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Melanoma: HELP
Articles by Ignazio Stanganelli
Based on 48 articles published since 2010
(Why 48 articles?)
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Between 2010 and 2020, I. Stanganelli wrote the following 48 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Spitz/Reed nevi: proposal of management recommendations by the Dermoscopy Study Group of the Italian Society of Dermatology (SIDeMaST). 2014

Broganelli, P / Titli, S / Lallas, A / Alaibac M Annetta, A / Battarra, V / Brunetti, B / Castagno, I / Cavicchini, S / Ferrari, A / Ghigliotti, G / Landi, C / Manganoni, A / Moscarella, E / Pellacani, G / Pizzichetta, M A / Rosina, P / Rubegni, P / Satta, R / Scalvenzi, M / Stanganelli, I / Stinco, G / Zalaudek, I / Zampieri, P / Argenziano, G / Anonymous1420806. ·Department of Oncology and Hematology, Section of Dermatology, City of Health and Science Hospital of Turin, Turin, Italy - paolobroganelli@inwind.it. ·G Ital Dermatol Venereol · Pubmed #25213387.

ABSTRACT: -- No abstract --

2 Review New paradigm for stage III melanoma: from surgery to adjuvant treatment. 2019

Ascierto, Paolo Antonio / Borgognoni, Lorenzo / Botti, Gerardo / Guida, Michele / Marchetti, Paolo / Mocellin, Simone / Muto, Paolo / Palmieri, Giuseppe / Patuzzo, Roberto / Quaglino, Pietro / Stanganelli, Ignazio / Caracò, Corrado. ·Unit Melanoma, Cancer Immunotherapy and Innovative Therapies, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy. paolo.ascierto@gmail.com. · Ospedale Santa Maria Annunziata and University of Florence, Florence, Italy. · Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy. · Unit Melanoma and Rare Tumors, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy. · Oncologia Medica B Policlinico Umberto I di Roma, Rome, Italy. · Surgical Oncology Unit, IOV-IRCCS of Padova and Dept. Surgery Oncology Gastroenterology, University of Padova, Padua, Italy. · Unit of Cancer Genetics, ICB-CNR, Sassari, Italy. · Research Director CNR, Italian Melanoma Intergroup (IMI), Unit of Cancer Genetics, Head Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Sassari, Italy. · IRCCS Fondazione Istituto Nazionale dei Tumori di Milano, Milan, Italy. · Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School, Turin, Italy. · Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, FC, Italy. · University of Parma, Parma, Italy. ·J Transl Med · Pubmed #31412885.

ABSTRACT: BACKGROUND: Recently the 8th version of the American Joint Committee on Cancer (AJCC) classification has been introduced, and has attempted to define a more accurate and precise definition of prognosis in line with the major progresses in understanding the biology and pathogenesis of melanoma. This new staging system introduces major changes in the stage III staging system. Indeed, surgical practice is changing in stage III patients, since, according to recent evidence, there is no survival benefit in radical lymph node dissection following a positive sentinel lymph node dissection. Therefore, some patients currently staged IIIB-C after dissection could be downgraded to IIIA (as in the case of patients with metastatic non-sentinel lymph nodes) since many completion lymph node dissections will no longer be performed. Moreover, new and effective targeted and immune strategies are being introduced in the pharmacological armamentarium in the adjuvant setting, showing major efficacy. CONCLUSIONS: This article provides the authors' personal view on the above-mentioned topics.

3 Review Dietary compounds and cutaneous malignant melanoma: recent advances from a biological perspective. 2019

Ombra, Maria Neve / Paliogiannis, Panagiotis / Stucci, Luigia Stefania / Colombino, Maria / Casula, Milena / Sini, Maria Cristina / Manca, Antonella / Palomba, Grazia / Stanganelli, Ignazio / Mandalà, Mario / Gandini, Sara / Lissia, Amelia / Doneddu, Valentina / Cossu, Antonio / Palmieri, Giuseppe / Anonymous310992. ·1Institute of Food Sciences, National Research Council, Avellino, Italy. · 0000 0001 1940 4177 · grid.5326.2 · 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. · 0000 0001 2097 9138 · grid.11450.31 · 3Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy. · 0000 0001 0120 3326 · grid.7644.1 · 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy. · 5Istituto Scientifico Romagnolo per Studio e Cura Tumori (IRST-IRCCS), Meldola, Italy. · 0000 0004 1755 9177 · grid.419563.c · 6Medical Oncology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy. · 0000 0004 1757 8431 · grid.460094.f · 7Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. · 0000 0004 1757 0843 · grid.15667.33 ·Nutr Metab (Lond) · Pubmed #31139235.

