammatory diseases that could be challenging to recognize on clinical ground. While melanoma (MM) of the NAC is exceedingly rare, benign lesions are more frequent but could be difficult to distinguish from MM. Besides MM, other malignant tumours can affect this area and in particular Paget's disease (PD). For clinically doubtful lesions, biopsy is required, with possible functional and aesthetic consequences in this sensitive area. Dermoscopy and reflectance confocal microscopy (RCM) are widely used techniques for the diagnosis of many skin lesions, but their use for NAC lesions is not well established. The objective of this study was to evaluate current literature on these imaging techniques for NAC lesions. We searched in Medline, PubMed and Cochrane database all studies up to November 2018 dealing with dermoscopy, RCM and this special site. We found that the most described malignant tumour was PD and that only two primary MMs of the NAC have been reported with these imaging techniques. Although there are few data on diagnostic accuracy of non-invasive imaging techniques for NAC lesions, it seems that dermoscopy and RCM can add relevant information to be integrated with clinical examination for the diagnosis of NAC lesions and in particular for the differential diagnosis of PD and eczema.

3 Review Dermoscopy for the Diagnosis of Conjunctival Lesions. 2018

Cinotti, Elisa / La Rocca, Anna / Labeille, Bruno / Grivet, Damien / Tognetti, Linda / Lambert, Victor / Kaspi, Mathilde / Nami, Niccolò / Fimiani, Michele / Perrot, Jean Luc / Rubegni, Pietro. ·Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena 53100, Italy. Electronic address: elisacinotti@gmail.com. · Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena 53100, Italy. · Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne Cedex 2 42055, France. · Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne Cedex 2 42055, France; Laboratory Biology, Engineering, and Imaging of Corneal Graft, Jean Monnet University, EA2512, Saint-Etienne 42000, France. ·Dermatol Clin · Pubmed #30201153.

ABSTRACT: This article describes the present literature on dermoscopy of conjunctiva and shows the results of a dermoscopy study of 147 conjunctival tumors. Melanomas were characterized by a heavy pigmentation, irregular dots, and a higher prevalence of gray color compared with nevi. Squamous cell carcinomas had peculiar hairpin and glomerular vessels. Primary acquired melanoses were characterized by regularly distributed light brown dots. A large part of nevi had small cysts.

4 Review Dermoscopic patterns of cutaneous melanoma metastases. 2014

Rubegni, Pietro / Lamberti, Arianna / Mandato, Filomena / Perotti, Roberto / Fimiani, Michele. ·Department of Clinical Medicine and Immunological Sciences, Dermatology Section, University of Siena, Siena, Italy. ·Int J Dermatol · Pubmed #24320196.

ABSTRACT: In 2-8% of patients with melanoma, the first clinical manifestation of the disease may be skin metastasis. In these cases, differential diagnosis with the primary melanoma, benign melanocytic lesions, and other malignant and benign skin growths is particularly challenging. For this reason, the dermatologist's approach to cutaneous metastases of malignant melanoma calls for knowledge of the great morphological variety of these lesions. Dermoscopic characteristics associated with CMMMs have not yet been codified. The aim of the present review is to provide additional information about dermoscopic aspects of these skin lesions.

5 Clinical Trial Impact of digital dermoscopy analysis on the decision to follow up or to excise a pigmented skin lesion: a multicentre study. 2011

Burroni, Marco / Wollina, Uwe / Torricelli, Rocco / Gilardi, Stefano / Dell'Eva, Giordana / Helm, Cathrine / Bardey, Wolfgang / Nami, Niccolò / Nobile, Franco / Ceccarini, Massimo / Pomponi, Adriano / Alessandro, Biondi / Rubegni, Pietro. ·Department of Dermatology, Section of Dermatology, University of Siena, Siena, Italy. ·Skin Res Technol · Pubmed #21447065.

ABSTRACT: BACKGROUND: The quality of early malignant melanoma (MM) diagnosis is dependent on the experience of dermatologists, tools like dermoscopy and histopathology, and awareness and education of the studied population. Does a higher rate of excision of pigmented skin lesions (PSL) increase the rate of detected melanomas? MATERIAL AND METHODS: The DB-MIPS objective tool, able to evaluate mathematical defined variables, has been used to verify the variability of measurements among PSL stored by five different centres located in Italy, Switzerland, and Germany. RESULTS: The objective analysis showed low differences in terms of moles' features among the different groups, arguing for robustness of the dermatological patient's PSL inspection. Differences in terms of false positives and predictive positive values have been detected. The tendency to follow up a lesion was proportional to the percentage of thin MM (<0.75 mm tumour thickness), while the interventism was proportional to the percentage of dysplastic moles. Similar percentage of thin melanoma has been observed in all the centres, indicating a standardization in early diagnosing among experienced dermatologists. The main difference among the centres was their mode of action, i.e. to follow up or remove suspicious PSL. CONCLUSION: Interventism depends neither on the geographic site nor on the features of the observed moles. Higher removal rates do not correspond to higher MM detections: this means that an in-depth knowledge of melanoma patterns is required and follow-up of suspicious moles is highly suggested.

