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Melanoma: HELP
Articles by Alon Scope
Based on 43 articles published since 2010
(Why 43 articles?)
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Between 2010 and 2020, A. Scope wrote the following 43 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 Review Reflectance confocal microscopy may enhance the accuracy of histopathologic diagnosis: A case series. 2019

Shahriari, Neda / Grant-Kels, Jane M / Rabinovitz, Harold / Oliviero, Margaret / Scope, Alon. ·Department of Dermatology, University of Connecticut, Farmington, Connecticut. · Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida. · Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. ·J Cutan Pathol · Pubmed #31298761.

ABSTRACT: Although histopathology is the time-honored gold standard diagnostic measure in dermatology, several factors may detract from an accurate microscopic diagnosis. Limiting factors include: human error, suboptimal biopsy-site selection or biopsy technique, and inherent restrictions of vertical tissue sectioning that lead to incomplete microscopic evaluation of the lesion. Reflectance confocal microscopy (RCM) is a non-invasive imaging tool that allows for the cellular-level examination of the lesion, at a horizontal plane, which may complement the subsequent vertical histopathological tissue examination. Herein, we report a case series whereby prebiopsy RCM examination enhanced the accuracy of histopathological diagnosis or allowed for a critical appraisal of initial histopathological misdiagnosis.

5 Review Confocal Microscopy in Skin Cancer. 2018

Ahlgrimm-Siess, Verena / Laimer, Martin / Rabinovitz, Harold S / Oliviero, Margaret / Hofmann-Wellenhof, Rainer / Marghoob, Ashfaq A / Scope, Alon. ·1Abteilung für Dermatologie, Universitätsklinikum Salzburg, Paracelsus Private Medical University of Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria. · 0000 0004 0523 5263 · grid.21604.31 · Skin and Cancer Associates, 201 NW 82nd Ave #501, Plantation, FL 33324 USA. · 3Medical University of Graz, Graz, Austria. · 0000 0000 8988 2476 · grid.11598.34 · 4Abteilung für Dermatologie, Universitätsklinikum Graz, Auenbruggerplatz 8, 8036 Graz, Austria. · 0000 0000 9937 5566 · grid.411580.9 · Dermatology Service, Memorial Sloan Kettering Skin Cancer Center Hauppauge, 800 Veterans Memorial Highway, 2nd Floor, Hauppauge, New York, 11788 USA. · 6Medical Screening Unit, Sheba Medical Center, Ramat Gan 5262000, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. · 0000 0004 1937 0546 · grid.12136.37 ·Curr Dermatol Rep · Pubmed #29780659.

ABSTRACT: Purpose of Review: Reflectance confocal microscopy (RCM) enables imaging of skin lesions at cellular level resolution at the bedside (in vivo) or in freshly excised tissue (ex vivo). This article provides an overview of strengths and limitations of non-invasive RCM in skin cancer diagnosis. Recent Findings: RCM features of common melanocytic and non-melanocytic skin neoplasms such as melanoma, actinic keratosis/squamous cell carcinoma, basal cell carcinoma, and nevi have been well defined and show good correlation with dermoscopic and histopathologic findings. Due to its technical properties, RCM is especially suitable for the examination of flat skin lesions. Summary: In vivo RCM has been shown to increase the accuracy of non-invasive diagnosis of common skin neoplasms and is a valuable adjunct to dermoscopy, particularly in cosmetically and functionally sensitive areas such as the face or the genital area.

6 Review In vivo reflectance confocal microscopy image interpretation for the dermatopathologist. 2018

Shahriari, Neda / Grant-Kels, Jane M / Rabinovitz, Harold / Oliviero, Margaret / Scope, Alon. ·Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida. · Department of Dermatology, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ·J Cutan Pathol · Pubmed #29178501.