ABSTRACT: Cutaneous malignant melanoma is a heterogeneous disease, being the consequence of specific genetic alterations along several molecular pathways. Despite the increased knowledge about the biology and pathogenesis of melanoma, the incidence has grown markedly worldwide, making it extremely important to develop preventive measures. The beneficial role of correct nutrition and of some natural dietary compounds in preventing malignant melanoma has been widely demonstrated. This led to numerous studies investigating the role of several dietary attitudes, patterns, and supplements in the prevention of melanoma, and ongoing research investigates their impact in the clinical management and outcomes of patients diagnosed with the disease. This article is an overview of recent scientific advances regarding specific dietary compounds and their impact on melanoma development and treatment.

4 Review Anti-hypertensive drugs and skin cancer risk: a review of the literature and meta-analysis. 2018

Gandini, Sara / Palli, Domenico / Spadola, Giuseppe / Bendinelli, Benedetta / Cocorocchio, Emilia / Stanganelli, Ignazio / Miligi, Lucia / Masala, Giovanna / Caini, Saverio. ·Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. · Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. · Division of Melanoma and Muscolo-Cutaneous Sarcoma, European Institute of Oncology, Milan, Italy. · Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy. · Environmental and Occupational Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. · Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: s.caini@ispo.toscana.it. ·Crit Rev Oncol Hematol · Pubmed #29458778.

ABSTRACT: INTRODUCTION: Several anti-hypertensive drugs have photosensitizing properties, however it remains unclear whether long-term users of these drugs are also at increased risk of skin malignancies. We conducted a literature review and meta-analysis on the association between use of anti-hypertensive drugs and the risk of cutaneous melanoma and non-melanoma skin cancer (NMSC). METHODS: We searched PubMed, EMBASE, Google Scholar and the Cochrane Library, and included observational and experimental epidemiological studies published until February 28th, 2017. We calculated summary relative risk (SRR) and 95% confidence intervals (95% CI) through random effect models to estimate the risk of skin malignancies among users of the following classes of anti-hypertensive drugs: thiazide diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB) and β-blockers. We conducted sub-group and sensitivity analysis to explore causes of between-studies heterogeneity, and assessed publication bias using a funnel-plot based approach. RESULTS: Nineteen independent studies were included in the meta-analysis. CCB users were at increased skin cancer risk (SRR 1.14, 95% CI 1.07-1.21), and β-blockers users were at increased risk of developing cutaneous melanoma (SRR 1.21, 95% CI 1.05-1.40), with acceptable between-studies heterogeneity (I CONCLUSION: Family doctors and clinicians should inform their patients about the increased risk of skin cancer associated with the use of CCB and β-blockers and instruct them to perform periodic skin self-examination. Further studies are warranted to elucidate the observed associations.

5 Review Vitamin D status and risk for malignant cutaneous melanoma: recent advances. 2017

Ombra, Maria N / Paliogiannis, Panagiotis / Doneddu, Valentina / Sini, Maria C / Colombino, Maria / Rozzo, Carla / Stanganelli, Ignazio / Tanda, Francesco / Cossu, Antonio / Palmieri, Giuseppe. ·aInstitute of Food Sciences, National Research Council (CNR), Avellino bDepartment of Surgical, Microsurgical and Medical Sciences, University of Sassari cInstitute of Biomolecular Chemistry, National Research Council (CNR), Cancer Genetics Unit, Sassari dRomagna Scientific Institute for the Study and Cure of Tumors, Skin Cancer Unit, Meldola, Italy. ·Eur J Cancer Prev · Pubmed #28125434.

ABSTRACT: Cutaneous malignant melanoma, whose incidence is increasing steadily worldwide, is the result of complex interactions between individual genetic factors and environmental risk factors. Ultraviolet radiation represents the most important environmental risk factor for the development of skin cancers, including melanoma. Sun exposure and early sunburn during childhood are the principal causes of cutaneous melanoma insurgence in adults, with double the risk relative to a nonexposed population. Consequently, ultraviolet protection has long been recognized as an important measure to prevent such a malignancy. Biological and epidemiological data suggest that vitamin D status could affect the risk of cancer and play a role in cancer prevention by exerting antiproliferative effects. Solar radiations are critical for vitamin D synthesis in humans; however, uncontrolled and intensive sun exposure is dangerous to skin health and may contribute toward the development of cutaneous malignant melanoma. An optimum balance between sun protection and exposure is thus advocated. Additional research is required to confirm the preventive role of vitamin D in melanoma incidence or a positive influence on patient outcome.

6 Review Coffee, tea and caffeine intake and the risk of non-melanoma skin cancer: a review of the literature and meta-analysis. 2017

Caini, Saverio / Cattaruzza, Maria Sofia / Bendinelli, Benedetta / Tosti, Giulio / Masala, Giovanna / Gnagnarella, Patrizia / Assedi, Melania / Stanganelli, Ignazio / Palli, Domenico / Gandini, Sara. ·Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Via delle Oblate 2, 50139, Florence, Italy. s.caini@ispo.toscana.it. · Department of Public Health and Infectious Diseases, Faculty of Medicine, Policlinico Umberto I, "Sapienza" University, Rome, Italy. · Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Via delle Oblate 2, 50139, Florence, Italy. · Division of Dermatoncological Surgery, European Institute of Oncology, Milan, Italy. · Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. · Skin Cancer Unit, Scientific Institute of Romagna for the Study and Treatment of Cancer, IRCSS, IRST, Meldola, Italy. ·Eur J Nutr · Pubmed #27388462.