6 Article Commentary on: Reflectance confocal microscopy and dermoscopy aid in evaluating repigmentation within or adjacent to lentigo maligna melanoma surgical scars. 2020

Tognetti, L / Cinotti, E / Fiorani, D / Couzan, C / Perrot, J L / Rubegni, P. ·Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy. · Service de Dermatologie, Hôpital Universitaire de Saint-Etienne, St. Etienne, France. ·J Eur Acad Dermatol Venereol · Pubmed #31930647.

ABSTRACT: -- No abstract --

7 Article Morphological classification of melanoma metastasis with reflectance confocal microscopy. 2019

Farnetani, F / Manfredini, M / Longhitano, S / Chester, J / Shaniko, K / Cinotti, E / Mazzoni, L / Venturini, M / Manganoni, A / Longo, C / Reggiani-Bonetti, L / Giannetti, L / Rubegni, P / Calzavara-Pinton, P / Stanganelli, I / Perrot, J L / Pellacani, G. ·Division of Dermatology, Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Division of Dermatology, University of Ferrara, Ferrara, Italy. · Department of Medical, Surgical, and Neurological Science, Dermatology Section, University of Siena, S Maria alle Scotte Hospital, Siena, Italy. · Skin Cancer Unit, IstitutoTumori Romagna (IRST), Meldola, Italy. · Division of Dermatology, SpedaliCivili University Hospital, Brescia, Italy. · Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy. · Department of Pathology, University of Modena and Reggio Emilia, Modena, Italy. · Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Division of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy. · Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France. ·J Eur Acad Dermatol Venereol · Pubmed #30394598.

ABSTRACT: BACKGROUND: Cutaneous malignant melanoma metastases differential diagnosis is challenging, as clinical and dermoscopic features can simulate primary melanoma or other benign or malignant skin neoplasms, and in-vivo reflectance confocal microscopy could assist. Our aim was to identify specific reflectance confocal microscopy features for cutaneous malignant melanoma metastases, and epidermal and dermal involvement. METHODS: A retrospective, multicentre observational study of lesions with proven cutaneous malignant melanoma metastases diagnosis between January 2005 and December 2016. Lesions were retrospectively assessed according to morphological features observed at reflectance confocal microscopy. Potential homogeneous subgroups of epidermal or dermal involvement were investigated with cluster analysis. RESULTS: Cutaneous malignant melanoma metastases (51 lesions in 29 patients) exhibited different frequencies of features according to metastasis dermoscopy patterns. Lesions classified at dermoscopy with nevus-like globular and non-globular patterns were more likely to be epidermotropic, showing characteristics of epidermal and dermal involvement at reflectance confocal microscopy. Other dermoscopy pattern classifications were more likely to be dermotropic, showing characteristics od dermal involvement at reflectance confocal microscopy. Distinguishing features at reflectance confocal microscopy included irregular (78%) and altered (63%) epidermis, pagetoid infiltration (51%), disarranged junctional architecture (63%), non-edged papillae (76%), dense and sparse, and cerebriform nests in the upper dermis (74%), and vascularity (51%). Cluster analysis identified three groups, which were retrospectively correlated with histopathological diagnoses of dermotropic and epidermotropic diagnoses (P < 0.001). The third cluster represents lesions with deep dermis morphological changes, which were too deep for evaluation with reflectance confocal microscopy. CONCLUSIONS: Specific reflectance confocal microscopy features of cutaneous malignant melanoma metastases for correct diagnosis, and subtype diagnosis, seem achievable in most cases where morphological alterations are located above the deep dermis.

8 Article Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi. 2018

Tognetti, Linda / Cinotti, Elisa / Moscarella, Elvira / Farnetani, Francesca / Malvehy, Josep / Lallas, Aimilios / Pellacani, Giovanni / Argenziano, Giuseppe / Cevenini, Gabriele / Rubegni, Pietro. ·Dermatology Division, Department of Medical, Surgical and NeuroSciences, University of Siena, Siena, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. · Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy. · Dermatology Unit, University of Campania, Naples, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena Italy. · Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain. · First Department of Dermatology, Aristotele University, Thessaloniki, Greece. ·Dermatol Pract Concept · Pubmed #30479866.

ABSTRACT: Background: Differential diagnosis of clinically atypical nevi (aN) and early melanomas (eMM) still represents a challenge even for experienced dermoscopists, as dermoscopy alone is not sufficient to adequately differentiate these equivocal melanocytic skin lesions (MSLs). Objectives: The objectives of this study were to investigate what were the most relevant parameters for noninvasive differential diagnosis between eMM and aN among clinical, personal, and dermoscopic data and to evaluate their impact as risk factors for malignancy. Methods: This was a retrospective study performed on 450 MSLs excised from 2014 to 2016 with a suspicion of malignancy. Dermoscopic standardized images of the 450 MSLs (300 aN and 150 eMM) were collected and evaluated. Patients' personal data (ie, age, gender, body site, maximum diameter) were also recorded. Dermoscopic evaluations were performed by 5 different experts in dermoscopy blinded to histopathological diagnosis. Fleiss' κ was calculated to measure concordance level between experts in the description of dermoscopic parameters for each MSL. The power of the studied variables in discriminating malignant from benign lesions was also investigated through F-statistics. Results: The variables age and maximum diameter supplied the highest discriminant power ( Conclusions: The objective clinical and personal data collected here could supply a fundamental contribution in the correct diagnosis of equivocal MSLs and should be included in diagnostic algorithms along with significant dermoscopic features (ie, atypical network, blue-white veil, and shiny white streaks).

