STUDY. Morphologic Features of Melanophages Under In Vivo Reflectance Confocal Microscopy
|
|
- Marcia Barrett
- 5 years ago
- Views:
Transcription
1 STUDY Morphologic Features of Melanophages Under In Vivo Reflectance Confocal Microscopy Pascale Guitera, MD; Ling-Xi L. Li, MD, PhD; Richard A. Scolyer, MD; Scott W. Menzies, MS, PhD Objectives: To determine morphologic features of melanophages under in vivo reflectance confocal microscopy (RCM) and to highlight morphologic features that are important in distinguishing melanophages from melanocytes. Design: Consecutive retrospective study. Setting: Referral center for pigmented lesions. Patients: The study group retrospectively constituted 20 consecutive patients having biopsy-proven lichen planus like keratoses that dermoscopically and histopathologically showed many melanophages and that had been imaged under RCM before biopsy. Main Outcome Measures: The RCM characteristics of isolated dermal bright cells were scored blinded to dermoscopic features and histopathologic diagnosis. Results: Under RCM, melanophages were significantly smaller than melanocytes (mean [SD] cell diameter, 13.6 [1.6] vs 18.2 [2.9] µm, P=.006). Nuclei (intracellular lowreflectance round-oval structures) were visible in only 16% (29 of 184) of the cells in melanophages vs 57% (28 of 49) of the cells in melanocytes (P.001). When identified, nuclei were smaller in melanophages than in melanocytes (mean [SD] diameter, 3.2 [1.2] vs 6.4 [0.7] µm, P.001). Compared with melanocytes, melanophages were significantly more ill defined (76% [140 of 184] vs 18% [9 of 49], P.001), less round (23% [42 of 184] vs 69% [34 of 49], P.001), and less dendritic (1% [2 of 184] vs 12% [6 of 49]) (P=.001). Conclusion: Observed differences in morphologic features should enable distinction between melanophages and melanocytes under RCM, thereby improving the accuracy of skin lesion diagnosis using this technique. Arch Dermatol. 2010;146(5): Author Affiliations: Sydney Melanoma Diagnostic Centre, Departments of Dermatology (Drs Guitera and Menzies) and Anatomical Pathology (Drs Li and Scolyer), Royal Prince Alfred Hospital, Camperdown, and Disciplines of Pathology (Dr Scolyer) and Dermatology (Dr Menzies), The University of Sydney, Sydney, New South Wales, Australia. IN VIVO REFLECTANCE CONFOCAL microscopy (RCM) allows visualization of the upper layers of skin at cellular resolution. Melanin and melanosomes appear bright under reflectance at near-infrared wavelengths that are used in RCM. 1 Recent studies 2-10 have shown that identification and assessment of specific features of melanomas and nevi can improve the accuracy of melanocytic lesion diagnosis using RCM. These studies have examined only melanocytic lesions or selected images of cases. Therefore, their results cannot necessarily be directly extrapolated to normal clinical scenarios, in which pigmented lesions assessed under RCM include melanocytic and nonmelanocytic lesions. To our knowledge, none of the recent studies have determined if RCM can differentiate whether melanin-containing bright cells under RCM are melanocytes or pigment-laden macrophages (melanophages) on the basis of their morphologic features given by their reflectance signal. 11 When visualized histopathologically by light microscopy, melanophages measure 20 to 70 µm in diameter and contain a large vesicular nucleus (often with a single nucleolus) and phagocytized melanin in fine cytoplasmic granules. 12 Under RCM, they appear as bright plump, oval, or starshaped cells with no visible nucleus, and they may have ill-defined edges and may aggregate when particularly numerous in the upper dermis. 13 Under RCM, melanocytes in the superficial layers of the skin have a dark nucleus and bright cytoplasm and are frequently twice the size of keratinocytes. Atypia of melanocytes at the dermoepidermal junction under RCM is characteristic of melanoma. 9 Marked melanocyte atypia under RCM is characterized by large ( 50 µm) cell diameter, unusual cell shape (eg, triangular or star shaped), or the presence of large and eccentric nuclei. Papillary dermal melanocytes in melanoma appear as isolated round-oval refractive cells with a dark nucleus under RCM. 13 One feature reported to be a robust criterion using RCM 492
2 for differentiating melanoma cells from nevus cells in the dermis is the presence of nucleated cells that are not aggregated in nests. 9,14 However, distinguishing such cells from melanophages is important, and criteria for doing so have not been described to date. Furthermore, no systematic study describing the RCM features of melanophages has been previously published, to our knowledge. The objective of this study was to determine morphologic features of melanophages under in vivo RCM and to highlight morphologic features that are important in distinguishing melanophages from melanocytes. METHODS RECRUITMENT The RCM images and histopathologic sections were obtained retrospectively from patients seen in a secondary care setting (Sydney Melanoma Diagnostic Centre, Camperdown, New South Wales, Australia) from September 27, 2005, to June 13, The study was approved by the Sydney South West Area Health Service Ethics Committee (Royal Prince Alfred Hospital zone) (protocol X ), and informed and signed consent was obtained from all patients. The objective of our study was to describe morphologic features of melanophages under RCM by examining defined cutaneous histopathologic entities that had been imaged using RCM before biopsy. For that purpose, patients were recruited retrospectively who had RCM-imaged lichen planus like keratoses (LPLKs) with histologically confirmed dermal melanophages without increased melanocytes compared with normal skin. Control groups were identified by retrospectively recruiting patients who had RCM-imaged melanocytic, nonmelanocytic, or inflammatory lesions without increased dermal melanophages on histopathologic examination. STUDY GROUP The study group retrospectively constituted 20 consecutive patients having biopsy-proven LPLKs that dermoscopically and histopathologically showed many melanophages and that had been imaged under RCM before biopsy. The lesions were recognized under dermoscopy because they contained multiple blue-gray dots (granularity) in combination with areas of seborrheic keratosis or solar lentigo. 15,16 Such lesions are often biopsied because they can mimic lentigo maligna. The patients underwent RCM of lesions, and then a biopsy specimen was obtained to confirm the diagnosis, as well as the presence of numerous melanophages and the absence of any underlying or associated melanocytic proliferation on routine histopathologic examination. CONTROL SUJECTS Control Group 1 Control group 1 retrospectively constituted 25 consecutive patients who had RCM images obtained before biopsy and in whom histopathologic examination showed melanocytic lesions without increased melanophages compared with normal skin. All histopathologic slides were reviewed by a dermatopathologist (R.A.S.) to assure quality of the groups of lesions. Control Group 2 Control group 2 retrospectively constituted 20 consecutive patients who had RCM images obtained before biopsy and in whom histopathologic examination showed nonmelanocytic lesions without increased melanophages compared with normal skin. Control Group 3 To evaluate the RCM features of melanophages having other dermal inflammatory cell infiltrates, the RCM archival database was screened for inflammatory lesions. Fourteen patients with inflammatory disorders assessed using RCM between September 27, 2005, and June 13, 2007, were retrospectively identified, and the histopathologic findings were reviewed. Only 5 patients demonstrated a mixed dermal inflammatory cell (predominantly lymphocytic) infiltrate without increased melanophages compared with normal skin. These 5 patients were recruited as control group 3 to ensure that the nonmelanophage inflammatory infiltrate seen in most LPLKs was not confounding our measurements. RCM INSTRUMENT efore biopsy, RCM images were acquired using a reflectance confocal laser scanning microscope (Vivascope 1500; Lucid Inc, Henrietta, New York), which uses an 830-nm laser source. Instrument and acquisition procedures have been described previously. 