ABSTRACT: PURPOSE: Laboratory studies suggested that caffeine and other nutrients contained in coffee and tea may protect against non-melanoma skin cancer (NMSC). However, epidemiological studies conducted so far have produced conflicting results. METHODS: We performed a literature review and meta-analysis of observational studies published until February 2016 that investigated the association between coffee and tea intake and NMSC risk. We calculated summary relative risk (SRR) and corresponding 95 % confidence intervals (95 % CI) by using random effects with maximum likelihood estimation. RESULTS: Overall, 37,627 NMSC cases from 13 papers were available for analysis. Intake of caffeinated coffee was inversely associated with NMSC risk (SRR for those in the highest vs. lowest category of intake: 0.82, 95 % CI 0.75-0.89, I CONCLUSIONS: Coffee intake appears to exert a moderate protective effect against BCC development, probably through the biological effect of caffeine. However, the observational nature of studies included, subject to bias and confounding, suggests taking with caution these results that should be verified in randomized clinical trials.

7 Review Epidemiological and genetic factors underlying melanoma development in Italy. 2015

Palmieri, Giuseppe / Colombino, Maria / Casula, Milena / Budroni, Mario / Manca, Antonella / Sini, Maria Cristina / Lissia, Amelia / Stanganelli, Ignazio / Ascierto, Paolo A / Cossu, Antonio. ·Institute of Biomolecular Chemistry, National Research Council (CNR), Sassari, Italy. · Department of Pathology, Hospital-University Health Unit (AOU), Sassari, Italy. · Skin Cancer Unit, Istituto Scientifico Romagnolo Tumori (IRST), Meldola, Italy. · Istituto Nazionale Tumori (INT), Fondazione G. Pascale, Naples, Italy. ·Melanoma Manag · Pubmed #30190844.

ABSTRACT: Among human cancers, melanoma remains one of the malignancies with an ever-growing incidence in white populations. Recent advances in biological and immunological therapeutic approaches as well as increased efforts for secondary prevention are contributing to improve the survival rates. It is likely that a significant fall in mortality rates for melanoma will be achieved by further increase of the early detection through a more accurate selection of the higher-risk individuals (i.e., carriers of predisposing genetic alterations). A similar scenario occurs in Italy. In the present review, we have considered data on incidence, survival and mortality rates of melanoma in Italian population, including evaluation of the main risk factors and genetic mutations underlying disease susceptibility.

8 Review Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: a comprehensive review and meta-analysis. 2014

Caini, Saverio / Boniol, Mathieu / Tosti, Giulio / Magi, Serena / Medri, Matelda / Stanganelli, Ignazio / Palli, Domenico / Assedi, Melania / Marmol, Veronique Del / Gandini, Sara. ·Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy. Electronic address: s.caini@ispo.toscana.it. · International Prevention Research Institute, Lyon, France. · Division of Dermatoncological Surgery, European Institute of Oncology, Milan, Italy. · Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy. · Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention, Florence, Italy. · Department of Dermatology. Hopital Erasme. Université Libre de Bruxelles, Brussels, Belgium. · Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. ·Eur J Cancer · Pubmed #25087185.

ABSTRACT: Vitamin D is formed mainly in the skin upon exposure to sunlight and can as well be taken orally with food or through supplements. While sun exposure is a known risk factor for skin cancer development, vitamin D exerts anti-proliferative and pro-apoptotic effects on melanocytes and keratinocytes in vitro. To clarify the role of vitamin D in skin carcinogenesis, we performed a review of the literature and meta-analysis to evaluate the association of vitamin D serum levels and dietary intake with cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) risk and melanoma prognostic factors. Twenty papers were included for an overall 1420 CM and 2317 NMSC. The summary relative risks (SRRs) from random effects models for the association of highest versus lowest vitamin D serum levels was 1.46 (95% confidence interval (CI) 0.60-3.53) and 1.64 (95% CI 1.02-2.65) for CM and NMSC, respectively. The SRR for the highest versus lowest quintile of vitamin D intake was 0.86 (95% CI 0.63-1.13) for CM and 1.03 (95% CI 0.95-1.13) for NMSC. Data were suggestive of an inverse association between vitamin D blood levels and CM thickness at diagnosis. Further research is needed to investigate the effect of vitamin D on skin cancer risk in populations with different exposure to sunlight and dietary habits, and to evaluate whether vitamin D supplementation is effective in improving CM survival.

9 Review Dermoscopy, confocal laser microscopy, and hi-tech evaluation of vascular skin lesions: diagnostic and therapeutic perspectives. 2012

Grazzini, Marta / Stanganelli, Ignazio / Rossari, Susanna / Gori, Alessia / Oranges, Teresa / Longo, Anna Sara / Lotti, Torello / Bencini, Pier Luca / De Giorgi, Vincenzo. ·Department of Dermatology, University of Florence, Firenze, Italy. ·Dermatol Ther · Pubmed #22950556.