9 Article Dermoscopy is looking for a technical evolution to improve its diagnostic potential. 2018

Cinotti, E / Rubegni, P. ·Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, 53100, Siena, Italy. ·Br J Dermatol · Pubmed #30141559.

ABSTRACT: -- No abstract --

10 Article An integrated clinical-dermoscopic risk scoring system for the differentiation between early melanoma and atypical nevi: the iDScore. 2018

Tognetti, L / Cevenini, G / Moscarella, E / Cinotti, E / Farnetani, F / Mahlvey, J / Perrot, J L / Longo, C / Pellacani, G / Argenziano, G / Fimiani, M / Rubegni, P. ·Dermatology Unit, Department of Medical, Surgical and NeuroSciences, University of Siena, Siena, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. · Dermatology Unit, University of Campania, Naples, Italy. · Skin Cancer Unit Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain. · Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France. ·J Eur Acad Dermatol Venereol · Pubmed #29888421.

ABSTRACT: BACKGROUND: Dermoscopy revealed to be extremely useful in the diagnosis of early melanoma, the most important limitation being its subjectivity in giving a final diagnosis. To overcome this problem, several algorithms and checklists have been proposed. However, they generally demonstrated modest level of diagnostic accuracy, unsatisfactory concordance between dermoscopists and/or poor specificity. OBJECTIVE: To test a new methodological approach for the differentiation between early melanoma and atypical nevi, based on an integrated clinical-anamnestic dermoscopic risk scoring system (iDScore). METHODS: We selected a total of 435 standardized dermoscopic images of clinically atypical melanocytic skin lesion (MSL) excised in the suspect of malignancy (i.e. 134 early melanomas - MM - and 301 atypical nevi). Data concerning patient age and sex and lesion dimension and site were collected. A scoring classifier was designed based on this data set integrated with the dermoscopic evaluations performed by three experts blinded to histological diagnosis. RESULTS: A total of seven dermoscopic structures, three age groups (30-40 years, 41-60 years and >60 years), two maximum diameter categories (5-10 mm and >10 mm) and three body areas (i.e. frequently, chronically and seldom photoexposed sites) were selected by the scoring classifier as interdependently significant variables. The total risk score (S) of a lesion resulted from the simple sum of partial scores assigned to each selected variable. The iDScore-aided diagnosis showed an high accuracy (receiver operating characteristic-area under the curve = 0.903; IC: 95% = 0.887-0.918). A risk-based criticality scale corresponding to different S ranges was proposed. CONCLUSION: The iDScore checklist is proposed as a feasible and efficient tool to support dermatologists in non-invasive differentiation between atypical nevi and early MM on the basis of few selected clinical-anamnestic data and standardized dermoscopic features.

11 Article Benign and malignant collision tumors of melanocytic skin lesions with hemangioma: Dermoscopic and reflectance confocal microscopy features. 2018

Tognetti, L / Cinotti, E / Perrot, J L / Campoli, M / Fimiani, M / Rubegni, P. ·Division of Dermatology - Department of Medical, Surgical and Neuro Sciences, University of Siena, Siena, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. · Dermatology Unit, University of St. Etienne, Saint Etienne, France. ·Skin Res Technol · Pubmed #29388348.

ABSTRACT: BACKGROUND: Though the combination/collision of nevi or lentigo simplex and hemangiomas is frequent, the malignant collision tumor melanoma-hemangioma is exceptional and can sometime clinically simulate a benign collision. To date, a series of collision tumors of hemangiomas associated with either benign or malignant melanocytic skin lesions (MSL) has yet to be studied by non-invasive imaging and clinico-pathologic correlates. METHODS: We present 10 cases of patients with collision tumors of hemangioma with different MSL including: 2 in situ lentigo-maligna melanoma, 1 invasive melanoma, 5 melanocytic nevi, and 2 lentigo simplex. The clinical aspect along with the dermoscopic and reflectance confocal microscopy (RCM) features is described and compared with histopathologic findings. RESULTS: Dermoscopic examination allows to recognize a dark ring in malignant collision melanoma-hemangioma and a jelly ring sign in benign collision of nevi/lentigo simplex-hemangioma. These peculiar features were confirmed by RCM and histopathologic findings. CONCLUSION: Two simple dermoscopic clues confirmed by RCM features can be proposed to help distinguish between benign and malignant collisions tumors.

12 Article Dermoscopy vs. reflectance confocal microscopy for the diagnosis of lentigo maligna. 2018

Cinotti, E / Labeille, B / Debarbieux, S / Carrera, C / Lacarrubba, F / Witkowski, A M / Moscarella, E / Arzberger, E / Kittler, H / Bahadoran, P / Gonzalez, S / Guitera, P / Agozzino, M / Farnetani, F / Hofmann-Wellenhof, R / Ardigò, M / Rubegni, P / Tognetti, L / Łudzik, J / Zalaudek, I / Argenziano, G / Longo, C / Ribero, S / Malvehy, J / Pellacani, G / Cambazard, F / Perrot, J L. ·Department of Dermatology, University Hospital of St-Etienne, Saint-Etienne, France. · Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy. · Departments of Dermatology, Centre Hospitalier Lyon Sud, Pierre Benite, France. · Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Barcelona, Spain. · Dermatology Clinic, University of Catania, Catania, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Dermatology Unit, Second University of Naples, Nuovo Policlinico, Naples, Italy. · Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. · Department of Dermatology, Clinical Research Center, Hopital Archet 2, Nice, France. · Medicine and Medical Specialities Department, Madrid and Dermatology Department, Alcalá University, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. · Department of Dermatology, The University of Sydney, Sydney Melanoma Diagnostic Centre and Melanoma Institute Australia, Sydney, NSW, Australia. · Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. · Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland. · Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy. · Department of Medical Sciences, University of Turin, Turin, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #29341263.