1,9 Each image corresponds to a horizontal section at a selected depth, with approximately a µm field of view, a lateral resolution of 1.0 µm, and an axial resolution of 3 to 5 µm. Confocal sections, beginning at the stratum corneum and ending within the papillary dermis (stacks), were systematically recorded in the center of the lesion and in areas of interest for clinical diagnosis. The maximal optical penetration depth of the laser beam was 250 µm. More than 100 images per lesion were recorded (a minimum of 4 stacks in the center and 1 mosaic of at least 4 4 mm). RCM OSERVATIONS The confocal images were scored retrospectively more than 1 year after acquisition by a single observer (P.G.) who was blinded to dermoscopic features and histopathologic diagnosis. The RCM images were viewed by opening codified folders containing all raw images acquired for the corresponding case without sorting. These folders were randomly mixed and then analyzed one by one in a blinded fashion. Cells of the superficial dermis were defined as cells just under the honeycombed pattern layer (corresponding to the epidermis) with admixed vessels and reticulate structures (the latter corresponding to collagen fibers). The criteria analyzed were as follows: (1) Dermal bright cells (presence or absence). (2) Density, defined as minimal when fewer than 5 dermal bright cells were seen. If minimal density was found, cell characteristics were not recorded when they did not differ from the contingent of dermal bright cells in normal skin. If at least 5 dermal bright cells were seen, the cell characteristics were recorded for up to 10 cells. Cells were chosen randomly in the middle of the screen and then progressing centripetally until up to 10 cells were characterized on all raw images acquired in the superficial dermis. (3) Organization in nests (sparse, dense, or cerebriform) 14 or a different type of aggregation. (4) Isolated cells (not organized in nests or aggregates). Cell characteristics recorded included maximum cell diameter in microns, cell shape (ill defined, round, or dendritic), maximum nucleus (hyporeflective intracellular roundoval structure) diameter in microns, and nucleus to cell ratio. (5) Visibility of the nucleus, defined as the number of visible nuclei divided by the number of cells recorded in each group. (6) Cell type predominance (melanophage, melanocyte, mixed cell type, or nondefined cell type) according to the glossary by Scope et al
3 A A Figure 1. Study group lesion. A, In vivo reflectance confocal microscopy of dermal bright cells in a lichen planus like keratosis. Dermal bright cells seen (melanophages) are typically small, with ill-defined edges and no visible nuclei (hyporeflective ovoid to round bodies) visible. However, some cells (arrows) contained very small nuclei. ar indicates 50 µm., Histopathologic findings of small melanophages (arrows) and scattered lymphocytes in the superficial dermis (original magnification 400). MEASUREMENT OF HEMATOXYLIN-EOSIN STAINED MELANOPHAGES IN LPLKs Five melanophages were measured in the region of the histopathologic section with the highest melanophage density. The maximum diameter of melanophages in LPLKs was measured under light microscopy at 400 magnification using an ocular micrometer. STATISTICAL ANALYSIS Statistical analysis was performed using commercially available software (STATA, release 9; StataCorp LP, College Station, Texas). Absolute and relative frequencies of observations in each group were obtained for each RCM feature already described. Descriptive statistics for continuous variables included means, medians, standard deviations, and interquartile ranges. Differences between groups were calculated using t test for comparison of the mean cell and nucleus diameters Figure 2. Study group lesion. A, In vivo reflectance confocal microscopy of dense ill-defined aggregates of dermal bright cells in a lichen planus like keratosis. Melanophages aggregate when they are particularly numerous in the upper dermis. These aggregates (arrows) are different from the nests typically observed in melanocytic lesions because the edges of the melanophage aggregates are ill defined, and few nuclei are seen. ar indicates 50 µm., Histopathologic findings of melanophage aggregates in the superficial dermis (arrow) (original magnification 400). and nucleus to cell ratio and using 2 test of independence for comparison of the presence of dermal bright cells and the cell shape. RESULTS The cohort included 36 male and 34 female patients aged 12 to 82 years (mean age, 53 years). The study group comprised 20 patients with LPLKs. The melanocytic control group 1 comprised 6 patients with melanomas and 19 patients with nevi (15 dysplastic or atypical); among 25 patients, 9 lesions (4 lentigo maligna and 5 benign nevi) were junctional melanocytic, and 16 lesions were dermal or compound. The nonmelanocytic control group 2 comprised 20 patients (6 with nonpigmented basal cell carcinomas, 5 with ephelides, and 9 with other lesions [2 tricholem- 494
4 A A Figure 3. Control group 1 lesion. A, In vivo reflectance confocal microscopy of dermal bright cells in a dysplastic compound nevus. Dermal bright nevus cells are typically larger than melanophages, round, and well defined, with larger-diameter visible nuclei (arrows). ar indicates 50 µm., Histopathologic findings of large nevus cells involving the junctional zone of the epidermis (cells with pale cytoplasm marked by arrows) and nevus cells in the dermis (original magnification 200). mal cysts, 2 scars, and 1 each of neurofibroma, seborrheic keratosis, dermatofibroma, trichoepithelioma, and granuloma]). In the inflammatory infiltrate control group 3, histopathologic analysis showed moderate chronic (predominantly lymphoplasmacytic) inflammatory infiltrates in the superficial dermis; there were associated epidermal changes (spongiosis or hyperkeratosis and parakeratosis) in 2 patients, and there were small numbers of necrotizing granulomas in the dermis in a third patient. The RCM features are given for each group. MELANOPHAGES WITHOUT MELANOCYTES (LPLK-STUDY GROUP) In the study group, dermal bright cells were seen under RCM in all 20 patients with LPLKs. There were at least 5 dermal bright cells seen using RCM in all but 1 patient Figure 4. Control group 3 lesion. A, In vivo reflectance confocal microscopy (RCM) of dermal bright cells in an inflammatory skin lesion. These dermal bright cells are smaller than melanophages, with nonvisible nuclei (arrows). ar indicates 50 µm., Histopathologic findings of epidermal spongiosis, focal interface inflammation with lichenoid change, and mixed dermal inflammatory cell infiltrate consisting predominantly of small lymphocytes (note the paucity of melanophages in the dermal inflammatory cell infiltrate corresponding to the RCM image) (original magnification 400). (Figure 1). They were present in ill-defined sparse aggregates in 10 cases and in ill-defined dense aggregates in 2 cases (Figure 2). No sparse, dense, or cerebriform organization of melanocytic lesion nests was identified. The mean (SD) cell diameter of 184 isolated dermal bright cells was 13.6 (1.6) µm. Seventy-six percent (140 of 184) were ill defined, 23% (42 of 184) were round, and 1% (2 of 184) were dendritic. The mean nucleus to cell ratio was 0.25, with a mean (SD) nucleus diameter of 3.2 (1.2) µm. The nucleus was visible in 16% (29 of 184) of cells. MELANOCYTIC LESIONS WITHOUT MELANOPHAGES (CONTROL GROUP 1) Under RCM, dermal bright cells were seen in 48% (12 of 25) of patients in control group 1, with at least 5 dermal bright cells seen in 20% (5 patients). Therefore, dermal 495