ABSTRACT: Reflectance confocal microscopy (RCM) is a technology utilized for bedside diagnosis of cutaneous pathology by non-invasive, in vivo, cellular-level imaging. With the recent establishment of reimbursement codes by the US Centers for Medicaid and Medicare Services, RCM is now likely to be employed by clinical dermatologists and impact decision making on skin cancer management. Dermatopathologists, therefore, would benefit from learning how to interpret RCM images and how RCM findings correlate with histopathological criteria of diagnosis. This review briefly explains the principles behind RCM image acquisition, describes the key RCM features of normal skin, and delineates the RCM characteristics of frequently observed benign and malignant neoplasms.

7 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.

8 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.

9 Review The study of nevi in children: Principles learned and implications for melanoma diagnosis. 2016

Scope, Alon / Marchetti, Michael A / Marghoob, Ashfaq A / Dusza, Stephen W / Geller, Alan C / Satagopan, Jaya M / Weinstock, Martin A / Berwick, Marianne / Halpern, Allan C. ·Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, 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. · Harvard School of Public Health, Social and Behavioral Sciences, Boston, Massachusetts. · Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatoepidemiology Unit, Veteran's Affairs Medical Center, Providence, Rhode Island; Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island; Departments of Dermatology and Epidemiology, Brown University, Providence, Rhode Island. · Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, New Mexico. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: halperna@mskcc.org. ·J Am Acad Dermatol · Pubmed #27320410.

ABSTRACT: Melanocytic nevi are a strong phenotypic marker of cutaneous melanoma risk. Changes in nevi during childhood and adolescence make these prime periods for studying nevogenesis. Insights gained by the study of nevi in childhood have implications for melanoma detection in both adults and children. A more comprehensive understanding of the morphologic characteristics of nevi in different anatomic locations, in association with the patient's age and pigmentary phenotype may aid in the identification of melanomas. When monitoring melanocytic lesions over time, it is essential to differentiate normal from abnormal change. This review summarizes the rapidly expanding body of literature relevant to nevus phenotype, particularly in the context of our experience with the Study of Nevi in Children (SONIC) Project.

10 Review Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy. 2016

Kittler, Harald / Marghoob, Ashfaq A / Argenziano, Giuseppe / Carrera, Cristina / Curiel-Lewandrowski, Clara / Hofmann-Wellenhof, Rainer / Malvehy, Josep / Menzies, Scott / Puig, Susana / Rabinovitz, Harold / Stolz, Wilhelm / Saida, Toshiaki / Soyer, H Peter / Siegel, Eliot / Stoecker, William V / Scope, Alon / Tanaka, Masaru / Thomas, Luc / Tschandl, Philipp / Zalaudek, Iris / Halpern, Allan. ·Department of Dermatology, Medical University of Vienna, Vienna, Austria. Electronic address: harald.kittler@meduniwien.ac.at. · Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York. · Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy. · Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER ER), Instituto de Salud Carlos III, Barcelona, Spain. · University of Arizona Cancer Center, Tucson, Arizona. · Department of Dermatology and Venerology, Nonmelanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria. · Sydney Melanoma Diagnostic Center, Sydney Cancer Center, Royal Prince Alfred Hospital, Camperdown, Australia. · Skin and Cancer Associates, Plantation, Florida. · Department of Dermatology, Klinikum München, Munich, Germany. · Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan. · Dermatology Research Center, University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australia. · University of Maryland Medical Center, Baltimore Department of Veterans Affairs Medical Center, Baltimore, Maryland. · Department of Dermatology, University of Missouri Health Sciences Center, Columbia, Missouri. · Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Dermatology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Department of Dermatology, Keio University, Tokyo, Japan. · Service de Dermatologie, Center Hospitalier Universitaire de Lyon, Lyon, France. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. ·J Am Acad Dermatol · Pubmed #26896294.