ABSTRACT: BACKGROUND: Several dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques. OBJECTIVE: We evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images. METHODS: A total of 223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination was compared. Interinvestigator variability and confidence level in the diagnosis were also evaluated. RESULTS: Overall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80%, vs. 61%) and less specific (81% vs. 92%) than dermoscopy for LM/LMM. In particular, RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher interinvestigator agreement and a higher confidence level in the diagnosis than dermoscopy. CONCLUSION: Reflectance confocal microscopy and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM.

13 Article Melanoma arising from a plaque-type blue naevus with subcutaneous cellular nodules of the scalp. 2018

Yan, L / Tognetti, L / Nami, N / Lamberti, A / Miracco, C / Sun, L / Fimiani, M / Rubegni, P. ·Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou, China. · Section of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. · Section of Plastic Surgery Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy. ·Clin Exp Dermatol · Pubmed #29034495.

ABSTRACT: Plaque-type blue naevus (PTBN) is a very rare variant of blue naevus (BN). The potential malignancy of subcutaneous cellular nodules (SCN) in PTBN was discovered in 2012, and there is currently no clear consensus on prognostic factors or management guidelines of such lesions. PTBN on the scalp have not been described in the literature. We report the clinical, histopathological and immunohistological features of a 50-year-old man who presented with a 30-year history of scalp PTBN, with malignant proliferation of nodular elements and fatal outcome 8 years later. This case suggests that long-term monitoring of patients with PTBN is required. Early surgical removal of such lesions should be considered, especially in the presence of any case of enlargement or change.

14 Article Clinical and dermoscopic characterization of pediatric and adolescent melanomas: Multicenter study of 52 cases. 2018

Carrera, Cristina / Scope, Alon / Dusza, Stephen W / Argenziano, Giuseppe / Nazzaro, Gianluca / Phan, Alice / Tromme, Isabelle / Rubegni, Pietro / Malvehy, Josep / Puig, Susana / Marghoob, Ashfaq A. ·Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER), Barcelona, Spain; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatology Unit, University of Campania, Naples, Italy. · Dipartimento di Fisiopatologia e dei Trapianti, Università degli Studi di Milano-UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy. · Department of Dermatology, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Pierre Bénite Cedex, France. · Department of Dermatology, King Albert II Institute, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium. · Dipartimento di Scienze Mediche, Chirurgiche e Neuroscienze, Sezione di Dermatologia, Università di Siena, Siena, Italy. · Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER), Barcelona, Spain. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: marghooa@mskcc.org. ·J Am Acad Dermatol · Pubmed #29024734.

ABSTRACT: BACKGROUND: Knowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse, and this may in part contribute to delay in detection and thicker tumors. OBJECTIVE: To analyze the clinicodermoscopic characteristics of PM. METHODS: Retrospective study of 52 melanomas diagnosed in patients before the age of 20 years. RESULTS: On the basis of its clinical, dermoscopic, and histopathologic characteristics, PM can be classified as spitzoid or nonspitzoid. The nonspitzoid melanomas (n = 37 [72.3%]) presented in patients with a mean age of 16.3 years (range, 8-20) and were associated with a high-risk phenotype and a pre-existing nevus (62.2%). The spitzoid melanomas (n = 15 [27.7%]) were diagnosed in patients at a mean age of 12.5 years (range, 2-19) and were mostly de novo lesions (73.3%) located on the limbs (73.3%). Whereas less than 25% of PMs fulfilled the modified clinical ABCD criteria (amelanotic, bleeding bump, color uniformity, de novo at any diameter), 40% of spitzoid melanomas did. Dermoscopic melanoma criteria were found in all cases. Nonspitzoid melanomas tended to be multicomponent (58.3%) or have nevus-like (25%) dermoscopic patterns. Spitzoid melanomas revealed atypical vascular patterns with shiny white lines (46.2%) or an atypical pigmented spitzoid pattern (30.8%). There was good correlation between spitzoid subtype histopathologically and dermoscopically (κ = 0.66). LIMITATIONS: A retrospective study without re-review of pathologic findings. CONCLUSION: Dermoscopy in addition to conventional and modified clinical ABCD criteria helps in detecting PM. Dermoscopy assists in differentiating spitzoid from nonspitzoid melanomas.