5 Table. Comparison of Study Group and Control Groups Among Group Members, No. (%) Among Dermal right Cells Seen Experimental Group Lichen planus like keratoses with melanophages without melanocytes enign and malignant melanocytic lesions without melanophages Nonmelanocytic lesions without melanophages Nonmelanocytic lesions with inflammatory infiltrate without melanophages Dermal right Cells Seen 5 Dermal right Cells Seen Cell Diameter, Mean (SD), µm Cell Shape, No. (%) Visible Nucleus, No. (%) Ill Defined Round Dendritic Study Group (n=20) (184 Dermal right Cells Seen) a 20 (100) 19 (95) 13.6 (1.6) 140 (76) 42 (23) 2 (1) 29 (16) Control Group 1 (n=25) (49 Dermal right Cells Seen) a 12 (48) 5 (20) 18.2 (2.9) 9 (18) 34 (69) 6 (12) 28 (57) Control Group 2 (n=20) 4 (20) Control Group 3 (n=5) (10 Dermal right Cells Seen) 1 (20) 1 (20) 6.8 (1.5) 9 (90) 1 (10)... 0 a The mean (SD) nucleus diameters were 3.2 (1.2) µm for the study group (n=29) and 6.4 (0.7) µm for control group 1 (n=28). The mean (SD) nucleus to cell ratios were 0.25 (0.07) for the study group (n=29) and 0.36 (0.08) for control group 1 (n=28). bright cell characteristics were based on findings in 5 patients (3 dysplastic compound nevi, 1 lentigo maligna, and 1 superficial spreading melanoma). Dermal bright cells were organized as nests in 4 of 5 patients (dense in 2 patients, sparse in 1 patient, and cerebriform in 1 patient). The mean (SD) cell diameter of 49 isolated dermal bright cells was 18.2 (2.9) µm. Eighteen percent (9 of 49) were ill defined, 69% (34 of 49) were round, and 12% (6 of 49) were dendritic. The mean nucleus to cell ratio was 0.36, with a mean (SD) nucleus diameter of 6.4 (0.7) µm. The nucleus was visible in 57% (28 of 49) of cells (Figure 3). NONMELANOCYTIC LESIONS WITHOUT MELANOPHAGES (CONTROL GROUP 2) Scattered dermal bright cells were seen under RCM in 20% (4 of 20) of patients in control group 2. Findings in these patients contained minimal ( 5) cells. NONMELANOCYTIC LESIONS WITHOUT MELANOPHAGES UT WITH AN INFLAMMATORY INFILTRATE (CONTROL GROUP 3) Dermal bright cells were seen under RCM in 20% (1 of 5) of patients in control group 3. However, these were significantly smaller (maximum cell diameter, 6-10 µm; mean [SD] cell diameter, 6.8 [1.5] µm) than those seen under RCM in nonmelanocytic lesions with numerous melanophages (Figure 4). DIFFERENCES ETWEEN GROUPS Differences between groups are summarized in the Table. The mean cell diameter was significantly smaller in melanophages than in melanocytes (P=.006). Compared with melanocytes, melanophages were significantly more ill defined (P.001), less round (P.001), and less dendritic (P=.001). The mean nucleus diameter (P.001), visibility of the nucleus (P.001), and nucleus to cell ratio (P=.02) were significantly less in melanophages compared with melanocytes. Numerous melanophages (defined as in the glossary published previously 13 ) were identified under RCM in all patients in the study group except for 1 patient in whom there were only 2 dermal bright cells seen. In contrast, a predominance of melanophages was not diagnosed using RCM in 12 melanocytic lesions in which dermal bright cells were seen. MEASUREMENT OF HEMATOXYLIN-EOSIN STAINED MELANOPHAGES IN THE LPLK (MELANOPHAGE) GROUP The mean (SD) diameter of 100 hematoxylin-eosin stained melanophages was 12.9 (3.8) µm. This was consistent with RCM measurements. COMMENT To our knowledge, the RCM characteristics of melanophages have not previously been studied systematically. To establish an accurate RCM diagnosis of a skin lesion with dermal bright cells, it is essential to distinguish melanocytes from melanophages. In contrast to melanocytes, melanophages have been described as nonnucleated cells under RCM. 13 Although results of a previous histopathologic study 12 suggested a large size range for melanophages (20-80 µm), the melanophages in our study as measured using RCM were significantly smaller, tending to be round and ill defined but not dendritic and with smaller and less visible nuclei compared with melanocytes. Under RCM, the LPLK (melanophage) study group had high densities of dermal bright cells that were often aggregated. ecause only typical LPLKs were included with many melanophages on dermoscopy and confirmed by histopathologic examination, the high den- 496
6 A Figure 5. Control group 1 lesion. A, In vivo reflectance confocal microscopy of dermal bright cells in an advanced lentigo maligna. Dermal bright melanoma cells are typically larger than melanophages, round, and well defined, with large diameter and visible nuclei (arrows); some are organized in dense nests (short arrows). The dermoepidermal junction is destroyed, so the distinction between dermal and epidermal bright cells is unclear. ar indicates 50 µm., Histopathologic findings of large atypical melanocytes (arrows) involving the basal region of the epidermis and the edge of a pilosebaceous unit (original magnification 400). sity of dermal bright cells identified under RCM reflects the case selection. The aggregation differed from the organization of nests typically observed in melanocytic lesions 14 (Figure 2). The RCM features of isolated dermal bright (melanocytic) cells in control group 1 were based on 3 dysplastic compound nevi, 1 lentigo maligna, and 1 superficial spreading melanoma. Although we did not intend to perform a detailed characterization of melanocytes in this study (as they have been described previously by others 17 ), melanoma cells were usually larger and more polymorphous than nevus cells, and the larger standard deviation of dermal cells bright under RCM in control group 1 reflects this heterogeneity. Of note, dermal bright nucleated cells were seen under RCM in 1 lentigo maligna (Figure 5). However, the histopathologic features of this case showed single atypical junctional melanocytes and occasional junctional nests but no dermal melanocytes or significant number of dermal melanophages. The reason for the apparent discrepancy between the RCM and histopathologic findings may be related to sampling, such that the dermal component identified on RCM was not present in the histopathologic biopsy sections. Alternatively, difficulty in determining the exact site of the cells (junctional or dermal) on RCM could also explain the findings, especially because the dermoepidermal junction was partially disrupted. Our RCM measurements of dermal bright cells in control group 3 are consistent with those reported in the literature. 