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Melanoma: HELP
Articles by Alon Scope
Based on 48 articles published since 2008
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Between 2008 and 2019, A. Scope wrote the following 48 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial An Evolving Approach to the Detection of Melanoma and Other Skin Cancers Using In Vivo Reflectance Confocal Microscopy. 2016

Scope, Alon / Marchetti, Michael A. ·Department of Dermatology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel2Dermatology 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. ·JAMA Dermatol · Pubmed #27580064.

ABSTRACT: -- No abstract --

2 Editorial The Recognition Process in Dermoscopy: Analytic Approach vs Heuristic Approach. 2015

Scope, Alon / Braun, Ralph P. ·Department of Dermatology, Sheba Medical Center, Ramat Gan and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Department of Dermatology, University Hospital Zürich, Switzerland. ·JAMA Dermatol · Pubmed #25715053.

ABSTRACT: -- No abstract --

3 Editorial Dermatologists, general practitioners, and the best method to biopsy suspect melanocytic neoplasms. 2010

Marghoob, Ashfaq A / Terushkin, Vitaly / Dusza, Stephen W / Busam, Klaus / Scope, Alon. · ·Arch Dermatol · Pubmed #20231507.

ABSTRACT: -- No abstract --

4 Editorial Remodeling of the dermoepidermal junction in superficial spreading melanoma: insights gained from correlation of dermoscopy, reflectance confocal microscopy, and histopathologic analysis. 2008

Scope, Alon / Zalaudek, Iris / Ferrara, Gerardo / Argenziano, Giuseppe / Braun, Ralph P / Marghoob, Ashfaq A. · ·Arch Dermatol · Pubmed #19075152.

ABSTRACT: -- No abstract --

5 Editorial Three roots of melanoma. 2008

Zalaudek, Iris / Marghoob, Ashfaq A / Scope, Alon / Leinweber, Bernd / Ferrara, Gerardo / Hofmann-Wellenhof, Rainer / Pellacani, Giovanni / Soyer, H Peter / Argenziano, Giuseppe. · ·Arch Dermatol · Pubmed #18936403.

ABSTRACT: -- No abstract --

6 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.

7 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.

8 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.

9 Review Reflectance confocal microscopy in the diagnosis of solitary pink skin tumours: review of diagnostic clues. 2015

Longo, C / Moscarella, E / Argenziano, G / Lallas, A / Raucci, M / Pellacani, G / Scope, A. ·Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy. · Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy. · Department of Dermatology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. ·Br J Dermatol · Pubmed #25640416.

ABSTRACT: Reflectance confocal microscopy (RCM) is a noninvasive tool that can be helpful in the diagnosis of nonpigmented skin tumours. As RCM enables visualization of architectural and cytological structures at near-histological resolution, it can improve the diagnostic accuracy of dermoscopically equivocal solitary pink neoplasms. For management decisions, it is important to identify specific morphological clues that allow bedside classification of nonpigmented skin neoplasms into benign vs. malignant and melanocytic vs. nonmelanocytic. More specifically, the presence of a nested melanocytic proliferation at the dermoepidermal junction or dermis level permits the clinician to ascribe a given lesion as melanocytic; the identification of basaloid bright tumour islands is a key RCM feature for the diagnosis of basal cell carcinoma; and the presence of disarrayed epidermis along with small demarcated papillae is suggestive for the diagnosis of squamous cell carcinoma. The present review offers a comprehensive description of the main RCM diagnostic clues for solitary pink neoplasms that direct clinicians to the correct diagnosis and that may serve as groundwork for future prospective studies.

10 Review Blue lesions. 2013

Longo, Caterina / Scope, Alon / Lallas, Aimilios / Zalaudek, Iris / Moscarella, Elvira / Gardini, Stefano / Argenziano, Giuseppe / Pellacani, Giovanni. ·Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, Reggio Emilia 42100, Italy. Electronic address: longo.caterina@gmail.com. ·Dermatol Clin · Pubmed #24075551.

ABSTRACT: Blue color is found in a wide range of malignant and benign melanocytic and nonmelanocytic lesions and in lesions that result from penetration of exogenous materials, such as radiation or amalgam tattoo or traumatic penetration of particles. Discriminating between different diagnostic entities that display blue color relies on careful patient examination and lesion assessment. Dermoscopically, the extent, distribution, and patterns created by blue color can help diagnose lesions with specificity and differentiate between benign and malignant entities. This article provides an overview of the main diagnoses whereby blue color can be found, providing simple management rules for these lesions.