15 Article Clinicopathological predictors of recurrence in nodular and superficial spreading cutaneous melanoma: a multivariate analysis of 214 cases. 2017

Pizzichetta, Maria A / Massi, Daniela / Mandalà, Mario / Queirolo, Paola / Stanganelli, Ignazio / De Giorgi, Vincenzo / Ghigliotti, Giovanni / Cavicchini, Stefano / Quaglino, Pietro / Corradin, Maria T / Rubegni, Pietro / Alaibac, Mauro / Astorino, Stefano / Ayala, Fabrizio / Magi, Serena / Mazzoni, Laura / Manganoni, Maria Ausilia / Talamini, Renato / Serraino, Diego / Palmieri, Giuseppe / Anonymous1830926. ·Division of Oncology B, CRO Aviano National Cancer Institute, Via Franco Gallini 2, 33081, Aviano, Italy. pizzichetta@cro.it. · Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Unit of Medical Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy. · Department of Medical Oncology, National Institute for Cancer Research, IRCCS San Martino, Genoa, Italy. · Skin Cancer Unit, Istituto Tumori Romagna (IRST), Meldola, Italy. · Department of Dermatology, University of Parma, Parma, Italy. · Department of Dermatology, University of Florence, Florence, Italy. · Clinic of Dermatology, IRCCS San Martino-IST, Genoa, Italy. · Department of Dermatology, Fondazione Ospedale Maggiore Policlinico IRCCS, Milan, Italy. · Dermatologic Clinic, Dept Medical Sciences, University of Torino, Turin, Italy. · Division of Dermatology, Pordenone Hospital, Pordenone, Italy. · Department of Dermatology, University of Siena, Siena, Italy. · Department of Dermatology, University of Padova, Padua, Italy. · Division of Dermatology, Celio Hospital, Rome, Italy. · National Cancer Institute, "Fondazione G. Pascale"-IRCCS, Naples, Italy. · Department of Dermatology, ASST degli Spedali Civili di Brescia, Brescia, Italy. · Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy. · Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Sassari, Italy. ·J Transl Med · Pubmed #29115977.

ABSTRACT: BACKGROUND: Nodular melanoma (NM) accounts for most thick melanomas and because of their frequent association with ulceration, fast growth rate and high mitotic rate, contribute substantially to melanoma-related mortality. In a multicentric series of 214 primary melanomas including 96 NM and 118 superficial spreading melanoma (SSM), histopathological features were examined with the aim to identify clinicopathological predictors of recurrence. METHODS: All consecutive cases of histopathologically diagnosed primary invasive SSM and NM during the period 2005-2010, were retrieved from the 12 participating Italian Melanoma Intergroup (IMI) centers. Each center provided clinico-pathological data such as gender, age at diagnosis, anatomical site, histopathological conventional parameters, date of excision and first melanoma recurrence. RESULTS: Results showed that NM subtype was significantly associated with Breslow thickness (BT) at multivariate analysis: [BT 1.01-2 mm (OR 7.22; 95% CI 2.73-19.05), BT 2.01-4 mm (OR 7.04; 95% CI 2.54-19.56), and BT > 4 mm (OR 51.78; 95% CI 5.65-474.86) (p < 0.0001)]. Furthermore, mitotic rate (MR) was significantly correlated with NM histotype: [(MR 3-5 mitoses/mm CONCLUSIONS: We found that NM subtype was significantly associated with higher BT and MR but it was not a prognostic factor since it did not significantly correlate with melanoma recurrence rate. Conversely, increased BT and MR as well as SNLB positivity were significantly associated with a higher risk of melanoma recurrence.

16 Article [Contribution of reflectance confocal microscopy in the diagnosis of uterine cervix melanoma: First case report]. 2017

Perrot, J L / Labeille, B / Richard Coulet, E / Cochin, S / Biron Schneider, A-C / Rubegni, P / Cambazard, F / Cinotti, E / Anonymous4660911. ·Service de dermatologie, hôpital universitaire de Saint-Étienne, 42055 Saint-Étienne cedex 2, France. · SIPATH-anatomie et cytopathologie pathologique, 73, rue Général-Giraud, 42300 Roanne, France. · Clinique du Renaison, 75, rue Général-Giraud, 42300 Roanne, France. · Service de dermatologie, hôpital universitaire S. Maria alle Scotte, 16, viale Bracci, 53100 Siena, Italie. · Service de dermatologie, hôpital universitaire S. Maria alle Scotte, 16, viale Bracci, 53100 Siena, Italie. Electronic address: elisa.cinotti@gmail.com. ·Ann Dermatol Venereol · Pubmed #28668262.

ABSTRACT: -- No abstract --

17 Article Handheld In Vivo Reflectance Confocal Microscopy for the Diagnosis of Eyelid Margin and Conjunctival Tumors. 2017

Cinotti, Elisa / Singer, Aurélie / Labeille, Bruno / Grivet, Damien / Rubegni, Pietro / Douchet, Catherine / Cambazard, Frédéric / Thuret, Gilles / Gain, Philippe / Perrot, Jean Luc. ·Department of Medical, Surgical, and Neurological Science, Dermatology Section, University of Siena, S Maria alle Scotte Hospital, Siena, Italy. · Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne, France. · Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France. · Biology, Engineering and Imaging of Corneal Graft Laboratory, EA2521, Jean Monnet University, Saint-Etienne, France. · Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France. · French University Institute, Paris, France. ·JAMA Ophthalmol · Pubmed #28654937.