18 These cells were infrequently visible; only 1 of 5 patients had dermal bright cells seen under RCM. However, these had nonvisible nuclei and were significantly smaller than melanophages, with the latter approximately twice the diameter. In conclusion, this study characterizes dermal bright cells of melanophages as having a mean cell diameter of 13.6 µm, with an ill-defined outline. Melanophages had a small nucleus (mean diameter, 3.2 µm), which was visible in only 16% (29 of 184) of cells. Such observations should aid in distinguishing between melanophages and melanocytes, both of which appear as dermal bright cells under RCM, thereby improving the diagnostic accuracy of this technique. Accepted for Publication: October 13, Correspondence: Scott W. Menzies, MS, PhD, Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia (scott.menzies@sswahs.nsw.gov.au). Author Contributions: All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Guitera and Menzies. Acquisition of data: Guitera, Li, and Scolyer. Analysis and interpretation of data: Guitera, Li, Scolyer, and Menzies. Drafting of the manuscript: Guitera. Critical revision of the manuscript for important intellectual content: Scolyer and Menzies. Statistical analysis: Guitera. Study supervision: Menzies. Financial Disclosure: None reported. Additional Contributions: Patrick FitzGerald helped with the statistical analysis. Tony onin provided editorial assistance with the manuscript. REFERENCES 1. Rajadhyaksha M, Grossman M, Esterowitz D, Webb RH, Anderson RR. In vivo confocal scanning laser microscopy of human skin: melanin provides strong contrast. J Invest Dermatol. 1995;104(6): Langley RG, Rajadhyaksha M, Dwyer PJ, Sober AJ, Flotte TJ, Anderson RR. Confocal scanning laser microscopy of benign and malignant melanocytic skin lesions in vivo. J Am Acad Dermatol. 2001;45(3): Langley RG, Walsh N, Sutherland AE, et al. The diagnostic accuracy of in vivo confocal scanning laser microscopy compared to dermoscopy of benign and malignant melanocytic lesions: a prospective study. Dermatology. 2007;215(4): usam KJ, Charles C, Lohmann CM, Marghoob A, Goldgeier M, Halpern AC. Detection of intraepidermal malignant melanoma in vivo by confocal scanning laser microscopy. Melanoma Res. 2002;12(4):
7 5. Marghoob AA, Charles CA, usam KJ, et al. In vivo confocal scanning laser microscopy of a series of congenital melanocytic nevi suggestive of having developed malignant melanoma. Arch Dermatol. 2005;141(11): Gerger A, Koller S, Kern T, et al. Diagnostic applicability of in vivo confocal laser scanning microscopy in melanocytic skin tumors. J Invest Dermatol. 2005; 124(3): Gerger A, Koller S, Weger W, et al. Sensitivity and specificity of confocal laserscanning microscopy for in vivo diagnosis of malignant skin tumors. Cancer. 2006;107(1): Gerger A, Hofmann-Wellenhof R, Langsenlehner U, et al. In vivo confocal laser scanning microscopy of melanocytic skin tumours: diagnostic applicability using unselected tumour images. r J Dermatol. 2008;158(2): Pellacani G, Guitera P, Longo C, Avramidis M, Seidenari S, Menzies S. The impact of in vivo reflectance confocal microscopy for the diagnostic accuracy of melanoma and equivocal melanocytic lesions. J Invest Dermatol. 2007;127 (12): Guitera P, Pellacani G, Longo C, Seidenari S, Avramidis M, Menzies S. In vivo reflectance confocal microscopy enhances secondary evaluation of melanocytic lesions. J Invest Dermatol. 2009;129(1): usam KJ, Charles C, Lee G, Halpern AC. Morphologic features of melanocytes, pigmented keratinocytes, and melanophages by in vivo confocal scanning laser microscopy. Mod Pathol. 2001;14(9): Lasser A. The mononuclear phagocytic system: a review. Hum Pathol. 1983;14 (2): Scope A, envenuto-andrade C, Agero AL, et al. In vivo reflectance confocal microscopy imaging of melanocytic skin lesions: consensus terminology glossary and illustrative images. J Am Acad Dermatol. 2007;57(4): Pellacani G, Cesinaro AM, Seidenari S. In vivo confocal reflectance microscopy for the characterization of melanocytic nests and correlation with dermoscopy and histology. r J Dermatol. 2005;152(2): Zaballos P, lazquez S, Puig S, et al. Dermoscopic pattern of intermediate stage in seborrhoeic keratosis regressing to lichenoid keratosis: report of 24 cases. r J Dermatol. 2007;157(2): ugatti L, Filosa G. Dermoscopy of lichen planus like keratosis: a model of inflammatory regression. J Eur Acad Dermatol Venereol. 2007;21(10): Li LX, Crotty KA, Scolyer RA, et al. Use of multiple cytometric markers improves discrimination between benign and malignant melanocytic lesions: a study of DNA microdensitometry, karyometry, argyrophilic staining of nucleolar organizer regions and MI1-Ki67 immunoreactivity. Melanoma Res. 2003;13(6): Ardigò M, Maliszewski I, Cota C, et al. Preliminary evaluation of in vivo reflectance confocual microscopy features of discoid lupus erhythematosus. r J Dermatol. 2007;156(6): Archives Web Quiz Winner C ongratulations to the winner of our February quiz, Melvin Chiu, MD, Division of Dermatology, David Geffen School of Medicine, University of California, Los Angeles. The correct answer to our February challenge was LEOPARD syndrome (LS) associated with multiple granular cell tumors (GCTs). For a complete discussion of this case, see the Off-Center Fold section in the March Archives (Gunson TH, Hashim N, Sharpe GR. Generalized lentiginosis, short stature, and multiple cutaneous nodules. Arch Dermatol. 2010;146[3]: ). e sure to visit the Archives of Dermatology Web site ( to try your hand at the interactive quiz. We invite visitors to make a diagnosis based on selected information from a case report or other feature scheduled to be published in the following month s print edition of the Archives. The first visitor to our Web editors with the correct answer will be recognized in the print journal and on our Web site and will also receive a free copy of The Art of JAMA II. 498
Reflectance-Mode Confocal Microscopy for the In Vivo Characterization of Pagetoid Melanocytosis in Melanomas and Nevi
See related Commentary on page vii Reflectance-Mode Confocal Microscopy for the In Vivo Characterization of Pagetoid Melanocytosis in Melanomas and Nevi Giovanni Pellacani, Anna Maria Cesinaro,w and Stefania
More informationSTUDY. Reflectance Confocal Microscopy and Features of Melanocytic Lesions. An Internet-Based Study of the Reproducibility of Terminology
STUDY Reflectance Confocal Microscopy and Features of Melanocytic Lesions An Internet-Based Study of the Reproducibility of Terminology Giovanni Pellacani, MD; Marco Vinceti, MD; Sara Bassoli, MD; Ralph
More informationMorphologic Features of Melanocytes, Pigmented Keratinocytes, and Melanophages by In Vivo Confocal Scanning Laser Microscopy
Morphologic Features of Melanocytes, Pigmented Keratinocytes, and Melanophages by In Vivo Confocal Scanning Laser Microscopy Klaus J. Busam, M.D., Carlos Charles, M.D., Grace Lee, M.D., Allan C Halpern,
More informationSensitivity and Specificity of Confocal Laser-Scanning Microscopy for In Vivo Diagnosis of Malignant Skin Tumors
193 Sensitivity and Specificity of Confocal Laser-Scanning Microscopy for In Vivo Diagnosis of Malignant Skin Tumors Armin Gerger, MD 1 Silvia Koller, MD 2 Wolfgang Weger, MD 2 Erika Richtig, MD 2 Helmut
More informationEARLY ONLINE RELEASE
EARLY ONLINE RELEASE Note: This article was posted on the Archives Web site as an Early Online Release. Early Online Release articles have been peer reviewed, copyedited, and reviewed by the authors. Additional
More informationDiagnosis of Lentigo Maligna Melanoma. Steven Q. Wang, M.D. Memorial Sloan-Kettering Cancer Center Basking Ridge, NJ
Diagnosis of Lentigo Maligna Melanoma Steven Q. Wang, M.D. Memorial Sloan-Kettering Cancer Center Basking Ridge, NJ Conflict of Interest: None Topics Epidemiology and Natural History Clinical and Histologic
More informationBasics in Dermoscopy
Basics in Dermoscopy Manal Bosseila Professor of Dermatology, Cairo University Member of European Academy Dermatology & Venereology EADV Member of International Dermoscopy Society IDS Member of Aesthetic
More informationRegression 2/3/18. Histologically regression is characterized: melanosis fibrosis combination of both. Distribution: partial or focal!