ABSTRACT: Vascular skin lesions comprise a wide and heterogeneous group of malformations and tumors that can be correctly diagnosed based on natural history and physical examination. However, considering the high incidence of such lesions, a great number of them can be misdiagnosed. In addition, it is not so rare that an aggressive amelanotic melanoma can be misdiagnosed as a vascular lesion. In this regard, dermoscopy and confocal laser microscopy examination can play a central role in increasing the specificity of the diagnosis of such lesions. In fact, the superiority of these tools over clinical examination has encouraged dermatologists to adopt these devices for routine clinical practice, with a progressive spread of their use. In this review, we will go through the dermoscopic and the confocal laser microscopy of diagnosis of most frequent vascular lesions (i.e., hemangiomas angiokeratoma, pyogenic granuloma, angiosarcoma) taking into particular consideration the differential diagnosis with amelanotic melanoma.

10 Article Insights into Genetic Susceptibility to Melanoma by Gene Panel Testing: Potential Pathogenic Variants in ACD, 2020

Pastorino, Lorenza / Andreotti, Virginia / Dalmasso, Bruna / Vanni, Irene / Ciccarese, Giulia / Mandalà, Mario / Spadola, Giuseppe / Pizzichetta, Maria Antonietta / Ponti, Giovanni / Tibiletti, Maria Grazia / Sala, Elena / Genuardi, Maurizio / Chiurazzi, Pietro / Maccanti, Gabriele / Manoukian, Siranoush / Sestini, Serena / Danesi, Rita / Zampiga, Valentina / Starza, Roberta La / Stanganelli, Ignazio / Ballestrero, Alberto / Mastracci, Luca / Grillo, Federica / Sciallero, Stefania / Cecchi, Federica / Tanda, Enrica Teresa / Spagnolo, Francesco / Queirolo, Paola / Imi, Italian Melanoma Intergroup / Goldstein, Alisa M / Bruno, William / Ghiorzo, Paola. ·Genetics of Rare Cancers, Department of Internal Medicine and Medical Specialties, University of Genoa, 16132 Genova, Italy. · IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy. · Unit of Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy. · Divisione di Chirurgia del Melanoma, IRCCS Fondazione Istituto Nazionale per lo studio e la cura dei tumori Milano, 20133, Italy. · Division of Oncology B, CRO Aviano National Cancer Institute, Aviano, 33081, Italy. · Department of Diagnostic and clinical medicine and public health, University of Modena and Reggio Emilia, 41124 Modena, Italy. · Department of Pathology, ASST Sette Laghi, 21100 Varese , Italy. · Medical Genetics Laboratory, Clinical Pathology Department, S. Gerardo Hospital, 20900 Monza, Italy. · UOC Genetica Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy. · Sezione Genetica Medica, Dipartimento di Scienze della Vita e di Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy. · UO Dermatologia P.O. Misericordia, 58100 Grosseto, Italy. · Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy. · Plastic & Reconstructive Surgery Unit, Regional Melanoma Referral Center and Melanoma & Skin Cancer Unit Tuscan Tumour Institute (ITT), Santa Maria Annunziata Hospital, 50012 Firenze, Italy. · Romagna Cancer Registry, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, 47014 Meldola, Italy. · Biosciences Laboratory, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola and Department of Dermatology, University of Parma, 47014 Parma, Italy. · Hematology and Bone Marrow Transplantation Unit, CREO, University of Perugia, 06156 Perugia, Italy. · Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, 47014 Meldola, Italy. · Department of Internal Medicine, Università degli Studi di Genova, 16132 Genova, Italy. · Department of Integrated Surgical and Diagnostic Sciences, Università degli Studi di Genova, 16132 Genova, Italy. · IRCCS Ospedale Policlinico San Martino, Unit of Medical Oncology 1, 16132 Genova, Italy. · IRCCS Ospedale Policlinico San Martino, Medical Oncology 2, 16132 Genova, Italy. · Italian Melanoma Intergroup (IMI), 16121 Genova, Italy. · Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, MD 20892, USA. ·Cancers (Basel) · Pubmed #32325837.

ABSTRACT: The contribution of recently established or candidate susceptibility genes to melanoma missing heritability has yet to be determined. Multigene panel testing could increase diagnostic yield and better define the role of candidate genes. We characterized 273

11 Article Germline and somatic mutations in patients with multiple primary melanomas: a next generation sequencing study. 2019

Casula, Milena / Paliogiannis, Panagiotis / Ayala, Fabrizio / De Giorgi, Vincenzo / Stanganelli, Ignazio / Mandalà, Mario / Colombino, Maria / Manca, Antonella / Sini, Maria Cristina / Caracò, Corrado / Ascierto, Paolo Antonio / Satta, Rosanna Rita / Anonymous1911035 / Lissia, Amelia / Cossu, Antonio / Palmieri, Giuseppe / Anonymous1921035. ·Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Traversa La Crucca 3, Baldinca Li Punti, 07100, Sassari, Italy. · Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy. · National Tumor Institute "Fondazione G. Pascale", Napoli, Italy. · Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Department of Dermatology, University of Parma, Parma, Italy. · Unit of Medical Oncology, "Papa Giovanni XXIII" Hospital of Bergamo, Bergamo, Italy. · Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Traversa La Crucca 3, Baldinca Li Punti, 07100, Sassari, Italy. gpalmieri@yahoo.com. ·BMC Cancer · Pubmed #31382929.

