Diagnosis of Lentigo Maligna Melanoma. Steven Q. Wang, M.D. Memorial Sloan-Kettering Cancer Center Basking Ridge, NJ
|
|
- Winifred Morton
- 5 years ago
- Views:
Transcription
1 Diagnosis of Lentigo Maligna Melanoma Steven Q. Wang, M.D. Memorial Sloan-Kettering Cancer Center Basking Ridge, NJ
2 Conflict of Interest: None
3 Topics Epidemiology and Natural History Clinical and Histologic Presentations Diagnostic Challenges and Modalities Treatment Options
4 Epidemiology Sun exposed sites Elderly patients Incidence 1.3/100,000 in Australia 1 0.8/100,000 in US 2 Most common subtype of melanoma on face Long term cumulative UVR 1. Holman CD, Int J Cancer Newell GR, Cancer Res. 1988
5 Natural History The majority of lesions are slowly growing intraepidermal melanocytic proliferations When invasion is detected, it is usually minimal (Clark level II) A small subset of LMs progresses rapidly to invasive melanoma A small subset is associated with desmoplastic melanoma
6 Histological Presentation
7 Diagnostic Challenges Differential Diagnoses include: Pigmented actinic keratosis Solar lentigo Seborrheic keratosis Pigmented BCCs LPLKs
8 Diagnostic Modalities Careful clinical exam, include palpation Woods light Multiple mapping biopsies Control biopsy of sun damaged skin Dermoscopy Confocal reflectance microscopy
9 Diagnostic Modalities Careful clinical exam, include palpation Woods light Multiple mapping biopsies Control biopsy of sun damaged skin Dermoscopy Confocal reflectance microscopy
10 Dermoscopy Powerful tool to aid the diagnosis of benign vs. malignant pigmented skin lesions. A hand-held microscope that provides detailed visualization of the structures contained within the epidermis, epidermaldermal junction, and papillary dermis not visible to the naked eye.
11 Clinical Exam Light
12 Addition of alcohol oil
13 Application of dermoscopy light oil Glass plate
14
15 Networks
16 Networks
17 Globules Networks
18 Globules Networks
19 Networks Globules Vessels
20 Lentigo Maligna Melanoma Asymmetric pigmented follicular openings Formation of rhomboidal structures Slat-gray dots and globules Obliteration of hair follicles Change over time Polymorphous vessels
21 Schiffner R. et al JAAD 2000
22 EAR Asymmetric pigmented follicular openings
23 EAR Asymmetric pigmented follicular openings
24 EAR Asymmetric pigmented follicular openings
25 Slate gray dots and globules progressing to short streaks
26 Slate gray dots and globules progressing to short streaks
27 Slate gray dots and globules progressing to short streaks
28 Slate gray dots and globules progressing to short streaks
29 Streaks progressing to dark rhomboidal structures
30 Streaks progressing to dark rhomboidal structures
31 Streaks progressing to dark rhomboidal structures
32 Homogeneous areas with hair follicles respected
33 Homogeneous areas with obliterated hair follicles
34 Polymorphous vessels Focal dark structureless areas
35 Differentiating LM vs. AK vs. LPLK Clue: Quality and distribution of the granular particles
36
37 Lentigo Maligna
38 Pigmented Actinic Keratosis
39
40 Lichen planus-like keratosis
41 AK LM LPLK
42 Pigmented Actinic Keratosis -Very broad pseudonetwork
43
44 Pigmented AK
45 Challenging Cases
46
47
48 Superior Cheek : LM Inferior Cheek: AK
49 The Role of Confocal Laser Microscope
50 Subsurface Imaging Confocal Laser Microscope Technology: live in vivo imaging high resolution m (lateral) 3-5 m (axial) visualization of nuclear, cellular architecture max depth 350 m of the skin Field of view: 0.4 x 0.4 cm
51 Confocal Microscope Laser 830nm Confocal pinhole 400x450µm Objective 30X Specimen PMT Mirror light from outside focal plane optically rejected only in-focus information collected (resolution 5 µm) can be focussed below specimen surface to isolate sub-surface images (max depth 400 µm = papillary dermis) Incremental movement of the focal depth produces 3D image sets
52
53
54
55 SINGLE IMAGE, 30X, 1000 x 1000 pixels 0.5 mm 0.5 mm
56 Imaging Modes Mosaic view Stack view
57 Imaging Mode: Mosaic Field of view: 0.4 x 0.4 cm 8x8 images stitched together
58 MOSAIC, 4X 4mm 0.5 mm 4mm, 4X 0.5 mm 30X The light source moves horizontally over a 2D grid
59
60 Imaging Mode: stack Field of view: 0.5 x 0.5mm
61 STACK, 30X 0.5 mm 0.5 mm 5 μm
62
63
64
65
66
67 RCM imaging of normal intact skin
68 Stratum corneum 0.9 NA, 30X 0.5 mm
69 Stratum granulosum 0.9 NA, 30X 0.5 mm
70 Stratum spinosum 0.9 NA, 30X 0.5 mm
71 Stratum basalis 0.9 NA, 30X 0.5 mm
72 Dermal Papillae 0.9 NA, 30X 0.5 mm
73 Dermis 0.9 NA, 30X 0.5 mm
74
75
76 Lentigo Maligna
77 Normal Epidermis
78 /10/2006
79 Lentigo Maligna
80 Normal Epidermis
81 Thank You
82 Therapeutic Options Surgery is the treatment of choice