Regression Margaret Oliviero MSN, ARNP Harold S. Rabinovitz MD Histologically regression is characterized: melanosis fibrosis combination of both Distribution: partial or focal! Dermatoscopic terminology
More informationDermoscopy: Recognizing Top Five Common In- Office Diagnoses
Dermoscopy: Recognizing Top Five Common In- Office Diagnoses Vu A. Ngo, DO Department of Family Medicine and Dermatology Choctaw Nation Health Services Authority Learning Objectives Introduction to dermoscopy
More informationBenign and malignant epithelial lesions: Seborrheic keratosis: A common benign pigmented epidermal tumor occur in middle-aged or older persons more
Benign and malignant epithelial lesions: Seborrheic keratosis: A common benign pigmented epidermal tumor occur in middle-aged or older persons more common on the trunk; but extremities, head and neck are
More informationManagement of patients with melanocytic and non-melanocytic neoplasms
Management of patients with melanocytic and non-melanocytic neoplasms Ashfaq Marghoob MD Harold Rabinovitz MD Margaret Oliviero ARNP Harald Kittler MD Jupiter Cancer Centrer Characteristic Dermoscopic
More informationHistopathology of Melanoma
THE YALE JOURNAL OF BIOLOGY AND MEDICINE 48, 409-416 (1975) Histopathology of Melanoma G. J. WALKER SMITH Department ofpathology, Yale University School ofmedicine, 333 Cedar Street, New Haven, Connecticut
More informationHistopathology: skin pathology
Histopathology: skin pathology These presentations are to help you identify, and to test yourself on identifying, basic histopathological features. They do not contain the additional factual information
More informationConfocalist. Why this is important? No Relevant Conflict of Interest Dermpath Lab
Confocal Application in Practice Everyday (CAPE) AAD F109: Imaging in San Diego 2/18/2018 Jane M. Grant-Kels, MD Founding Chair Emeritus Department of Dermatology Professor of Dermatology, Pathology, &
More informationValidation Study of Automated Dermal/Epidermal Junction Localization Algorithm in Reflectance Confocal Microscopy Images of Skin
Validation Study of Automated Dermal/Epidermal Junction Localization Algorithm in Reflectance Confocal Microscopy Images of Skin Sila Kurugol* a, Milind Rajadhyaksha b, Jennifer G. Dy a, Dana H. Brooks
More informationDiagnostic Applicability of In Vivo Confocal Laser Scanning Microscopy in Melanocytic Skin Tumors
See related Commentaries on pages v, vi and viii Diagnostic Applicability of In Vivo Confocal Laser Scanning Microscopy in Melanocytic Skin Tumors Armin Gerger, Silvia Koller, Thomas Kern, Cesare Massone,
More informationIn vivo confocal scanning laser microscopy of pigmented Spitz nevi: Comparison of in vivo confocal images with dermoscopy and routine histopathology
In vivo confocal scanning laser microscopy of pigmented Spitz nevi: Comparison of in vivo confocal images with dermoscopy and routine histopathology Giovanni Pellacani, MD, a Anna Maria Cesinaro, MD, b
More informationPathology of the skin. 2nd Department of Pathology, Semmelweis University
Pathology of the skin 2nd Department of Pathology, Semmelweis University Histology of the skin Epidermis: Stratum corneum Stratum granulosum Stratum spinosum Stratum basale Dermis: papillary and reticular
More informationChronology of lichen planus-like keratosis features by dermoscopy: a summary of 17 cases
DERMATOLOGY PRACTICAL & CONCEPTUAL www.derm101.com Chronology of lichen planus-like keratosis features by dermoscopy: a summary of 17 cases Soko Watanabe 1, Mizuki Sawada 1, Itaru Dekio 1, Sumiko Ishizaki
More informationAppendix : Dermoscopy
Go Back to the Top To Order, Visit the Purchasing Page for Details APP Appendix : Dermoscopy Dermoscopy, also known as dermatoscopy, epiluminoscopy and epiluminescent microscopy, is an effective non-invasive
More informationF006 Imaging in Dermatology Melanocytic Neoplasia Clinical-Confocal-Pathological-Correlations
F006 Imaging in Dermatology Melanocytic Neoplasia Clinical-Confocal-Pathological-Correlations Melissa Gill, MD SkinMedical Research and Diagnostics Dobbs Ferry, NY, USA Department of Pathology SUNY Downstate
More informationActinic keratosis (AK) is the most common precancerous
Confocal laser microscopic imaging of actinic keratoses in vivo: A preliminary report David Aghassi, MD, R. Rox Anderson, MD, and Salvador González, MD Boston, Massachusetts Background: Real-time near-infrared
More informationMalignant non-melanocytic lesions
Malignant non-melanocytic lesions Course C023: Fundamentals of Dermoscopy March 4, 2019, 11:20 AM - 11:50 PM Room: 146B Jason B. Lee, MD Professor & Vice Chair Director of Dermatopathology & Pigmented
More informationISPUB.COM. Seborrheic Keratosis: A Pictorial Review of the Histopathologic Variations. D Sarma, S Repertinger
ISPUB.COM The Internet Journal of Dermatology Volume 7 Number 2 Seborrheic Keratosis: A Pictorial Review of the Histopathologic Variations D Sarma, S Repertinger Citation D Sarma, S Repertinger.. The Internet
More information22/04/2015. Dermoscopy of Melanoma. Ilsphi Browne. Overview
Dermoscopy of Melanoma Ilsphi Browne Overview The device Dermoscopic criteria (terminology) Colour Patterns Global features Local features Approach to diagnosing pigmented lesions Other uses in general
More informationORIGINAL ARTICLE Journal of Investigative Dermatology (2010), Volume 130 & 2010 The Society for Investigative Dermatology
ORIGINAL ARTICLE The Impact of In Vivo Reflectance Confocal Microscopy on the Diagnostic Accuracy of Lentigo Maligna and Equivocal Pigmented and Nonpigmented Macules of the Face Pascale Guitera 1,7, Giovanni
More informationConfocalist. Why this is important? 7/17/2017. No Relevant Conflict of Interest. Dermpath Lab
Confocal Application in Practice Everyday (CAPE) AAD NYC 7/2017 Jane M. Grant-Kels, MD Founding Chair Emeritus Department of Dermatology Professor of Dermatology, Pathology, & Pediatrics Director of Cutaneous
More informationDIFFERENCES IN DERMOSCOPIC IMAGES FROM NON-POLARIZED DERMOSCOPE AND POLARIZED DERMOSCOPE INFLUENCE THE DIAGNOSTIC ACCURACY AND CONFIDENCE LEVEL.
DIFFERENCES IN DERMOSCOPIC IMAGES FROM NON-POLARIZED DERMOSCOPE AND POLARIZED DERMOSCOPE INFLUENCE THE DIAGNOSTIC ACCURACY AND CONFIDENCE LEVEL. 1. Steven Q. Wang MD 1 (wangs@mskcc.org) 2. Stephen W. Dusza
More informationAbrupt Intralesional Color Change on Dermoscopy as a New Indicator of Early Superficial Spreading Melanoma in a Japanese Woman
Published online: June 24, 2015 1662 6567/15/0072 0123$39.50/0 This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC)
More informationDisclosure. Objectives. PAFP CME Conference Lou Mancano MD, FAAFP Reading Health System November 18, 2016
PAFP CME Conference Lou Mancano MD, FAAFP Reading Health System November 18, 2016 1 Disclosure The speaker has no conflict of interest, financial agreement, or working affiliation with any group or organization.
More informationNIH Public Access Author Manuscript Br J Dermatol. Author manuscript; available in PMC 2015 April 01.