ABSTRACT: BACKGROUND: Evolving dermoscopic terminology motivated us to initiate a new consensus. OBJECTIVE: We sought to establish a dictionary of standardized terms. METHODS: We reviewed the medical literature, conducted a survey, and convened a discussion among experts. RESULTS: Two competitive terminologies exist, a more metaphoric terminology that includes numerous terms and a descriptive terminology based on 5 basic terms. In a survey among members of the International Society of Dermoscopy (IDS) 23.5% (n = 201) participants preferentially use descriptive terminology, 20.1% (n = 172) use metaphoric terminology, and 484 (56.5%) use both. More participants who had been initially trained by metaphoric terminology prefer using descriptive terminology than vice versa (9.7% vs 2.6%, P < .001). Most new terms that were published since the last consensus conference in 2003 were unknown to the majority of the participants. There was uniform consensus that both terminologies are suitable, that metaphoric terms need definitions, that synonyms should be avoided, and that the creation of new metaphoric terms should be discouraged. The expert panel proposed a dictionary of standardized terms taking account of metaphoric and descriptive terms. LIMITATIONS: A consensus seeks a workable compromise but does not guarantee its implementation. CONCLUSION: The new consensus provides a revised framework of standardized terms to enhance the consistent use of dermoscopic terminology.

11 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.

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

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

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

13 Review Blue lesions. 2013

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

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

14 Review 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.

15 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.

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

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

ABSTRACT: -- No abstract --

17 Article Reflectance confocal microscopy made easy: The 4 must-know key features for the diagnosis of melanoma and nonmelanoma skin cancers. 2019

Pellacani, Giovanni / Scope, Alon / Gonzalez, Salvador / Guitera, Pascale / Farnetani, Francesca / Malvehy, Josep / Witkowski, Alexander / De Carvalho, Nathalie / Lupi, Omar / Longo, Caterina. ·Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · The Kittner Skin Cancer Screening & Research Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: scopea1@gmail.com. · Medicine and Medical Specialties Department, Alcalá University Madrid, Madrid, Spain. · Melanoma Institute Australia, The University of Sydney Discipline of Dermatology and Sydney Melanoma Diagnostic Centre, Sydney, Australia. · Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, IDIBAPS, Barcelona University, Centre for Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain. · Department of Dermatology, 4 WSK Hospital Wroclaw, Wroclaw, Poland. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Department of Dermatology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil. · Department of Dermatology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy. ·J Am Acad Dermatol · Pubmed #30954581.

ABSTRACT: BACKGROUND: Reflectance confocal microscopy (RCM)-based skin cancer diagnosis requires proficiency. OBJECTIVE: To identify a short list of key RCM features of skin cancers and test their diagnostic utility. METHODS: We identified key RCM features through consensus among 6 experts using a modified Delphi method. To test the diagnostic utility of these RCM key features, 10 novice RCM readers evaluated a subset of 100 RCM cases from a retrospective data set of benign and malignant skin neoplasms. RESULTS: From 56 features reported in the literature, the experts identified 18 RCM features as highly valuable for skin cancer diagnosis. On the basis of consensus definitions, these RCM features were further clustered into 2 melanoma-specific key features (atypical cells and dermoepidermal junction disarray), 1 basal cell carcinoma-specific key feature (basaloid cords/islands), and 1 squamous cell carcinoma-specific key feature (keratinocyte disarray). The novice reading study showed that the presence of at least 1 of the 4 key features was associated with an overall sensitivity for skin cancer diagnosis of 91%, with a sensitivity for melanoma of 93%, a sensitivity for basal cell carcinoma of 92%, and a sensitivity for squamous cell carcinoma of 67%, and an overall specificity of 57%. LIMITATIONS: The consensus was based on only six RCM experts and the validation study was retrospective. CONCLUSIONS: A consensus terminology short list identifying the 4 RCM key features for skin cancer diagnosis may facilitate dissemination of RCM to novice users.