ABSTRACT: INTRODUCTION: Multiple primary melanomas (MPM) occur up to 8% of patients with cutaneous malignant melanoma (CMM). They are often sporadic harbouring several somatic mutations, but also familial cases harbouring a CDKN2A germline mutation have been describe in Caucasian populations. The aim of this study was to investigate the incidence, the distribution patterns and the impact of known and unknown germline and somatic mutations in patients with MPM from Italy. MATERIALS AND METHODS: One-hundred and two MPM patients were enrolled for germline mutation analysis, and five patients with at least four MPMs were identified for somatic mutation analysis. The demographic, pathologic and clinical features were retrieved from medical records. Molecular analysis for both germline and somatic mutations was performed in genomic DNA from peripheral blood and tissue samples, respectively, through a next generation sequencing approach, using a specific multiple-gene panel constructed by the Italian Melanoma Intergroup for somatic analysis and a commercial cancer hotspot panel for somatic analysis. RESULTS: CDKN2A mutations were detected in 6/16 (37.5%) and 3/86 (3.5%) MPM cases with and without family history for melanoma, respectively. Furthermore, multiple MC1R and, to a lesser extent, ATM variants have been identified. BAP1 variants were found only in MPM patients from southern Italy. The most frequent somatic variants were the pathogenic BRAF CONCLUSIONS: CDNK2A mutation is the most relevant susceptibility mutation in Italian patients with MPM, especially those with a family history for CMM. The prevalence of this mutation and other sequence variants identified in this study varies among specific sub-populations. Furthermore, some heterogeneity in driver somatic mutations between sporadic MPMs has been observed, as well as in a number of associated sequence variants the clinical impact of which needs to be further elucidated.

12 Article Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy. 2019

Peccerillo, Francesca / Mandel, Victor Desmond / Di Tullio, Francesca / Ciardo, Silvana / Chester, Johanna / Kaleci, Shaniko / de Carvalho, Nathalie / Del Duca, Ester / Giannetti, Luca / Mazzoni, Laura / Nisticò, Steven Paul / Stanganelli, Ignazio / Pellacani, Giovanni / Farnetani, Francesca. ·Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. · Division of Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. · Skin Cancer Unit, Scientific Institute of Romagna for the Study and Treatment of Cancer, IRCSS, IRST, Meldola, Italy. · Dermatology Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy. · Department of Dermatology, University of Parma, Parma, Italy. · Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy, farnetani.francesca@gmail.com. ·Dermatology · Pubmed #30404078.

ABSTRACT: BACKGROUND: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. OBJECTIVES: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). METHODS: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the re visited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. RESULTS: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p < 0.001), tumor islands located in the epidermis (100%, p < 0.001), smaller vascular diameter (100%, p < 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p < 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p < 0.001) with a larger vascular diameter (50%, p < 0.001). CONCLUSIONS: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.

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

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

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

14 Article Evaluation of the agreement between TNM 7th and 8th in a population-based series of cutaneous melanoma. 2019

Crocetti, E / Stanganelli, I / Mancini, S / Vattiato, R / Giuliani, O / Ravaioli, A / Balducci, C / Falcini, F / Pimpinelli, N. ·Romagna Cancer Registry, IRCCS, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy. · Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence Medical School, Florence, Italy. · Skin Cancer Unit, IRCCS, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy. · University of Parma, Parma, Italy. · Romagna Local Health Unit, Forlì, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #30317667.

ABSTRACT: BACKGROUND: The 8th edition of TNM has introduced new rules for staging cutaneous melanoma. OBJECTIVE: To compare TNM 7th and 8th editions in defining pathological stages of melanoma. METHODS: A population-based series of 1847 skin melanoma from Romagna cancer registry (Italy) incident during 2003-2012 has been used to measure the agreement (with Cohen's kappa) between TNM 8th and 7th editions in defining melanoma stage. Disease-specific survival has been computed for each stage according to TNM 7th and 8th. RESULTS: The agreement between the two TNM editions was quite good when considered on average (kappa = 70.7%), moderate for stage I (61.5%), nearly perfect for stage II (95.0%), but extremely poor for stage III (8.1%). The overall melanoma-specific observed survival was 90.8% at 5 year and 88.9% at 10 year with a strong prognostic effect of stage. CONCLUSION: TNM 8th edition introduces several changes which do not seem really helpful in addressing the care of stage I melanoma and may complicate the definition and comparability of stage III.