NIH Public Access Author Manuscript Published in final edited form as: Br J Dermatol. 2014 April ; 170(4): 802 808. doi:10.1111/bjd.12678. Impact of in vivo reflectance confocal microscopy on the number
More informationConfocal Microscopy in Skin Cancer
Current Dermatology Reports (2018) 7:105 118 https://doi.org/10.1007/s13671-018-0218-9 SKIN CANCER (A MARGHOOB AND M MARCHETTI, SECTION EDITORS) Confocal Microscopy in Skin Cancer Verena Ahlgrimm-Siess
More informationDiagnostics Assessment Programme
Diagnostics Assessment Programme Diagnostics Consultation Document: VivaScope 1500 and 3000 imaging systems for detecting and monitoring skin cancer lesions Evaluation Report NATIONAL INSTITUTE FOR HEALTH
More informationLichenoid Tissue Reaction in Malignant Melanoma A Potential Diagnostic Pitfall
natomic Pathology / LICHENOID TISSUE RECTION IN MLIGNNT MELNOM Lichenoid Tissue Reaction in Malignant Melanoma Potential Diagnostic Pitfall CPT Scott R. Dalton, MC, US, 1,3 Capt Matt. aptista, USF, MC,
More informationSTUDY. Microscopic In Vivo Description of Cellular Architecture of Dermoscopic Pigment Network in Nevi and Melanomas
STUDY Microscopic In Vivo Description of Cellular Architecture of Dermoscopic Pigment Network in Nevi and Melanomas Giovanni Pellacani, MD; Anna Maria Cesinaro, MD; Caterina Longo, MD; Costantino Grana,
More information6/17/2018. Breaking Bad (Part 1) Dermoscopy of Brown(ish) Things. Bad?
Breaking Bad (Part 1) Dermoscopy of Brown(ish) Things Jennie T. Clarke, MD ssociate Professor of Dermatology University of Utah School of Medicine Bad? 1 Brown(ish) Things Bad Melanoma Pigmented basal
More informationDermoscopy. Enhanced Diagnostic Ability: Pigmented Lesions. Ted Rosen, MD Baylor College of Medicine Houston, Texas
Dermoscopy Enhanced Diagnostic Ability: Pigmented Lesions Ted Rosen, MD Baylor College of Medicine Houston, Texas Faculty Disclosure Statement No conflicts relevant to this workshop! Sir William Osler
More informationReflectance Confocal Microscopy Real-Time In Vivo Imaging of Basal and Squamous Cell Carcinomas
Journal of Analytical Oncology, 2012, 1, 155-163 155 Reflectance Confocal Microscopy Real-Time In Vivo Imaging of Basal and Squamous Cell Carcinomas Anna Haydee Chacon 1,*, Uzma Farooq 1, Katlein Franca
More informationDermatopathology: The tumor is composed of keratinocytes which show atypia, increase mitoses and abnormal mitoses.
Squamous cell carcinoma (SCC): A common malignant tumor of keratinocytes arising in the epidermis, usually from a precancerous condition: 1- UV induced actinic keratosis, usually of low grade malignancy.
More informationSPECIAL TOPIC. Institut National de la Sante et de la Recherche Medicale (INSERM U895), Nice, France c
November 2011 1260 Volume 10 Issue 1i Copyright 2011 ORIGINAL ARTICLES Journal of Drugs in Dermatology SPECIAL TOPIC A Pilot Study Using Reflectance Confocal Microscopy (RCM) in the Assessment of a Novel
More informationDermoscopy. Sir William Osler. Dermoscopy. Dermoscopy. Melanoma USA Primary Care Update Faculty Disclosure Statement
Diagnostic Ability: Pigmented Lesions Ted Rosen, MD Baylor College of Medicine Houston, Texas Enhanced 2010 Primary Care Update Faculty Disclosure Statement Ted Rosen, MD Speakers Bureau: Abbott, Amgen,
More informationNON-MELANOCYTIC MELANOMA LOOK-ALIKES. Hideko Kamino, M.D. Dermatopathology Section New York University School of Medicine
NON-MELANOCYTIC MELANOMA LOOK-ALIKES Hideko Kamino, M.D. Dermatopathology Section New York University School of Medicine There is a diagnostically important group of entities called non-melanocytic melanoma
More informationNoninvasive imaging devices have emerged as powerful
Non-Invasive Imaging Techniques: Dermatoscopy and Confocal Microscopy Before a Biopsy Relatively new tools can provide helpful information to support diagnosis and guide management strategies. By Christine
More informationDermoscopy in everyday practice. What and Why? When in doubt cut it out? Trilokraj Tejasvi MD
Dermoscopy in everyday practice Trilokraj Tejasvi MD Assistant Professor, Department of Dermatology, Director Teledermatology services, University of Michigan, Faculty Associate, GLOBAL REACH, Michigan
More informationDiagnostics guidance Published: 11 November 2015 nice.org.uk/guidance/dg19
VivaScope 1500 and 3000 imaging systems for detecting skin cancer lesions Diagnostics guidance Published: 11 November 2015 nice.org.uk/guidance/dg19 NICE 2018. All rights reserved. Subject to Notice of
More informationDERMATOLOGY PRACTICAL & CONCEPTUAL. Introduction. Dermoscopy. Hiroshi Sakai 1, Kyoko Tonomura 1, Hirotsugu Shirabe 1, Masaru Tanaka 2
DERMATOLOGY PRACTICAL & CONCEPTUAL www.derm101.com Assessment of the colors of melanin pigment in acral compound nevus by using a novel dermoscopy technique with surgical light illumination and saturation
More informationF109 Imaging in Dermatology Melanocytic Neoplasia Clinical-Confocal-Pathological-Correlations
F109 Imaging in Dermatology Melanocytic Neoplasia Clinical-Confocal-Pathological-Correlations Melissa Gill, MD SkinMedical Research and Diagnostics Dobbs Ferry, NY, USA Department of Pathology SUNY Downstate
More informationMaligna Melanoma and Atypical Fibroxanthoma: An Unusual Collision Tumour G Türkcü 1, A Keleş 1, U Alabalık 1, D Uçmak 2, H Büyükbayram 1 ABSTRACT
Maligna Melanoma and Atypical Fibroxanthoma: An Unusual Collision Tumour G Türkcü 1, A Keleş 1, U Alabalık 1, D Uçmak 2, H Büyükbayram 1 ABSTRACT Two different neoplasia in the same biopsy material called
More informationHIGH-RESOLUTION OPTICAL COHERENCE TOMOGRAPHY FOR THE DIAGNOSIS OF ACTINIC KERATOSIS
Romanian Reports in Physics XX, XYZ (2018) HIGH-RESOLUTION OPTICAL COHERENCE TOMOGRAPHY FOR THE DIAGNOSIS OF ACTINIC KERATOSIS A.G. PEHOIU 1, I. POPESCU 2, C. GIURCANEANU 1,2, A.M. FORSEA 1,2 1 Carol Davila
More informationالمركب النموذج--- سبيتز وحمة = Type Spitz's Nevus, Compound SPITZ NEVUS 1 / 7
SPITZ NEVUS 1 / 7 Epidemiology An annual incidence rate of 1.4 cases of Spitz nevus per 100,000 individuals has been estimated in Australia, compared with 25.4 per 100,000 individuals for cutaneous melanoma
More informationOBSERVATION. Detection of Clinically Amelanotic Malignant Melanoma and Assessment of Its Margins by In Vivo Confocal Scanning Laser Microscopy
OBSERVATION Detection of Clinically Amelanotic Malignant Melanoma and Assessment of Its Margins by In Vivo Confocal Scanning Laser Microscopy Klaus J. Busam, MD; Katherine Hester, MD; Carlos Charles, MD;
More informationELECTRON MICROSCOPY OF A SMALL PIGMENTED CUTANEOUS LESION*
ELECTRON MICROSCOPY OF A SMALL PIGMENTED CUTANEOUS LESION* The description of the lesion in the title of this rcport is intentionally non-committal. Diagnosed clinically as a lentigo, it was removed as