18 Article Reflectance confocal microscopy terminology glossary for nonmelanocytic skin lesions: A systematic review. 2019

Navarrete-Dechent, Cristian / DeRosa, Antonio P / Longo, Caterina / Liopyris, Konstantinos / Oliviero, Margaret / Rabinovitz, Harold / Marghoob, Ashfaq A / Halpern, Allan C / Pellacani, Giovanni / Scope, Alon / Jain, Manu. ·Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Samuel J. Wood Library, Weill Cornell Medical College, New York, New York. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Azienda Unità Sanitaria Locale, Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. · Dermatology Associates, Plantation, Florida. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Medical Screening Institute, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. · Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: jainm@mskcc.org. ·J Am Acad Dermatol · Pubmed #30529706.

ABSTRACT: BACKGROUND: There is lack of uniformity in reflectance confocal microscopy (RCM) terminology for nonmelanocytic lesions (NMLs). OBJECTIVE: To review published RCM terms for NMLs and identify likely synonymous terms. METHODS: We conducted a systematic review of original research articles published up to August 19, 2017, adhering to Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. Two investigators gathered all published RCM terms used to describe basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and seborrheic keratosis/solar lentigo/lichen planus-like keratosis (SK/SL/LPLK). Synonymous terms were grouped on the basis of similarity in definition and histopathologic correlates. RESULTS: The inclusion criteria was met by 31 studies. Average frequency of use per term was 1.6 (range 1-8). By grouping synonymous terms, the number of terms could be reduced from 58 to 18 for BCC, 58 to 36 for SCC, 23 to 12 for SK/SL/LPLK, and from 139 to 66 terms (52.5% reduction) in total. The frequency of term usage stratified by anatomic layer (suprabasal epidermis vs epidermal basal layer, dermoepidermal junction, and superficial dermis) was 27 (25.7%) versus 78 (74.2%) for BCC; 60 (64.5%) versus 33 (34.5%) for SCC, and 15 (45.4%) versus 18 (54.5%) for SK/SL/LPLK, respectively. LIMITATIONS: Articles that were not peer reviewed were excluded. CONCLUSION: Systematic review of published RCM terms provides the basis for future NMLs terminology consensus.

19 Article Accuracy of tele-consultation on management decisions of lesions suspect for melanoma using reflectance confocal microscopy as a stand-alone diagnostic tool. 2019

Scope, A / Dusza, S W / Pellacani, G / Gill, M / Gonzalez, S / Marchetti, M A / Rabinovitz, H S / Marghoob, A A / Alessi-Fox, C / Halpern, A C. ·Medical Screening Institute, 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, NY, USA. · Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. · SkinMedical Research and Diagnostics, Dobbs Ferry, NY, USA. · SUNY Downstate, Brooklyn, NY, USA. · Department of Medicine and Medical Specialties, University de Alcalà, Madrid, Spain. · Skin and Cancer Associates, Plantation, FL, USA. · Caliber Imaging and Diagnostics, Rochester, NY, USA. ·J Eur Acad Dermatol Venereol · Pubmed #30242916.

ABSTRACT: BACKGROUND: Diagnostic accuracy of reflectance confocal microscopy (RCM) as a stand-alone diagnostic tool for suspect skin lesions has not been extensively studied. OBJECTIVE: Primary aim was to measure experts' accuracy in RCM-based management decisions. Secondary aim was to identify melanoma-specific RCM features. METHODS: The study enrolled patients ≥18 years that underwent biopsy of skin lesions clinically suspected to be melanoma. One hundred lesions imaged by RCM were randomly selected from 439 lesions prospectively collected at four pigmented lesion clinics. The study data set included 23 melanomas, three basal cell and two squamous cell carcinomas, 11 indeterminate melanocytic lesions and 61 benign lesions including 50 nevi. Three expert RCM evaluators were blinded to clinical or dermoscopic images, and to the final histopathological diagnosis. Evaluators independently issued a binary RCM-based management decision, 'biopsy' vs. 'observation'; these decisions were scored against histopathological diagnosis, with 'biopsy' as the correct management decision for malignant and indeterminate lesions. A subset analysis of 23 melanomas and 50 nevi with unequivocal histopathological diagnosis was performed to identify melanoma-specific RCM features. RESULTS: Sensitivity, specificity and diagnostic accuracy were 74%, 67% and 70% for reader 1, 46%, 84% and 69% for reader 2, and 72%, 46% and 56% for reader 3, respectively. The overall kappa for management decisions was 0.34. Readers had unanimous agreement on management for 50 of the 100 lesions. Non-specific architecture, non-visible papillae, streaming of nuclei, coarse collagen fibres and abnormal vasculature showed a significant association with melanoma in the evaluation of at least two readers. CONCLUSIONS: Reflectance confocal microscopy tele-consultation of especially challenging lesions, based on image review without benefit of clinical or dermoscopy images, may be associated with limited diagnostic accuracy and interobserver agreement. Architectural and stromal criteria may emerge as potentially useful and reproducible criteria for melanoma diagnosis.