15 Article Multiple acquired pigmented lesions in a patient affected by melanoma. 2018

Savoia, Francesco / Tabanelli, Michela / Ascari Raccagni, Antonio / Crisanti, Emilia / Stanganelli, Ignazio / Piccolo, Domenico. ·Unit of Dermatology, AUSL della Romagna, Ravenna, Italy. · Unit of Pathologic Anatomy, AUSL della Romagna, Italy. · Skin Cancer Unit, IRST IRCCS Meldola (FC), Italy. · Italian Association Outpatient Dermatologists, Pescara, Pescara, Italy. ·J Dtsch Dermatol Ges · Pubmed #29786976.

ABSTRACT: -- No abstract --

16 Article Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy. 2018

Persechino, Flavia / De Carvalho, Nathalie / Ciardo, Silvana / De Pace, Barbara / Casari, Alice / Chester, Johanna / Kaleci, Shaniko / Stanganelli, Ignazio / Longo, Caterina / Farnetani, Francesca / Pellacani, Giovanni. ·Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy. · Skin Cancer Unit Scientific Institute of Romagna for The study and Treatment of Cancer, IRCSS, IRST, Meldola, Italy. · Skin Cancer Unit, IRCCS Santa Maria Nuova, Reggio Emilia, Italy. ·Exp Dermatol · Pubmed #29274094.

ABSTRACT: Pigmented facial macules are common on sun damage skin. The diagnosis of early stage lentigo maligna (LM) and lentigo maligna melanoma (LMM) is challenging. Reflectance confocal microscopy (RCM) has been proven to increase diagnostic accuracy of facial lesions. A total of 154 pigmented facial macules, retrospectively collected, were evaluated for the presence of already-described RCM features and new parameters depicting aspects of the follicle. Melanocytic nests, roundish pagetoid cells, follicular infiltration, bulgings from the follicles and many bright dendrites and infiltration of the hair follicle (ie, folliculotropism) were found to be indicative of LM/LMM compared to non-melanocytic skin neoplasms (NMSNs), with an overall sensitivity of 96% and specificity of 83%. Concerning NMSNs, solar lentigo and lichen planus-like keratosis resulted better distinguishable from LM/LMM because usually lacking malignant features and presenting characteristic diagnostic parameters, such as epidermal cobblestone pattern and polycyclic papillary contours. On the other hand, distinction of pigmented actinic keratosis (PAK) resulted more difficult, and needing evaluation of hair follicle infiltration and bulging structures, due to the frequent observation of few bright dendrites in the epidermis, but predominantly not infiltrating the hair follicle (estimated specificity for PAK 53%). A detailed evaluation of the components of the folliculotropism may help to improve the diagnostic accuracy. The classification of the type, distribution and amount of cells, and the presence of bulging around the follicles seem to represent important tools for the differentiation between PAK and LM/LMM at RCM analysis.

17 Article Dermoscopy and confocal microscopy for metachronous multiple melanomas: morphological, clinical, and molecular correlations. 2018

Colombino, Maria / Paliogiannis, Panagiotis / Pagliarello, Calogero / Cossu, Antonio / Lissia, Amelia / Satta, Rosanna / Mazzoni, Laura / Magi, Serena / Sini, Maria Cristina / Manca, Antonella / Casula, Milena / Doneddu, Valentina / Palmieri, Giuseppe / Stanganelli, Ignazio. ·Unit of Cancer Genetics, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Traversa La Crucca 3, 07100, Sassari, Italy. · Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Via Padre Manzella 4, 07100, Sassari, Italy. · Dermatologic Unit, University of Parma, 43121 Parma, Italy. · Anatomic Pathology Unit, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Via Matteotti 64, 07100, Sassari, Italy. · Dermatology Unit, Department of Clinical and Experimental Medicine, University of Sassari, V.le San Pietro 43, 07100, Sassari, Italy. · Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, FC, Italy. · Experimental Pathology and Oncology, Department of Clinical and Experimental Medicine, University of Sassari, Via Padre Manzella 4, 07100, Sassari, Italy, Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, FC, Italy. ·Eur J Dermatol · Pubmed #29180316.

ABSTRACT: Cutaneous melanoma is one of the most frequent malignancies of the skin in Caucasian populations. Patients who develop cutaneous melanoma are at increased risk of developing a second primary melanoma. The estimated incidence of multiple primary melanoma (MPM) ranges from 1.2% to 8.2% of cases, with a high preponderance of melanomas occurring metachronously. The aim of this study was to describe dermoscopic, microscopic, clinical, and molecular correlations between first and subsequent melanomas in patients with metachronous MPMs. Twenty-four paired melanomas from 12 MPM patients were evaluated for architectural characteristics based on dermoscopy and confocal microscopy, as well as for mutations in BRAF and NRAS genes by Sanger-based sequencing analysis. Specific scores used for classifying features of dermoscopy (global pattern; 7-point check list; ABCD Stolz score) and confocal microscopy (Segura and Pellacani) were compared with genetic and histological data. Consistency in dermoscopic patterns between the primary and subsequent cutaneous melanomas were observed in about two thirds of cases, whereas concordant features based on confocal microscopy were found in only about two fifths of cases. The majority of patients (7/12; 58%) presented consistent BRAF/NRAS mutation patterns between first and subsequent primary melanomas. A significant association between BRAF mutations and Pellacani score was evident. Similarities between the index melanoma and subsequent cutaneous melanomas were observed with regards to dermoscopic features and, to a much less extent, confocal microscopy findings. Our data further indicate that the Pellacani score may be used to predict BRAF mutations.