More informationCitation The Journal of Dermatology, 37(8), available at
NAOSITE: Nagasaki University's Ac Title Two cases of blaschkitis with promi Author(s) Utani, Atsushi Citation The Journal of Dermatology, 37(8), Issue Date 2010-08 URL Right http://hdl.handle.net/10069/25634
More informationDesmoplastic Melanoma R/O BCC. Clinical Information. 74 y.o. man with lesion on left side of neck r/o BCC
R/O BCC Sabine Kohler, M.D. Professor of Pathology and Dermatology Dermatopathology Service Stanford University School of Medicine Clinical Information 74 y.o. man with lesion on left side of neck r/o
More informationAssociate Clinical Professor of Dermatology MUSC
Re-excision of Moderately Dysplastic Nevi: Should we or shouldn t we? John C. Maize, Jr, M.D. Dermatologist and Dermatopathologist Trident Dermatology, Charleston SC Associate Clinical Professor of Dermatology
More informationBasal cell carcinoma 5/28/2011
Goal of this Presentation A practical approach to the diagnosis of cutaneous carcinomas and their mimics Thaddeus Mully, MD University of California San Francisco To review common non-melanoma skin cancers
More informationMalignant tumors of melanocytes : Part 3. Deba P Sarma, MD., Omaha
Malignant tumors of melanocytes : Part 3 Deba P Sarma, MD., Omaha Let s go over one case of melanoma using the following worksheet. Of the various essential information that needs to be included in the
More informationMalignant tumors of melanocytes: Part 1. Deba P Sarma, MD., Omaha
Malignant tumors of melanocytes: Part 1 Deba P Sarma, MD., Omaha The melanocytic tumor is one of the most difficult and confusing areas in Dematopathology. It is true that most (95%) of such lesions are
More informationBrief Report. Shivanand Gundalli 1, Smita Kadadavar 1, Somil Singhania 1, Rutuja Kolekar 2 INTRODUCTION. Melanocytic Nevus
Our Dermatology Online Histopathological spectrum of benign melanocytic nevi our experience in a tertiary care centre Shivanand Gundalli 1, Smita Kadadavar 1, Somil Singhania 1, Rutuja Kolekar 2 1 Department
More informationDermatopathology. Dr. Rafael Botella Estrada. Hospital La Fe de Valencia
Dermatopathology Dr. Rafael Botella Estrada. Hospital La Fe de Valencia Melanoma and mimics Dr. Martin Mihm Malignant lesions result from the accumulation of mutations Class I lesions (benign) Class II
More informationConfocal Reflectance Microscopy in Dermatology: Promise and Reality of Non-Invasive Diagnosis and Monitoring
Actas Dermosifiliogr. 2009;100:Supl. 2:59-69 Confocal Reflectance Microscopy in Dermatology: Promise and Reality of Non-Invasive Diagnosis and Monitoring S. González Dermatology Service. Memorial Sloan-Kettering
More informationMODULE 1. LOCAL AND GENERAL CRITERIA IN PIGMENTED MELANOCYTIC LESIONS.
DERMOSCOPY TEACHING PROGRAMME Dermoscopy Teaching Programme Module 1 MODULE 1. LOCAL AND GENERAL CRITERIA IN PIGMENTED MELANOCYTIC LESIONS. Dermoscopy is a non-invasive in vivo technique that provides
More informationMultispectral Digital Skin Lesion Analysis. Summary
Subject: Multispectral Digital Skin Lesion Analysis Page: 1 of 8 Last Review Status/Date: March 2016 Multispectral Digital Skin Lesion Analysis Summary There is interest in noninvasive devices that will
More informationLENTIGO SIMPLEX. Epidemiology
LENTIGO SIMPLEX Epidemiology The frequency of lentigo simplex in children and adults has not been determined. There does not appear to be a racial or gender predilection. Lentigo simplex is the most common
More informationAssisting diagnosis of melanoma through the noninvasive biopsy of skin lesions
Assisting diagnosis of melanoma through the noninvasive biopsy of skin lesions Symon D Oyly Cotton Ela Claridge School of Computer Science, The University of Birmingham Birmingham B15 2TT, UK Per Hall
More informationThe application of confocal microscopy for optical sectioning
Skin Imaging With Reflectance Confocal Microscopy Kishwer S. Nehal, MD,*, Dan Gareau, PhD,* and Milind Rajadhyaksha, PhD* Confocal microscopy is a new imaging modality for noninvasive real-time tissue
More informationKeywords: Microscopy, confocal - Skin neoplasms - Melanoma. Corrisponding author: Francesca Farnetani
JDREAM. Journal of interdisciplinary REsearch Applied to Medicine JDREAM (2018), v. 2 i. 1, 17-36 ISSN 2532-7518 DOI 10.1285/i25327518v2i1p17 http://siba-ese.unisalento.it, 2018 Università del Salento
More informationActinic keratosis (AK): Dr Sarma s simple guide
Actinic keratosis (AK): Dr Sarma s simple guide Actinic keratosis is a very common lesion that you will see in your day-to-day practice. First, let me explain the name Actinic keratosis. It means keratosis
More informationPrediction without Pigment: a decision algorithm for non-pigmented skin malignancy
DERMATOLOGY PRACTICAL & CONCEPTUAL www.derm101.com Prediction without Pigment: a decision algorithm for non-pigmented skin malignancy Cliff Rosendahl 1, Alan Cameron 1, Philipp Tschandl 2, Agata Bulinska
More informationCommon Benign Lesions and Skin Cancers. 22nd May 2015 Dr Mark Foley
Common Benign Lesions and Skin Cancers 22nd May 2015 Dr Mark Foley Thank you for downloading this file. This intended to supplement the presentation given at the NZ Wound Care Conference, it is not intended
More informationCase Report Micromelanomas: A Review of Melanomas 2mmand a Case Report
Case Reports in Oncological Medicine, Article ID 206260, 4 pages http://dx.doi.org/10.1155/2014/206260 Case Report Micromelanomas: A Review of Melanomas 2mmand a Case Report Sharad P. Paul 1,2,3 1 Skin
More informationSTUDY. Long- and Short-term Histological Observations of Congenital Nevi Treated With the Normal-Mode Ruby Laser
Long- and Short-term Histological Observations of Congenital Nevi Treated With the Normal-Mode Ruby Laser Shuhei Imayama, MD; Setsuko Ueda, MD STUDY Objective: To evaluate histologically the long- and
More informationSimulators of melanoma
Simulators of melanoma Philip E. LeBoit, M.D. Depts. of Pathology and Dermatology University of California, San Francisco Simulators of melanoma Simulators of melanoma in situ Melanocytic Non-melanocytic
More informationDermatoscopic features of cutaneous non-facial non-acral lentiginous growth pattern melanomas
DERMATOLOGY PRACTICAL & CONCEPTUAL www.derm101.com Dermatoscopic features of cutaneous non-facial non-acral lentiginous growth pattern melanomas Jeff Keir 1 1 Department of Dermatology, School of Medicine,
More informationMECHANISMS OF HUMAN DISEASE: LABORATORY SESSION PATHOLOGY OF THE SKIN LAB. Friday, February 12, :30 am 11:00 am
MECHANISMS OF HUMAN DISEASE: LABORATORY SESSION PATHOLOGY OF THE SKIN LAB Friday, February 12, 2012 9:30 am 11:00 am FACULTY COPY GOALS: Describe the basic clinical and morphologic features of various
More informationTeaching point. Case 1 2/3/18. Challenging Cases. Examples of challenging cases?