ABSTRACT: Importance: The clinical diagnosis of conjunctival and eyelid margin tumors is challenging, and new noninvasive imaging techniques could be valuable in this field. Objective: To assess the diagnostic accuracy of handheld in vivo reflectance confocal microscopy (IVCM) for the diagnosis of eyelid margin and conjunctival tumors. Design: A prospective observational study was conducted at University Hospital of Saint-Etienne from January 2, 2011, to December 31, 2016 (inclusion of patients until December 31, 2015, and follow-up until December 31, 2016). A total of 278 consecutive patients with eyelid margin or conjunctival lesions were included. Conjunctival lesions were diagnosed with a conventional clinical examination using a slitlamp and by handheld IVCM. Final diagnoses were established by histopathologic examination for 155 neoformations suspicious for being malignant through clinical and/or IVCM examination that were excised and on follow-up of 12 months or longer for the remaining 140 lesions. Main Outcomes and Measures: Sensitivity, specificity, and positive and negative predictive values for malignant tumors of the conjunctiva and eyelid margin were calculated using clinical examination with slitlamp and handheld IVCM. Results: In the 278 patients (136 [48.9%] females; mean [SD] age, 59 [21] years), a total of 166 eyelid margin and 129 conjunctival lesions were included in the analysis. Of the 155 excised neoformations with a histopathologic diagnosis, IVCM showed higher sensitivity compared with clinical examination conducted with the slitlamp for malignant tumors of the eyelid margin (98% vs 92%) and conjunctiva (100% vs 88%). The specificity for malignant eyelid margin tumors was higher for IVCM than for slitlamp examination (74% vs 46%), but slightly less for malignant conjunctival tumors (78% vs 88%). Analysis of all neoformations (155 excised and 140 in follow-up) confirmed these differences in the diagnostic accuracy of the clinical examination and IVCM. The presence of hyperreflective Langerhans cells mimicking malignant melanocytes was the main cause for misdiagnosis of malignant conjunctival tumors with IVCM. Conclusions and Relevance: Handheld IVCM could be a useful tool for the identification of malignant conjunctival tumors. Further studies are required to confirm the usefulness of this device and identify possible features that can differentiate Langerhans cells from malignant melanocytes to prevent the misdiagnosis of melanoma using IVCM.

18 Article Mucosal melanoma: clinical, histological and c-kit gene mutational profile of 86 French cases. 2017

Cinotti, E / Chevallier, J / Labeille, B / Cambazard, F / Thomas, L / Balme, B / Leccia, M T / D'Incan, M / Vercherin, P / Douchet, C / Rubegni, P / Perrot, J L. ·Department of Dermatology, University Hospital of Saint Etienne, Saint Etienne, France. · Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy. · Dermatology Department, University Hospital of Lyon Sud, Pierre Bénite, France. · Dermatopathology Department, University Hospital of Lyon Sud, Pierre Bénite, France. · Department of Dermatology, University Hospital of Grenoble, Grenoble, France. · Dermatology Department, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France. · Department of Public Health and Medical Information, University Hospital of Saint Etienne, Saint Etienne, France. · Department of Pathology, University Hospital of Saint Etienne, Saint Etienne, France. ·J Eur Acad Dermatol Venereol · Pubmed #28543798.

ABSTRACT: BACKGROUND: Mucosal melanomas are rare and highly aggressive tumours. Few studies evaluated mucosal melanomas of locations other than the head and neck region, and other than those of the Asian population. OBJECTIVES: The objective of this study was to analyse the clinical and histological features, as well as the mutational status of c-kit and b-raf gene of mucosal melanoma in any localization in a French series. METHODS: We investigated clinical (sex, age, performance status, survival, treatment of the patients and lack of pigmentation of the tumours) and histopathological features (ulceration, Breslow's index, mitotic rate), as well as the mutational status of c-kit and b-raf of 86 mucosal melanomas diagnosed in 15 years in four French University Hospitals. RESULTS: Most melanomas affected women (72%) and the genital region (46.5%). A fifth of melanomas were amelanotic. 81% of melanomas had a Breslow's index ≥1, whereas all glans melanomas, and most vulvar melanomas had a Breslow index ≤1 mm. Overall survival was 54% at 3 years; 11.6% of the 43 tested mucosal melanomas were c-kit-mutated while the 15 tested genital melanomas were not. The c-kit gene mutation did not influence the overall survival. Age ≥ 50, amelanotic type and performance status ≥1 were not poor prognostic factors in our series. CONCLUSION: This study confirmed that mucosal melanomas are rare and could be difficult to diagnose being often amelanotic and in hidden sites. Most melanomas were thick at the diagnosis, but glans and vulvar melanomas were thinner probably because of their greater visibility. The frequency of the c-kit mutation varied depending on the initial tumour site. In our series, the prognosis was poor, independently from c-kit mutations and the patient's general health and age. The presence of metastasis at diagnosis was associated with a worse prognosis indicating the importance of an early diagnosis.

19 Article A risk scoring system for the differentiation between melanoma with regression and regressing nevi. 2016

Rubegni, P / Tognetti, L / Argenziano, G / Nami, N / Brancaccio, G / Cinotti, E / Miracco, C / Fimiani, M / Cevenini, G. ·Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy. · Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, AOUS "Le Scotte", Siena, Italy. Electronic address: linda.tognetti@gmail.com. · Dermatology Unit, Department of Mental and Physic Health and Preventive Medicine, Second University of Naples, Naples, Italy. · Dermatology Department-University Hospital of Saint-Etienne, Saint-Etienne, France. · Section of Human Patology, University of Siena, Siena, Italy. · Department of Medical Biotechnologies, University of Siena, Siena, Italy. ·J Dermatol Sci · Pubmed #27157925.

