To measure and compare the accuracy of 4 different clinical methods in the diagnosis of melanoma in situ of the nail matrix among dermatologists with different levels of clinical experience. Design: Twelve cases of melanonychias (5 melanomas and 7 nonmelanomas) were presented following 4 successive steps: (1) clinical evaluation, (2) evaluation according to the ABCDEF rule, (3) dermoscopy of the nail plate, and (4) intraoperative dermoscopy. At each step, the dermatologists were asked to decide if the lesion was a melanoma.
Background Dermoscopy has furthered advances in the differential diagnosis of longitudinal melanonychia; however, fewer details observed in the nail, as compared to skin lesions, make interpretation difficult.Methods Ten cases of longitudinal melancholia, from several etiologies, were submitted to direct dermoscopic examination of the nail bed and matrix.Results We observed the presence of globules, streaks, and pigment network in the nail bed and matrix, which are dermoscopic features not seen in the nail plate.Conclusions This procedure enables visualization of dermascopic features not seen in the nail plate, making the diagnosis of melanocytic lesions easier.
A Web-based educational model, called JUTE, was developed for the early diagnosis of melanoma. It was compared with a control Website composed of information available on the Internet for teaching undergraduate medical students. The JUTE model was designed to allow the student linear navigation of the main topics that were assumed to be important in learning to make a diagnosis. The rate of success in correctly deciding to refer pigmented lesions to a dermatologist was compared among 34 new medical students who were randomly divided into two groups. There was no significant difference between the JUTE and control groups in the pre-test. When comparing the pre- and post-tests, the number of correct decisions increased significantly only in the JUTE group. In the JUTE group there was a slight but significant improvement when comparing decisions about thin melanoma before and after the training. The educational approach chosen for the JUTE Website appears to be useful for teaching the early recognition of melanoma and could be used for larger educational campaigns of skin cancer prevention.
Melanoma is a malignant melanocytic neoplasm with high mortality rate, and
steadily and universally increasing incidence rates. Polypoid melanoma is
considered an exophytic variant of the nodular subtype. The incidence of
polypoid melanoma is extremely variable, most likely because of the different
criteria used for its characterization. We presented a rare case of polypoid
melanoma and superficial spreading melanoma in the same lesion.
Although giant congenital melanocytic nevus is a rare lesion, it causes
significant deformity and carries a risk of malignant degeneration. Different
surgical techniques for the lesion removal are described, including serial
resection, resection with skin grafting, and resection and coverage with
expanded skin flap (skin expanders). The aim of this study is to report the
author's 40 years of experience with cases requiring at least 4 serial excisions
to complete the treatment. Serial resection is an effective, safe, and simple
technique that requires a lot of patience. Treatment often results in a single
linear scar, requires no donor sites, nor large flaps. It is not subject to
potencial complications of expanders and avoid aesthetic deformities depending
on the location.
Surgery is the best treatment for glomus tumors. Sometimes this can be a challenging procedure because, despite being a well-defined tumor, its visualization can be difficult. The use of nail bed and matrix dermoscopy facilitates the diagnosis and aids in the localization and demarcation of the tumor. It is a simple and low-cost procedure that does not involve additional risks to the patient who will undergo surgery.
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