83 Therapeutic Options Bub et al Arch Derm 2004
84 Therapeutic Options Standard Excision -5mm margin for LM NIH consensus panel -Inadequate surgical margin -High local recurrence rate of 15-20% Bub et al Arch Derm 2004
85
86 Therapeutic Options Mohs Surgery -Experience dependent. -Require immunostains (e.g., MART-1). -Enface section -Difficult to differentiate true LM vs. background suninduced melancyte atypia. Bub et al Arch Derm 2004
87 LM: Frozen vs Permanent Sections Frozen section Paraffin-embedded section
88
89
90
91
92 Therapeutic Options Staged Excision -Inconvenience -close collaboration with the pathologist Bub et al Arch Derm 2004
93 MSKCC SERIAL EXCISION TECHNIQUE Woods light marking Initial 5, 7, 10 mm margin Central pigmented lesion excised Margins excised 12-3, 3-6, 6-9, 9-12 Await pathology 24 hours Re-excise as needed
94 Tumor Center and Distinct Margin Areas Are Submitted Separately
95 12:00 Debulked Center 9:00 3:00 6:00
96 Distance between Tumor and Margin
97
98 Therapeutic Options Surgery is the treatment of choice Superficial treatments LN % recurrence rate 1-2 Radiotherapy Farshad et al 2002: retrospective review of 150 patients, 2yr follow up, a 7% recurrence rate Aldara Laser, 5FU, ED&C Collins P Clin Exp Dermatol 1991 Zacarian SA Arch Derm 1982
99 Candidates For Alternative Treatment Patient refuses surgery Poor surgical candidate Poor health and multiple medical problem Advanced age Lesion too large difficult anatomic location
100
101 Schon et al Br. J Derm 2007
102 Buttieker et al Arch Derm 2008
103 11/10/2008
104 3/18/2009
105 Conclusions Clinical diagnosis of LMM is difficult. Dermoscopy and confocal laser microscopy are valuable diagnostic tools. Surgery is the treatment of choice Alternative treatments include Aldara and radiation.
106 Acknowledgement Allan Halpern, MD Kishwer Nehal, MD Milind Rajadhyaksha, PhD Alon Scope, MD Jocelyn Lieb, MD Ashfaq Marghoob, MD Jason Chen, MD Career Development Award
107 Future Direction What if there is a way to map out the surgical border before Mohs surgery?
108
109
110
111
112
22/04/2015. 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 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 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 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 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 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 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 informationIdentifying Skin Cancer. Mary S. Stone MD Professor of Dermatology and Pathology University of Iowa Carver College of Medicine March, 2018
Identifying Skin Cancer Mary S. Stone MD Professor of Dermatology and Pathology University of Iowa Carver College of Medicine March, 2018 American Cancer Society web site Skin Cancer Melanoma Non-Melanoma
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 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 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 informationReflectance-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 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 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 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 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 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 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 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 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 informationBenign versus Cancerous Lesions How to tell the difference FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc
1 Benign versus Cancerous Lesions How to tell the difference FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc Benign lesions Seborrheic Keratoses: Warty, stuck-on Genetics and birthdays Can start in late
More informationDermoscopy Quiz 3-Point Checklist Algorithm
Dermoscopy Quiz 3-Point Checklist Algorithm GLOBAL PATTERN Globular LOCAL CRITERIA Aggregated globules Milia-like cysts 3 POINT CHECK LIST Symmetrical No abnormal net Slight Blue-white veil BENIGN MELANOCYTIC
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 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 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 informationClinical characteristics
Skin Cancer Fernando Vega, MD Seattle Healing Arts Clinical characteristics Precancerous lesions Common skin cancers ACTINIC KERATOSIS Precancerous skin lesions Actinic keratoses Dysplastic melanocytic
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 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 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 informationSTUDY. Morphologic Features of Melanophages Under In Vivo Reflectance Confocal Microscopy