11 Review Spitz nevi: a bridge between dermoscopic morphology and histopathology. 2013

Kerner, Miryam / Jaimes, Natalia / Scope, Alon / Marghoob, Ashfaq A. ·Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, NY 11788, USA. ·Dermatol Clin · Pubmed #23557659.

ABSTRACT: Few benign melanocytic lesions encountered in clinical practice elicit the level of controversy as that generated by lesions within the spectrum of Spitz nevi. Unlike melanoma, the dermoscopic structures found in Spitz nevi tend to be distributed in a symmetric and organized manner. This review highlights the melanoma-specific structures and patterns commonly seen in Spitz nevi. Knowledge of the dermoscopic structures and patterns encountered in Spitz nevi (particularly the classic symmetric starburst pattern), together with understanding of their growth dynamics, can inform the decision whether to biopsy or monitor.

12 Review Defining the patient at high risk for melanoma. 2010

Psaty, Estee L / Scope, Alon / Halpern, Allan C / Marghoob, Ashfaq A. ·Dermatology Service Department of Medicine Memorial Sloan-Kettering Cancer Center New York, NY 11788, USA. ·Int J Dermatol · Pubmed #20465687.

ABSTRACT: In this practical review, we aim to help clinicians identify patients who are at significant risk of developing malignant melanoma. Universal screening is challenging, thus it is important to effectively single out patients who have a high risk of developing the disease. We provide a summary of pertinent questions to review when taking the patient's history, point out the phenotypic features to note during skin examination, and suggest risk stratification as a means to plan initial and long-term surveillance strategy. We mention personal and family history of melanoma as prime risk factors for melanoma, yet the review also focuses on the patient who has no history of melanoma, either in himself or his family, and the proper ways to evaluate his likelihood of developing the disease.

13 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.

14 Review The most common challenges in melanoma diagnosis and how to avoid them. 2009

Marghoob, Ashfaq A / Changchien, Lily / DeFazio, Jennifer / Dessio, Whitney C / Malvehy, Josep / Zalaudek, Iris / Halpern, Allan C / Scope, Alon. ·Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. marghooa@mskcc.org ·Australas J Dermatol · Pubmed #19178485.

ABSTRACT: Due to its particularly lethal nature and tendency to affect relatively young individuals, the timely diagnosis of melanoma remains of paramount importance for clinicians and their patients. Unfortunately, melanomas can mimic benign lesions that are overwhelmingly more common in the population than are melanomas, and misdiagnosis or delay in diagnosis of melanoma can occur. Misdiagnosis of melanoma serves as one of the most common causes for malpractice litigation brought against medical practitioners. In this review we describe seven clinical scenarios that represent challenges in melanoma diagnosis and discuss potential strategies for avoiding the errors that commonly give rise to those scenarios.

15 Review Imaging techniques for the in vivo diagnosis of melanoma. 2008

Esmaeili, Azadeh / Scope, Alon / Halpern, Allan C / Marghoob, Ashfaq A. ·Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. ·Semin Cutan Med Surg · Pubmed #18486018.

ABSTRACT: The ability to detect early melanoma remains of paramount importance in our efforts to curtail deaths related to this malignancy. Fortunately, our clinical skills at recognizing the varied clinical presentation of early melanomas are continuously improving. Our enhanced clinical acumen together with improved awareness of the danger signs of melanoma has resulted in a greater proportion of thin melanomas being diagnosed today as compared to the past. The implementation and utilization of in vivo imaging technologies in clinical practice promises to further enhance our ability to detect melanoma while this cancer is still thin and easily curable. This article describes the utility and application of the in vivo imaging technologies that are currently in clinical use today including dermoscopy, total body photography, individual lesion photography, and reflectance confocal microscopy.

16 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.

17 Article The smart approach: feasibility of lentigo maligna superficial margin assessment with hand-held reflectance confocal microscopy technology. 2018

Pellacani, G / De Carvalho, N / Ciardo, S / Ferrari, B / Cesinaro, A M / Farnetani, F / Bassoli, S / Guitera, P / Star, P / Rawson, R / Rossi, E / Magnoni, C / Gualdi, G / Longo, C / Scope, A. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Department of Pathology, University of Modena and Reggio Emilia, Modena, Italy. · Melanoma Institute Australia, Sydney, NSW, Australia. · The University of Sydney, Sydney, NSW, Australia. · Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. · Department of Dermatolgy, Spedali Civili di Brescia, Brescia, Italy. · Skin Cancer Unit, IRCCS - Santa Maria Nuova, Reggio Emilia, Italy. · Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. ·J Eur Acad Dermatol Venereol · Pubmed #29704275.