Challenging Cases Examples of challenging cases? 1. Challenge in diagnosis 2. Challenge in monitoring an off label treatment 3. Challenge where clinical diagnosis does not match the pathology diagnosis
More informationSTUDY. Correlation of Dermoscopy With In Vivo Reflectance Confocal Microscopy of Streaks in Melanocytic Lesions
STUDY Correlation of Dermoscopy With In Vivo Reflectance Confocal Microscopy of Streaks in Melanocytic Lesions Alon Scope, MD; Melissa Gill, MD; Cristiane Benveuto-Andrade, MD; Allan C. Halpern, MD; Salvador
More informationClinical and Dermoscopic Features of Thin Nodular Melanoma
Clinical and Dermoscopic Features of Thin Nodular Melanoma A study of the International Dermoscopy Society Coordinator: Dr. Alexander J. Stratigos and colleagues, alstrat2@gmail.com ** Extended to May
More informationImportant Decisions in Dermatopathology: The Clinico- Pathologic Correlation. Dermatopathology Specialists Needed. Changing Trends
Important Decisions in Dermatopathology: The Clinico- Pathologic Correlation Uma Sundram, MD, PhD Departments of Pathology and Dermatology Stanford University May 29, 2008 Dermatopathology Specialists
More informationGrowth rate of melanoma in vivo and correlation with dermatoscopic and dermatopathologic findings
Dermatology Practical & Conceptual www.derm101.com Growth rate of melanoma in vivo and correlation with dermatoscopic and dermatopathologic findings Jürgen Beer, M.D. 1, Lina Xu, M.D. 1, Philipp Tschandl,
More informationSTUDY. Characteristic Epiluminescent Microscopic Features of Early Malignant Melanoma on Glabrous Skin
Characteristic Epiluminescent Microscopic Features of Early Malignant Melanoma on Glabrous Skin A Videomicroscopic Analysis STUDY Shinji Oguchi, MD; Toshiaki Saida, MD, PhD; Yoko Koganehira, MD; Sachiko
More informationSTUDY. Scott W. Menzies, MB,BS, PhD; Karin Westerhoff, MD; Harold Rabinovitz, MD; Alfred W. Kopf, MD; William H. McCarthy, MBBS, MEd; Brian Katz
STUDY Surface Microscopy of Pigmented Basal Cell Carcinoma Scott W. Menzies, MB,BS, PhD; Karin Westerhoff, MD; Harold Rabinovitz, MD; Alfred W. Kopf, MD; William H. McCarthy, MBBS, MEd; Brian Katz Objectives:
More informationXF Microlens Optic and XD Microlens Compression Optic for Non-Ablative Fractional Skin Treatment with the Palomar Icon System
Optic and XD Microlens Compression Optic for Non-Ablative Fractional Skin Treatment with the Palomar Icon System Sean Doherty, M.D., 1 Brooke Seckel, M.D., 1 James Childs Ph.D., 2 David Tabatadze Ph.D.,
More informationSignature nevi: individuals with multiple melanocytic nevi commonly have similar clinical and histologic patterns
Dermatology Practical & Conceptual www.derm101.com Signature nevi: individuals with multiple melanocytic nevi commonly have similar clinical and histologic patterns Robert M. Hurwitz, M.D. 1, Larry J.
More informationPathology of the skin. Dr Fónyad László, 1sz. Patológiai és Kísérleti Rákkutató Intézet, SE
Pathology of the skin Dr Fónyad László, 1sz. Patológiai és Kísérleti Rákkutató Intézet, SE The skin Biggest organ Kb. 1.8 nm Kb. 10 kg Most frequent site for tumor development (BCC) Pathology of the skin
More informationINTRODUCTION HOUSEKEEPING June 11 th Dr John Adams Dermatologist/Dermoscopist MOLEMAP NZ/Australia MOLESAFE USA
INTRODUCTION HOUSEKEEPING June 11 th 2015 Dr John Adams Dermatologist/Dermoscopist MOLEMAP NZ/Australia MOLESAFE USA Program Skin cancer statistics. Dermoscopy description and usefulness. Patient /lesion
More informationFundamentals of dermoscopy
Fundamentals of dermoscopy Learning objectives Upon completion of this session, participants should be able to: describe the basic principles of dermoscopy identify features associated with pigmented and
More informationFemale 18. Deeply pigmented lesion on trunk.?warty naevus?seborrhoeic keratosis?malignant melanoma. The best diagnosis is:
Female 18. Deeply pigmented lesion on trunk.?warty naevus?seborrhoeic keratosis?malignant melanoma. The best diagnosis is: A. deep penetrating naevus B. naevoid malignant melanoma C. pigment synthesising
More informationSupplementary Online Content
Supplementary Online Content Chernoff KA, Marghoob AA, Lacouture ME, Deng L, Busam KJ, Myskowski PL. Dermoscopic findings in cutaneous metastases. JAMA Dermatol. Published online January 15, 2014. doi:10.1001/jamadermatol.2013.8502
More informationMECHANISMS OF HUMAN DISEASE: LABORATORY SESSION PATHOLOGY OF THE SKIN LAB. Friday, February 13, :30 am 11:00 am
MECHANISMS OF HUMAN DISEASE: LABORATORY SESSION PATHOLOGY OF THE SKIN LAB Friday, February 13, 2009 9:30 am 11:00 am FACULTY COPY GOALS: Describe the basic clinical and morphologic features of various
More informationSTUDY. Dermoscopy of Squamous Cell Carcinoma and Keratoacanthoma
ONLINE FIRST STUDY Dermoscopy of Squamous Cell Carcinoma and Keratoacanthoma Cliff Rosendahl, MBBS; Alan Cameron, MBBS; Giuseppe Argenziano, MD; Iris Zalaudek, MD; Philipp Tschandl, MD; Harald Kittler,
More informationApps and Telemedicine H. Peter Soyer Dermatology Research Centre
Apps and Telemedicine H. Peter Soyer Dermatology Research Centre p.soyer@uq.edu.au https://twitter.com/hpsoyer William Gibson The future is already here it's just not very evenly distributed Vision 3D
More informationMelanoma-Back to Basics I Thought I Knew Ya! Paul K. Shitabata, M.D. Dermatopathologist APMG
Melanoma-Back to Basics I Thought I Knew Ya! Paul K. Shitabata, M.D. Dermatopathologist APMG At tumor board, a surgeon insists that all level II melanomas are invasive since they have broken through the
More informationIntroduction to Dermoscopy. Nicholas Compton, MD June 16, 2010
Introduction to Dermoscopy Nicholas Compton, MD June 16, 2010 Overview What is dermoscopy Brief history Types of dermoscopy General approach to lesion of interest 2 step algorithm 3-point checklist Practice
More informationNon-melanocytic Patterns
Non-melanocytic Lesions Non-melanocytic Patterns Michelle Tarbox, MD Assistant Professor of Dermatology and Dermatopathology Texas Tech University Health Sciences Center 2018 Seborrheic keratoses Acanthotic
More informationPigmented skin lesions: are they all of melanocytic origin? A histopathological perspective
Original Article Pigmented skin lesions: are they all of melanocytic origin? A histopathological perspective Rajesh Singh Laishram, Barida Ginia Myrthong, Sharmila Laishram, Rachel Shimray, Arun Kumar
More informationToby Maurer, MD University of California, San Francisco. Lifetime risk of an American developing melanoma
Distinguishing Pigmented Skin Lesions and Melanoma Toby Maurer, MD University of California, San Francisco Epidemiology of Melanoma Lifetime risk of an American developing melanoma 1935: 1 in 1500 1980:
More information