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
More informationLiving Beyond Cancer Skin Cancer Detection and Prevention
Living Beyond Cancer Skin Cancer Detection and Prevention Cutaneous Skin Cancers Identification Diagnosis Treatment options Prevention What is the most common cancer in people? What is the most common
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 informationDavid B. Troxel, MD. Common Medicolegal Situations: Misdiagnosis of Melanoma
Common Medicolegal Situations: Misdiagnosis of Melanoma David B. Troxel, MD Medical Director, The Doctors Company, Napa, California Clinical Professor Emeritus, University of California at Berkeley Past
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 informationGlenn D. Goldman, MD. University of Vermont Medical Center. University of Vermont College of Medicine
Glenn D. Goldman, MD University of Vermont Medical Center University of Vermont College of Medicine Recognize and identify the main types of skin cancer and their precursors Identify and understand new
More informationLentigo Maligna: Striking a Balance With the Risk-Benefit Ratio. Glen M. Bowen, MD Huntsman Cancer Institute University of Utah
Lentigo Maligna: Striking a Balance With the Risk-Benefit Ratio Glen M. Bowen, MD Huntsman Cancer Institute University of Utah I. Objectives: a. Review the terminology of LM/LMM b. Understand the relative
More informationKey factors in successfully integrating dermoscopy into your clinical practice
Key factors in successfully integrating dermoscopy into your clinical practice S051 Dilemmas and challenges in skin cancer therapies and management Monday, March 4 th 2019 (9AM-12PM) Room 209A 10:56-11:09AM
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 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 informationLearning Objectives. Tanning. The Skin. Classic Features. Sun Reactive Skin Type Classification. Skin Cancers: Preventing, Screening and Treating
Learning Objectives Skin Cancers: Preventing, Screening and Treating Robert A. Baldor, MD, FAAFP Professor, Family Medicine & Community Health University of Massachusetts Medical School Distinguish the
More informationWhat is Dermoscopy? Early Dermoscopes. Deciphering Dermoscopy: Terminology, Features & Algorithms 6/17/2018
Deciphering Dermoscopy: Terminology, Features & Algorithms Where did it come from and why do we use it? Jennie T. Clarke, MD Associate Professor of Dermatology University of Utah School of Medicine What
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 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 informationGlenn D. Goldman, MD. Fletcher Allen Health Care. University of Vermont College of Medicine
Glenn D. Goldman, MD Fletcher Allen Health Care University of Vermont College of Medicine Recognize and identify the main types of skin cancer Understand how and why Mohs surgery is utilized for the treatment
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 informationLimitations of nonsurgical treatment modalities. Nonsurgical Treatments (Table V) 1/31/2018
DISCLOSURE OF RELEVANT RELATIONSHIPS WITH INDUSTRY James M. Grichnik M.D. Ph.D. Alternative Therapies James M Grichnik MD PhD Director, Scully-Welsh Cancer Center Indian River Medical Center grichnik@irmc.cc
More informationWork Place Carcinogens Solar Radiation and Skin Cancer. November 2013 Dr Mark Foley
Work Place Carcinogens Solar Radiation and Skin Cancer November 2013 Dr Mark Foley Overview Work place carcinogens and skin cancer Who is a risk? Screening and Self skin exam Common skin cancers Many work
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 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 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 informationOncology and surgery. Dra. Irene Palacios. Clínica Universidad de Navarra
Oncology and surgery Dra. Irene Palacios. Clínica Universidad de Navarra HOW TO MANAGE HIGH RISK SCC Yaouhi Gloria Xu Anokhi Jambusaria-Pahlajani HOW TO STAGE SCC Problem with tumor depth Often not posible
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 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 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 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 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 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 informationVivoSight Imaging for Dermatologists
VivoSight Imaging for Dermatologists VivoSight: The new real time imaging tool VivoSight Image of Skin Stratum corneum 160 µm Stratum granulosum Stratum spinosum Epidermis-dermis junction Papillary dermis
More informationCutaneous Malignancies: A Primer COPYRIGHT. Marissa Heller, M.D.