20 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.

21 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.

22 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.

23 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 / Anonymous2970921. ·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.

24 Article Accuracy of dermatoscopy for the diagnosis of nonpigmented cancers of the skin. 2017

Sinz, Christoph / Tschandl, Philipp / Rosendahl, Cliff / Akay, Bengu Nisa / Argenziano, Giuseppe / Blum, Andreas / Braun, Ralph P / Cabo, Horacio / Gourhant, Jean-Yves / Kreusch, Juergen / Lallas, Aimilios / Lapins, Jan / Marghoob, Ashfaq A / Menzies, Scott W / Paoli, John / Rabinovitz, Harold S / Rinner, Christoph / Scope, Alon / Soyer, H Peter / Thomas, Luc / Zalaudek, Iris / Kittler, Harald. ·Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria. · Faculty of Medicine, The University of Queensland, Brisbane, Australia; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. · Department of Dermatology, Ankara University Faculty of Medicine, Ankara, Turkey. · Dermatology Unit, University of Campania, Naples, Italy. · Public, Private and Teaching Practice of Dermatology, Konstanz, Germany. · Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. · Department of Dermatology, Instituto de Investigaciones Médicas "A. Lanari," University of Buenos Aires, Buenos Aires, Argentina. · Centre de Dermatologie, Nemours, France. · Private Dermatology Practice, Lübeck, Germany. · First Department of Dermatology, Aristotle University, Thessaloniki, Greece. · Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden. · Memorial Sloan Kettering Cancer Center, Hauppauge, New York. · Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, and Discipline of Dermatology, University of Sydney, Sydney, Australia. · Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Skin and Cancer Associates, Plantation, Florida. · Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria. · Department of Dermatology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia. · Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon 1 University, Lyons Cancer Research Center, Lyon, France. · Department of Dermatology, Medical University of Graz, Graz, Austria. · Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria. Electronic address: harald.kittler@meduniwien.ac.at. ·J Am Acad Dermatol · Pubmed #28941871.

ABSTRACT: BACKGROUND: Nonpigmented skin cancer is common, and diagnosis with the unaided eye is error prone. OBJECTIVE: To investigate whether dermatoscopy improves the diagnostic accuracy for nonpigmented (amelanotic) cutaneous neoplasms. METHODS: We collected a sample of 2072 benign and malignant neoplastic lesions and inflammatory conditions and presented close-up images taken with and without dermatoscopy to 95 examiners with different levels of experience. RESULTS: The area under the curve was significantly higher with than without dermatoscopy (0.68 vs 0.64, P < .001). Among 51 possible diagnoses, the correct diagnosis was selected in 33.1% of cases with and 26.4% of cases without dermatoscopy (P < .001). For experts, the frequencies of correct specific diagnoses of a malignant lesion improved from 40.2% without to 51.3% with dermatoscopy. For all malignant neoplasms combined, the frequencies of appropriate management strategies increased from 78.1% without to 82.5% with dermatoscopy. LIMITATIONS: The study deviated from a real-life clinical setting and was potentially affected by verification and selection bias. CONCLUSIONS: Dermatoscopy improves the diagnosis and management of nonpigmented skin cancer and should be used as an adjunct to examination with the unaided eye.

25 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.

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