ABSTRACT: BACKGROUND: Spontaneous regression of melanomas is relatively common, its prevalence ranging from 10 to 35%. However, regressing nevi can exhibit worrisome feature and simulate melanoma both clinically and dermoscopically. Thus, the presence of regression can represent a confounding factor. OBJECTIVE: To investigate the frequency of dermoscopic patterns of "regression" in a series of benign and malignant melanocytic skin lesions, and to design an integrated scoring system. Scoring classifiers are very effective in selecting the significant parameters for discriminating two clinical conditions, thus can rapidly calculate a patient's risk for a given disease. METHODS: We selected a series of 95 regressing melanocytic lesions, including 50 regressing nevi and 45 melanomas with regression. For each lesion, 12 dermoscopic variables (i.e. five types of regression structures, five atypical pigmentation structures, atypical vascular pattern and pink areas) were examined by three expert in dermoscopy (blinded to the histological diagnosis). The dermoscopic evaluation was then combined with patient age, gender, body site and the maximum diameter of lesion. Concordance analysis with Cohen's kappa was performed between the three clinicians. A risk scoring system was designed by the leave-one-out cross-validation procedure to ensure model prediction power. RESULTS: The predictive score model revealed a sensitivity of 97.8% and a specificity of 75.5% in discriminating nevi and melanomas with regression. Using the score model, the diagnostic performance of the examiners increased by an average of 23.7% in sensitivity and 5.9% in specificity, compared with standard dermoscopic pattern analysis. CONCLUSIONS: We assessed the validity of an integrated risk scoring model as a new methodological approach that could help the dermatologist in the differentiation between melanoma with regression and regressing nevus. Future studies could test the setting up of a score model over an even more complex pool of data obtained from different skin lesions with various diagnostic devices.

20 Article Parallel-ridge pattern on dermatoscopy: observation in a case of purpura traumatica pedis. 2015

Feci, Luca / Fimiani, Michele / Rubegni, Pietro. ·Dermatology Section, Department of Clinical Medicine and Immunological Sciences, Siena University, Italy. ·Dermatol Pract Concept · Pubmed #26693086.

ABSTRACT: Dermatologists are often referred urgent cases of acral hematoma by general practitioners and sports medicine specialists for the purpose of excluding warts, nevi or melanoma. Acral hematoma is often a cause of anxiety to patients and their families. Here, we report a case of purpura traumatica pedis, referred to us as suspected plantar melanoma because of the finding of parallel-ridge pattern on dermatoscopic examination. To avoid unnecessary and costly procedures, doctors should inquire about any episode of physical exertion before the onset of purpura, recording the lesion's anatomic site (e.g., unilateral vs. bilateral involvement) and clinical features.

21 Article Computer-assisted melanoma diagnosis: a new integrated system. 2015

Rubegni, Pietro / Feci, Luca / Nami, Niccolò / Burroni, Marco / Taddeucci, Paolo / Miracco, Clelia / Munezero Butorano, Marie A G / Fimiani, Michele / Cevenini, Gabriele. ·aDepartment of Medical, Surgical and Neurological Science, Dermatology Section, Siena University Hospital bDepartment of Medicine, Surgery and Neurosurgery, Section of Pathological Anatomy, Policlinico Santa Maria alle Scotte cDepartment of Medical Biotechnologies, University of Siena, Siena, Italy. ·Melanoma Res · Pubmed #26426763.

ABSTRACT: In dermatology, attempts at synergy between man and machine have mainly been made to improve melanoma diagnosis. The aim of the present study was to test an 'integrated digital dermoscopy analysis' (i-DDA) system with a series of melanocytic lesions that were benign and malignant in nature, and to evaluate its discriminating power with respect to histological diagnosis. In a retrospective study we used an i-DDA system to evaluate a series of 856 excised, clinically atypical pigmented skin lesions (584 benign and 272 malignant). The system evaluated 48 parameters to be studied as possible discriminant variables, grouped into four categories (geometries, colours, textures and islands of colour) integrated with three personal metadata items (sex, age and site of lesion) and presence/absence of three dermoscopic patterns (regression structures, blue-white veil and polymorphic vascular structures). Stepwise multivariate logistic regression of i-DDA data selected nine variables with the highest possible discriminant power. At the end of the stepwise procedure the percentage of cases correctly classified by i-DDA was 89.2% (100% sensitivity and 40.8% specificity). The limitations of the study included those associated with a retrospective design and the 'a priori' exclusion of nonmelanocytic skin lesions. By incorporating numerical digital features with personal data and some dermoscopic patterns into the learning process, the proposed i-DDA improved the performance of assisted melanoma diagnosis, with the advantage that our results can be objectively repeated in any other clinical setting.