Cutaneous Malignancies: A Primer Marissa Heller, M.D. Associate Director of Dermatologic Surgery Department of Dermatology Beth Israel Deaconess Medical Center December 10, 2016 Skin Cancer Non-melanoma
More informationTotal body photography in high risk patients
Total body photography in high risk patients Doug Grossman, MD, PhD Department of Dermatology Huntsman Cancer Institute University of Utah Summer AAD F032 Practical Considerations for Patients with Melanoma
More informationKnow who is at risk: LOOK! for ABCDs, rapidly changing lesions, do a biopsy when indicated
Lindy P. Fox, MD Assistant Professor Director, Hospital Consultation Service Department of Dermatology University of California, San Francisco Applies to adults without history of malignancy or premalignant
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 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 informationThe impact of GP sub-specialisation and dermatoscopy use on diagnostic accuracy for melanomas in Australia
The impact of GP sub-specialisation and dermatoscopy use on diagnostic accuracy for melanomas in Australia Cliff Rosendahl, Gail Williams, Diann Eley, Tobias Wilson, Greg Canning, Jeffrey Keir, Ian McColl,
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 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 informationSKIN HISTOLOGY the microscopic anatomy of the Integument. Mikrogeo. com
SKIN HISTOLOGY the microscopic anatomy of the Integument Mikrogeo. com Hair follicles, sweat glands, sebaceous glands (even teeth) are products of the epidermis,embryologically speaking ectododerm, that
More informationContrast with Australian Guidelines A/Pr Pascale Guitera,
Contrast with Australian Guidelines A/Pr Pascale Guitera, Dermatologist, Sydney University NO CONFLICT OF INTEREST Sydney Melanoma Diagnostic Centre, RPAH 2011 2008 225 pages 16 pages http://www.cancer.org.au/file/healthprofessionals/clinica
More informationTechnicians & Nurses Program
ASCRS ASOA Symposium & Congress Technicians & Nurses Program May 6-10, 2016 New Orleans Evaluation and Treatment of Eyelid Malignancies Richard C. Allen MD PhD FACS Professor Section of Ophthalmology Dept.
More informationAdvances in Surgical Management of Primary Melanoma: Identifying Patients Who Need More than Conventional Wide Local Excision
Advances in Surgical Management of Primary Melanoma: Identifying Patients Who Need More than Conventional Wide Local Excision Christopher J. Miller, MD Director of Penn Dermatology Oncology Center Associate
More informationRosettes in actinic keratosis and squamous cell carcinoma: distribution, association to other dermoscopic signs and description of the rosette pattern
DOI: 10.1111/jdv.14474 JEADV ORIGINAL ARTICLE Rosettes in actinic keratosis and squamous cell carcinoma: distribution, association to other dermoscopic signs and description of the rosette pattern B. Lozano-Masdemont,
More informationKnow who is at risk: LOOK! for ABCDs, rapidly changing lesions, do a biopsy when indicated
Lindy P. Fox, MD Associate Professor Director, Hospital Consultation Service Department of Dermatology University of California, San Francisco Applies to adults without history of malignancy or premalignant
More informationPrinciples of Anatomy and Physiology
Principles of Anatomy and Physiology 14 th Edition CHAPTER 5 The Integumentary System Introduction The organs of the integumentary system include the skin and its accessory structures including hair, nails,
More informationMelanoma and Dermoscopy. Disclosure Statement: ABCDE's of melanoma. Co-President, Usatine Media
Melanoma and Dermoscopy Richard P. Usatine, MD, FAAFP Professor, Family and Community Medicine Professor, Dermatology and Cutaneous Surgery Medical Director, University Skin Clinic University of Texas
More informationLUMPS AND BUMPS: AN ORGANIZED APPROACH TO DIAGNOSIS AND MANAGEMENT
LUMPS AND BUMPS: AN ORGANIZED APPROACH TO DIAGNOSIS AND MANAGEMENT Tammy P. Than, M.S., O.D., F.A.A.O. The University of Alabama at Birmingham / School of Optometry 1716 University Blvd. Birmingham, AL
More informationcomedo-like openings (clods, brown or orange & circles) milia-like cysts (dots or clods, white) 1/29/18 Dotted vessels are also commonly seen in SCC
Brown circles Dotted vessels are also commonly seen in SCC Step1 1. Nevus (unequivocal) 2. DF/IDN 3. BCC 4. SCC Network Patchy network Peripheral network & central hypopigmentation DF: network with central
More informationSkin Cancer. 5 Warning Signs. American Osteopathic College of Occupational and Preventive Medicine OMED 2012, San Diego, Monday, October 8, 2012 C-1
Skin Cancer AMERICAN OSTEOPATHIC COLLEGE OF OCCUPATIONAL & PREVENTIVE MEDICINE OMED 2012 October 8, 2012 E. Robert Wanat II, D.O., M.P.H. Learning Objectives: Identify the 3 Basic Types of Skin Cancer
More informationManagement of Atypical Pigmented Lesions
Management of Atypical Pigmented Lesions Jennifer A. Stein MD, PhD Associate Director, Pigmented Lesion Section Ronald O. Perelman Department of Dermatology NYU Langone Medical Center July 29, 2017 1-4
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 informationPeriocular Malignancies
Periocular Malignancies Andrew Gurwood, O.D., F.A.A.O., Dipl. Marc Myers, O.D., F.A.A.O. Drs. Myers and Gurwood have no financial interests to disclose. Course Description Discussion of the most common
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 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 informationSkin Cancers Emerging Trends and Treatment Approaches
Skin Cancers Emerging Trends and Treatment Approaches Andrei Metelitsa, MD, FRCPC, FAAD Clinical Associate Professor, Dermatology, U of C Co-Director, Institute for Skin Advancement Copyright 2017 by Sea
More informationLumps and Bumps: An Organized Approach to Diagnosis and Management. Disclosure. Introduction. References. Structure of Skin.