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

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

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

19 Article Atopic dermatitis, naevi count and skin cancer risk: A meta-analysis. 2016

Gandini, Sara / Stanganelli, Ignazio / Palli, Domenico / De Giorgi, Vincenzo / Masala, Giovanna / Caini, Saverio. ·Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. Electronic address: sara.gandini@ieo.it. · Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy. Electronic address: igstanga@tin.it. · Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: d.palli@ispo.toscana.it. · Department of Dermatology, University of Florence, Florence, Italy. Electronic address: vincenzo.degiorgi@unifi.it. · Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: g.masala@ispo.toscana.it. · Cancer Risk Factors and Lifestyle Epidemiology, Cancer Research and Prevention Institute (ISPO), Florence, Italy. Electronic address: s.caini@ispo.toscana.it. ·J Dermatol Sci · Pubmed #27461758.

ABSTRACT: BACKGROUND: The risk of skin malignancy among atopic dermatitis (AD) patients is not well established. OBJECTIVE: We reviewed the epidemiological evidence on the association between AD, naevi count, and the risk of cutaneous melanoma and keratinocyte skin cancer (KSC). METHODS: We included all studies that compared the naevi count and the risk of skin cancer (melanoma and/or KSC) between AD patients and unaffected individuals. We calculated summary relative risks (SRRs) and 95% confidence intervals (CI) through random effects models; explored correlates of between-studies heterogeneity using sub-group and sensitivity analysis; and assessed publication bias using a funnel-plot-based approach. RESULTS: The number of common naevi larger ≥2mm on the whole body was consistently lower among AD patients vs. unaffected individuals when measured by trained health professionals. The risk of melanoma was not increased among AD patients (SRR=0.77, 95%CI 0.44-1.35, I CONCLUSIONS: AD patients may be at increased BCC risk; however, methodological limitations prevented from drawing definitive conclusions. Despite the lack of strong scientific evidence, AD patients should avoid excessive sun exposure, regularly perform skin self examination, and consult a doctor in case of a suspicious skin lesion.

20 Article Presurgical assessment of a melanoma during pregnancy based on dermoscopy and confocal laser microscopy. 2016

Stanganelli, Ignazio / Medri, Matelda / Tavaniello, Beatrice / Marengo, Mario / Mazzoni, Laura / Salfi, Nunzio C / Zannetti, Guido. ·Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Forlì-Cesena, Italy - matelda.medri@irst.emr.it. ·G Ital Dermatol Venereol · Pubmed #27348323.

ABSTRACT: -- No abstract --

21 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.

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

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

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

23 Article Activating PIK3CA mutations coexist with BRAF or NRAS mutations in a limited fraction of melanomas. 2015

Manca, Antonella / Lissia, Amelia / Capone, Mariaelena / Ascierto, Paolo A / Botti, Gerardo / Caracò, Corrado / Stanganelli, Ignazio / Colombino, Maria / Sini, MariaCristina / Cossu, Antonio / Palmieri, Giuseppe. ·Institute of Biomolecular Chemistry, National Research Council (CNR), Traversa La Crucca 3 - Baldinca Li Punti, Sassari, 07100, Italy. gpalmieri@yahoo.com. ·J Transl Med · Pubmed #25627962.

ABSTRACT: BACKGROUND: Activated PI3K-AKT pathway may contribute to decrease sensitivity to inhibitors of key pathogenetic effectors (mutated BRAF, active NRAS or MEK) in melanoma. Functional alterations are deeply involved in PI3K-AKT activation, with a minimal role reported for mutations in PIK3CA, the catalytic subunit of the PI3K gene. We here assessed the prevalence of the coexistence of BRAF/NRAS and PIK3CA mutations in a series of melanoma samples. METHODS: A total of 245 tumor specimens (212 primary melanomas and 33 melanoma cell lines) was screened for mutations in BRAF, NRAS, and PIK3CA genes by automated direct sequencing. RESULTS: Overall, 110 (44.9%) samples carried mutations in BRAF, 26 (10.6%) in NRAS, and 24 (9.8%) in PIK3CA. All identified PIK3CA mutations have been reported to induce PI3K activation; those detected in cultured melanomas were investigated for their interference with the antiproliferative activity of the BRAF-mutant inhibitor vemurafenib. A reduced suppression in cell growth was observed in treated cells carrying both BRAF and PIK3CA mutations as compared with those presenting a mutated BRAF only. Among the analysed melanomas, 12/245 (4.9%) samples presented the coexistence of PIK3CA and BRAF/NRAS mutations. CONCLUSIONS: Our study further suggests that PIK3CA mutations account for a small fraction of PI3K pathway activation and have a limited impact in interfering with the BRAF/NRAS-driven growth in melanoma.