ABSTRACT: BACKGROUND: Lentigo maligna may be challenging to clear surgically. OBJECTIVE: To evaluate feasibility of using superficial skin cuts as RCM imaging anchors for attaining negative surgical margins in lentigo maligna. METHODS: Included patients presented with lentigo maligna near cosmetically sensitive facial structures. We evaluated, with hand-held-RCM, microscopic clearance of melanoma beyond its dermoscopically detected edges. Evaluated margins were annotated using shallow skin cuts. If a margin was positive at 'first-step' RCM evaluation, we sequentially advanced the margin radially outward at that segment by 2-mm intervals until an RCM-negative margin was identified. Prior to final surgical excision, we placed sutures at the outmost skin cuts to allow comparison of RCM and histopathological margin assessments. Primary outcome measure was histopathological verification that RCM-negative margins were clear of melanoma. RESULTS: The study included 126 first-step margin evaluations in 23 patients, median age 70 years (range: 43-91). Seventeen patients (74%) had primary in-situ melanoma and six (26%) invasive melanoma, mean thickness 0.3 mm (range 0.2-0.4 mm). Six cases (26%) showed complete negative RCM margins on 'first-step', 11 (48%) were negative at 'second-step', and four (17%) at 'third-step'. In two additional cases (9%), margins clearance could not be determined via RCM due to widespread dendritic cells proliferation. The RCM-negative margins in all 21 cases proved clear of melanoma on histopathology. Of the 15 cases that returned at 1-year follow-up, none showed any residual melanoma on dermoscopic and RCM examinations. Interobserver reproducibility showed fair agreement between bedside RCM reader and blinded remote-site reader, with Spearman's rho of 0.48 and Cohen's kappa of 0.43; using bedside reader as reference, the remote reader's sensitivity was 92% and specificity 57% in positive margin detection. CONCLUSIONS: Margin mapping of lentigo maligna with hand-held-RCM, using superficial skin cuts, appears feasible. This approach needs validation by larger studies.

18 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.

19 Article Results of the 2016 International Skin Imaging Collaboration International Symposium on Biomedical Imaging challenge: Comparison of the accuracy of computer algorithms to dermatologists for the diagnosis of melanoma from dermoscopic images. 2018

Marchetti, Michael A / Codella, Noel C F / Dusza, Stephen W / Gutman, David A / Helba, Brian / Kalloo, Aadi / Mishra, Nabin / Carrera, Cristina / Celebi, M Emre / DeFazio, Jennifer L / Jaimes, Natalia / Marghoob, Ashfaq A / Quigley, Elizabeth / Scope, Alon / Yélamos, Oriol / Halpern, Allan C / Anonymous5761037. ·Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · IBM Research Division, Thomas J. Watson Research Center, Yorktown Heights, New York. · Departments of Neurology, Psychiatry, and Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia. · Kitware Inc, Clifton Park, New York. · Stoecker & Associates, Rolla, Missouri. · Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBER de Enfermedades Raras, Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain. · Department of Computer Science, University of Central Arkansas, Conway, Arkansas. · Dermatology Service, Aurora Centro Especializado en Cáncer de Piel, Medellín, Colombia; Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: halperna@mskcc.org. ·J Am Acad Dermatol · Pubmed #28969863.

ABSTRACT: BACKGROUND: Computer vision may aid in melanoma detection. OBJECTIVE: We sought to compare melanoma diagnostic accuracy of computer algorithms to dermatologists using dermoscopic images. METHODS: We conducted a cross-sectional study using 100 randomly selected dermoscopic images (50 melanomas, 44 nevi, and 6 lentigines) from an international computer vision melanoma challenge dataset (n = 379), along with individual algorithm results from 25 teams. We used 5 methods (nonlearned and machine learning) to combine individual automated predictions into "fusion" algorithms. In a companion study, 8 dermatologists classified the lesions in the 100 images as either benign or malignant. RESULTS: The average sensitivity and specificity of dermatologists in classification was 82% and 59%. At 82% sensitivity, dermatologist specificity was similar to the top challenge algorithm (59% vs. 62%, P = .68) but lower than the best-performing fusion algorithm (59% vs. 76%, P = .02). Receiver operating characteristic area of the top fusion algorithm was greater than the mean receiver operating characteristic area of dermatologists (0.86 vs. 0.71, P = .001). LIMITATIONS: The dataset lacked the full spectrum of skin lesions encountered in clinical practice, particularly banal lesions. Readers and algorithms were not provided clinical data (eg, age or lesion history/symptoms). Results obtained using our study design cannot be extrapolated to clinical practice. CONCLUSION: Deep learning computer vision systems classified melanoma dermoscopy images with accuracy that exceeded some but not all dermatologists.