Lumps and Bumps: An Organized Approach to Diagnosis and Management Nothing to disclose Disclosure Tammy Pifer Than, MS, OD, FAAO Carl Vinson VAMC tammythan@bellsouth.net References Fitzpatrick's Color
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 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 informationCancer Council Australia Wiki Guidelines 2017
WHAT IS THE ROLE OF SEQUENTIAL DIGITAL DERMOSCOPY IMAGING IN MELANOMA DIAGNOSIS? Cancer Council Australia Wiki Guidelines 2017 SHORT-TERM MONITORING 3 months Any change leads to excision Any melanocytic
More informationSkin Cancer 101: Diagnosis and Management of the Most Common Cancer
Skin Cancer 101: Diagnosis and Management of the Most Common Cancer Sarah Patton, PA-C, MSHS Skin Surgery Center www.skinsurgerycenter.com Seattle/Bellevue, WA Skin cancer Skin cancer is by far the most
More informationSkin biopsy. Sophia Otto SA Pathology
Skin biopsy Sophia Otto SA Pathology RCPA (Royal College of Pathologists of Australasia) The RCPA is the leading organisation representing pathologists in Australasia. Its mission is to train and support
More informationDiagnostic Dermatology & Dermatologic Surgery Overview
Diagnostic Dermatology & Dermatologic Surgery Overview A comprehensive range of innovative products & accessories for dermatologic diagnosis & surgery Clinical imaging The Fully integrated patient management
More informationFinding Melanoma. Is not easy!
Finding Melanoma Is not easy! Finding Melanoma Victoria mean depth at diagnosis is 1.5 mm. Melanoma 1.5mm Has Stage 1B Mortality 10% Melanoma Spotting a killer! Spotting a killer Visual Clues What are
More informationPhoebe Rich MD Adjunct Professor OHSU Portland, Oregon
Nail Tips for Diagnosis and Management of Nail Disorders Winter Clinical Dermatology Conference 2017 Hawaii Phoebe Rich MD Adjunct Professor OHSU Portland, Oregon Objectives diagnostic clues for benign
More informationSkin Cancer A Personal Approach. Dr Matthew Strack Dunedin New Zealand
Skin Cancer A Personal Approach Dr Matthew Strack Dunedin New Zealand Outline Dermoscopy Instruments and setup Photochemosurgery Clinical Aim: Leave with 2-3 ideas JLE Benign Junctional Nevus Management
More informationCutaneous Melanoma: Epidemiology (USA) The Sentinel Node in Head and Neck Melanoma. Cutaneous Melanoma: Epidemiology (USA)
The Sentinel Node in Head and Neck Melanoma Cutaneous Melanoma: Epidemiology (USA) 6 th leading cause of cancer among men and women 68,720 new cases of invasive melanoma in 2009 8,650 deaths from melanoma
More informationSkin Malignancies Non - Melanoma & Melanoma Marilyn Ng, MD Dept. of Surgery M&M Conference Downstate Medical Center July 19, 2012
Skin Malignancies Non - Melanoma & Melanoma Marilyn Ng, MD Dept. of Surgery M&M Conference Downstate Medical Center July 19, 2012 Case Presentation 57 yo man with 3 month hx of a nonhealing < 1 cm right
More informationMelanocytic Lesions: Use of Immunohistochemistry and Special Studies Napa Valley 2018
Melanocytic Lesions: Use of Immunohistochemistry and Special Studies Napa Valley 2018 Victor G. Prieto, MD, PhD Professor Depts. of Pathology and Dermatology University of Texas - MD Anderson Cancer Center
More information4 Skin and Body Membranes Study Guide
Name: SKIN AND BODY MEMBRANES: 4 Skin and Body Membranes Study Guide Period: Body membranes, which cover body surfaces, line its cavities, and form protective sheets around organs, fall into two major
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 information