22 Article Pigmented nodular melanoma: the predictive value of dermoscopic features using multivariate analysis. 2015

Pizzichetta, M A / Kittler, H / Stanganelli, I / Bono, R / Cavicchini, S / De Giorgi, V / Ghigliotti, G / Quaglino, P / Rubegni, P / Argenziano, G / Talamini, R / Anonymous1690828. ·Division of Medical Oncology - Preventive Oncology, Centro di Riferimento Oncologico, National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Italy. · Department of Dermatology, University of Vienna, Vienna, Austria. · Skin Cancer Unit, Istituto Tumori Romagna (IRST), Meldola, Italy. · Istituto Dermopatico Immacolata, IRCCS, Rome, Italy. · Department of Dermatology, Fondazione Ospedale Maggiore Policlinico IRCCS, Milan, Italy. · Department of Dermatology, University of Florence, Florence, Italy. · Clinic of Dermatology, IRCCS San Martino - Ist, Genoa, Italy. · Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy. · Department of Dermatology, University of Siena, Siena, Italy. · Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. · Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, National Cancer Institute, Via Franco Gallini, 2, 33081, Aviano, Italy. ·Br J Dermatol · Pubmed #25916655.

ABSTRACT: BACKGROUND: Nodular melanoma (NM), representing 10-30% of all melanomas, plays a major role in global mortality related to melanoma. Nonetheless, the literature on dermoscopy of NM is scanty. OBJECTIVES: To assess odds ratios (ORs) to quantify dermoscopic features of pigmented NM vs. pigmented superficial spreading melanoma (SSM), and pigmented nodular nonmelanocytic and benign melanocytic lesions. METHODS: To assess the presence or absence of global patterns and dermoscopic criteria, digitized images of 457 pigmented skin lesions from patients with a histopathological diagnosis of NM (n = 75), SSM (n = 93), and nodular nonmelanocytic and benign melanocytic lesions (n = 289; namely, 39 basal cell carcinomas, 85 seborrhoeic keratoses, 81 blue naevi, and 84 compound/dermal naevi) were retrospectively collected and blindly evaluated by three observers. RESULTS: Multivariate analysis showed that ulceration (OR 4.07), homogeneous disorganized pattern (OR 10.76), and homogeneous blue pigmented structureless areas (OR 2.37) were significantly independent prognostic factors for NM vs. SSM. Multivariate analysis of dermoscopic features of NM vs. nonmelanocytic and benign melanocytic lesions showed that the positive correlating features leading to a significantly increased risk of NM were asymmetric pigmentation (OR 6.70), blue-black pigmented areas (OR 7.15), homogeneous disorganized pattern (OR 9.62), a combination of polymorphous vessels and milky-red globules/areas (OR 23.65), and polymorphous vessels combined with homogeneous red areas (OR 33.88). CONCLUSIONS: Dermoscopy may be helpful in improving the recognition of pigmented NM by revealing asymmetric pigmentation, blue-black pigmented areas, homogeneous disorganized pattern and abnormal vascular structures, including polymorphous vessels, milky-red globules/areas and homogeneous red areas.

23 Article Differences in clinicopathological features and distribution of risk factors in Italian melanoma patients. 2015

Fava, P / Astrua, C / Chiarugi, A / Crocetti, E / Pimpinelli, N / Fargnoli, M C / Maurichi, A / Rubegni, P / Manganoni, A M / Bottoni, U / Catricalà, C / Cavicchini, S / Santinami, M / Alaibac, M / Annetta, A / Borghi, A / Calzavara Pinton, P / Capizzi, R / Clerico, R / Colombo, E / Corradin, M T / De Simone, P / Fantini, F / Ferreli, C / Filosa, G / Girgenti, V / Giulioni, E / Guarneri, C / Lamberti, A / Lisi, P / Nardini, P / Papini, M / Peris, K / Pizzichetta, M A / Salvini, C / Savoia, P / Strippoli, D / Tolomio, E / Tomassini, M A / Vena, G A / Zichichi, L / Patrizi, A / Argenziano, G / Simonacci, M / Quaglino, P. ·Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy. ·Dermatology · Pubmed #25659983.

ABSTRACT: BACKGROUND: No studies are available in the literature on the distribution of different melanoma features and risk factors in the Italian geographical areas. OBJECTIVE: To identify the differences in clinical-pathological features of melanoma, the distribution of risk factors and sun exposure in various Italian macro-areas. METHODS: Multicentric-observational study involving 1,472 melanoma cases (713 north, 345 centre, 414 south) from 26 referral centres belonging to the Italian Multidisciplinary Group for Melanoma. RESULTS: Melanoma patients in northern regions are younger, with thinner melanoma, multiple primaries, lower-intermediate phototype and higher counts of naevi with respect to southern patients; detection of a primary was mostly connected with a physician examination, while relatives were more involved in the south. Northern patients reported a more frequent use of sunbeds and occurrence of sunburns before melanoma despite sunscreen use and a lower sun exposure during the central hours of the day. CONCLUSIONS: The understanding of differences in risk factors distribution could represent the basis for tailored prevention programmes.

24 Article Multiple primary thick melanomas: similar dermoscopic pattern. 2014

Feci, Luca / Fimiani, Michele / Rubegni, Pietro. ·Department of Clinical Medicine and Immunological Sciences, Dermatology Section, University of Siena, Siena, Italy. ·Dermatol Pract Concept · Pubmed #25126457.

ABSTRACT: -- No abstract --

25 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.

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