20 Article Factors in Early Adolescence Associated With a Mole-Prone Phenotype in Late Adolescence. 2017

Xu, Haoming / Marchetti, Michael A / Dusza, Stephen W / Chung, Esther / Fonseca, Maira / Scope, Alon / Geller, Alan C / Bishop, Marilyn / Marghoob, Ashfaq A / Halpern, Allan C. ·Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts. · School Health Services, Framingham Public Schools, Framingham, Massachusetts. ·JAMA Dermatol · Pubmed #28593303.

ABSTRACT: Importance: Nevi are important phenotypic risk factors for melanoma in adults. Few studies have examined the constitutional and behavioral factors associated with a mole-prone phenotype in adolescents. Objective: To identify host, behavioral, and dermoscopic factors in early adolescence (age, 14 years) that are associated with a mole-prone phenotype in late adolescence (age, 17 years). Design, Setting, and Participants: A prospective observational cohort study from the Study of Nevi in Children was conducted from January 1, 2009, to December 31, 2014, with a 2- to 3-year follow-up. A total of 569 students from the school system in Framingham, Massachusetts, were enrolled in the 8th or 9th grade (baseline; mean [SD] age, 14.4 [0.7] years). The overall retention rate was 73.3%, and 417 students were reassessed in the 11th grade. Main Outcome and Measures: Mole-prone phenotype in the 11th grade, defined as total nevus count of the back and 1 randomly selected leg in the top decile of the cohort or having any nevi greater than 5 mm in diameter. Results: Of the 417 students assessed at follow-up in the 11th grade (166 females and 251 males; mean [SD] age, 17.0 [0.4] years), 111 participants (26.6%) demonstrated a mole-prone phenotype: 69 students (62.2%) with 1 nevus greater than 5 mm in diameter, 23 students (20.7%) with total nevus count in the top decile, and 19 students (17.1%) with both characteristics. On multivariate analysis, baseline total nevus count (adjusted odds ratio, 9.08; 95% CI, 4.0-23.7; P < .001) and increased variability of nevus dermoscopic pattern (adjusted odds ratio, 4.24; 95% CI, 1.36-13.25; P = .01) were associated with a mole-prone phenotype. Conclusions and Relevance: This study found clinically recognizable factors associated with a mole-prone phenotype that may facilitate the identification of individuals at risk for melanoma. These findings could have implications for primary prevention strategies and help target at-risk adolescents for higher-intensity counseling about sun protection and skin self-examination.

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

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

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

22 Article Paradigmatic cases of pigmented lesions: How to not miss melanoma. 2016

Farnetani, Francesca / Scope, Alon / Coco, Valeria / Guida, Stefania / Cesinaro, Anna Maria / Piana, Simonetta / Peris, Ketty / Pellacani, Giovanni / Longo, Caterina. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Department of Dermatology, Sheba Medical Center, Tel Aviv University, Ramat-Gan, Israel. · Department of Dermatology, Catholic University, Rome, Italy. · Pathology Unit, University of Modena and Reggio Emilia, Modena, Italy. · Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy. · Skin Cancer Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy. ·J Dermatol · Pubmed #27402032.

ABSTRACT: A large number of cases of melanoma exhibit clinical and dermoscopic clues leading to the correct diagnosis; however, sometimes melanoma can mimic benign melanocytic and non-melanocytic lesions. We present a small series of melanomas in which additional clues provided by confocal microscopy increased the index of suspicion and prompted us to perform an excisional biopsy. Practical rules that are useful in difficult-to-diagnose melanomas are discussed.

23 Article Towards three-dimensional temporal monitoring of naevi: a comparison of methodologies for assessing longitudinal changes in skin surface area around naevi. 2016

Chung, E / Marchetti, M A / Scope, A / Dusza, S W / Fonseca, M / DaSilva, D / Bajaj, S / Geller, A C / Bishop, M / Marghoob, A A / Halpern, A C. ·Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E. 60th Street, New York, NY 10022, U.S.A. · Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 52621, Israel. · Canfield Scientific Inc., Fairfield, NJ, U.S.A. · Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, U.S.A. ·Br J Dermatol · Pubmed #27106064.

ABSTRACT: -- No abstract --

24 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.

25 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.

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