24 Article CDKN2A mutations could influence the dermoscopic pattern of presentation of multiple primary melanoma: a clinical dermoscopic genetic study. 2015

De Giorgi, V / Savarese, I / D'Errico, A / Gori, A / Papi, F / Colombino, M / Sini, M Cristina / Stanganelli, I / Palmieri, G / Massi, D. ·Division Dermatology, Dept. of Surgery and Translational Medicine, University of Florence, Florence, Italy. ·J Eur Acad Dermatol Venereol · Pubmed #25200134.

ABSTRACT: BACKGROUND: Patients who develop cutaneous melanoma are at increased risk of developing a second primary melanoma. There are many aetiological reasons by which the risk of a second melanoma increases. Among others, genetic factors may contribute to modulating this risk. The risk of identifying a CDKN2A germline mutation increases with the number of primary melanomas and with the presence of familial history of melanoma. Patients with melanoma are especially encouraged to have regular follow-up visits with their dermatologist to perform clinical and dermatoscopic examination. In particular, dermoscopy could be very useful in multiple primary melanoma (MPM) patients. OBJECTIVES: To analyse the clinical and dermatoscopic features of multiple melanomas, focusing on those features that are more frequently found in the same patient to recognize them earlier and understand whether they appear with the similar peculiar dermatoscopic features, especially in CDKN2A carriers. METHODS: Medical records of MPM patients were selected from a database including 1065 patients with histopathologically proven melanoma diagnosis, all treated at the dermatology clinic of the University of Florence from 2000 to 2013. Pictures of melanoma were independently and blindly administered to three dermatologist experts in dermoscopy to evaluate the presence or absence of ABCD criteria for each clinical image, and the main pattern for the dermoscopic images. The results were then analyzed and crossed to rate the clinical and dermoscopic features of MPM. RESULTS: Seventy five (7.0%) of 1065 patients included in our database were found to carry an MPM disease. Among them, we selected 12 (16%) patients with three or more MPMs. The presence of the CDKN2A melanoma susceptibility gene was observed in 4/12 (33.33%) patients; two patients presented the C500G and c.5 + 1delG polymorphisms in the CDKN2A gene. In CDKN2A carriers, each patient showed a similar and specific dermatoscopic pattern in their lesions. CONCLUSIONS: Even being aware of the limitations of this study, according to hereditary characters and their modes of transmissions, we could speculate that for each patient with a CDKN2A germline mutation, it is possible to find the same kind of dermoscopical pattern among their melanocytic tumours.

25 Article Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy. 2015

Stanganelli, I / Longo, C / Mazzoni, L / Magi, S / Medri, M / Lanzanova, G / Farnetani, F / Pellacani, G. ·Skin Cancer Unit, IRCCS IRST, Istituto Scientifico Romagnolo per lo Studio e la Cura Tumori, Meldola, FC, Italy. ·Br J Dermatol · Pubmed #25154446.

ABSTRACT: BACKGROUND: Successful treatment of melanoma depends on early diagnosis, but its varied clinical presentation means that no single noninvasive method or criterion can provide reliable detection in all cases. OBJECTIVES: To determine whether combining sequential dermoscopy imaging with reflectance confocal microscopy (RCM) can improve melanoma detection and reduce the burden of unnecessary excisions. METHODS: We conducted a retrospective study with median follow-up of 25 months. We included equivocal pigmented lesions that lacked clear dermoscopy criteria for melanoma at baseline but were excised subsequently because of changes during digital monitoring. RCM imaging was performed before excision. Main melanoma dermoscopy features, seven-point checklist score at baseline, and changes in structure and/or colour, and development of new melanoma-specific criteria at follow-up (scored as major, moderate or minor) were considered. Main melanoma RCM criteria were evaluated and diagnosis was made. Histopathological diagnosis was the reference standard for defining parameter frequency and diagnostic accuracy. RESULTS: Seventy lesions were included. Major changes were more frequently correlated with melanoma diagnosis, although one-third (four of 12) of melanomas showed moderate or minor changes. Cytological atypia and architectural disarrangement on RCM were correlated with melanoma diagnosis. A correct melanoma diagnosis was achieved with RCM in almost all cases (11 of 12, 92%). Referring for excision only those lesions with RCM-positive features and/or presenting major changes at digital dermoscopy follow-up, theoretically 27 of 58 naevi could be saved from surgery. CONCLUSIONS: Integration of RCM in the clinical and instrumental strategy for managing difficult pigmented lesions provided additional diagnostic information useful in the decision-making process.

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