Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy

Stanganelli, Ignazio; Longo, Caterina; Mazzoni, Laura; Magi, Serena; Medri, Matelda; Lanzanova, Giuseppe; Farnetani, Francesca; Pellacani, Giovanni

doi:10.1111/bjd.13373

Cited by 62 publications

(69 citation statements)

References 31 publications

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“…It is important to highlight the efficiency of digital follow-up of high-risk patients in early detection and removal of malignant lesions and, as in our case, the aid of confocal microscopy to reduce even more the number needed to treat, as it has been recently demonstrated [13,14]. Moreover, we highlight the importance of detection of e.g.…”

Section: Discussionmentioning

confidence: 70%

Atypical Clinical Presentation of Xeroderma Pigmentosum in a Patient Harboring a Novel Missense Mutation in the XPC Gene: The Importance of Clinical Suspicion

et al. 2015

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Background: Xeroderma pigmentosum (XP) is a genodermatosis caused by abnormal DNA repair. XP complementation group C (XPC) is the most frequent type in Mediterranean countries. We describe a case with a novel mutation in the XPC gene. Case: A healthy Caucasian male patient was diagnosed with multiple primary melanomas. Digital follow-up and molecular studies were carried out. Results: During digital follow-up 8 more additional melanomas were diagnosed. Molecular studies did not identify mutations in CDKN2A, CDK4 or MITF genes. Two heterozygous mutations in the XPC gene were detected: c.2287delC (p.Leu763Cysfs*4) frameshift and c.2212A>G (p.Thr738Ala) missense mutations. Conclusion: The p.Thr738Ala missense mutation has not been previously described. Missense mutations in the XPC gene may allow partial functionality that could explain this unusual late onset XP. Atypical clinical presentation of XPC could be misdiagnosed when genetic aberrations allow partial DNA repair capacity.

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Section: Discussionmentioning

confidence: 70%

Atypical Clinical Presentation of Xeroderma Pigmentosum in a Patient Harboring a Novel Missense Mutation in the XPC Gene: The Importance of Clinical Suspicion

et al. 2015

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“…RCM evaluation has the potential to improve sensitivity (improve melanoma detection) [19,20] and specificity (reduce excisions of benign lesions [12,21–23]). In one study, RCM evaluation of doubtful lesions reduced the need for unnecessary excisions by over 50% [21] and in another, it reduced the number needed to treat from 3.73 (clinical and dermoscopy evaluation) to 2.87 (addition of RCM to clinical and dermoscopy evaluation) [12].…”

Section: Background: Reflectance Technologymentioning

confidence: 99%

“…If the lesion presents equivocal or benign features on RCM, digital dermoscopic monitoring can be considered [19,21,66]. …”

Section: Background: Reflectance Technologymentioning

confidence: 99%

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Advances in the use of Reflectance Confocal Microscopy in Melanoma

2018

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In vivo reflectance confocal microscopy (RCM) is a noninvasive high-resolution skin imaging tool that has become an important adjunct to clinical exam, dermoscopy and histopathology assessment, in the diagnosis and management of melanoma. RCM generates a horizontal view of the skin, whereby cellular and subcellular (e.g., nuclei, melanophages, collagen) structures, to the level of the upper dermis, are projected onto a screen at near-histological resolution. Morphologic descriptors, standardized terminology, and diagnostic algorithms are well established for the RCM assessment of melanoma, melanocytic, and nonmelanocytic lesions. Clinical applications of RCM in melanoma are broad and include diagnosis, assessment of large lesions on cosmetically sensitive areas, directing areas to biopsy, delineating margins prior to surgery, detecting response to treatment and assessing recurrence. This review will provide an overview of RCM technology, findings by melanoma subtype, clinical applications, as well as explore the accuracy of RCM for melanoma diagnosis, pitfalls and emerging uses of this technology ex vivo.

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“…In the last few years reflectance confocal microscopy (RCM) has opened a new dimension in non-invasive optical digital biopsy of skin tissue (22)(23)(24). RCM analyzes different horizontal layers of the epidermis, dermo-epidermal junction and papillary dermis and permits a close dermoscopy/confocal/histological correlation.…”

Section: Reflectance Confocal Microscopy Featuresmentioning

confidence: 99%

Diagnostic spectrum of nodular melanoma

Stanganelli¹

2016

cderm

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SummaryNodular melanoma represents 10 to 30% of all melanomas and circa 50% of those with a Breslow thickness greater than 2 mm. The main cause of death among malignant cutaneous tumors, it presents a high metastatic potential even in the early growth stages, making an early diagnosis fundamental. It is more common in men than in women, its onset is in later age, in any part of the body, more often on the neck and head. Due to its clinical characteristics (symmetrical, nodular, amelanotic/hypomelanotic or highly pigmented lesion) nodular melanoma is difficult to diagnose with the ABCD rule (Asymmetry, irregular Borders, Color variation and Diameter).

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Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy

Abstract: Integration of RCM in the clinical and instrumental strategy for managing difficult pigmented lesions provided additional diagnostic information useful in the decision-making process.

Cited by 62 publications

References 31 publications

Atypical Clinical Presentation of Xeroderma Pigmentosum in a Patient Harboring a Novel Missense Mutation in the <b><i>XPC</i></b> Gene: The Importance of Clinical Suspicion

Atypical Clinical Presentation of Xeroderma Pigmentosum in a Patient Harboring a Novel Missense Mutation in the <b><i>XPC</i></b> Gene: The Importance of Clinical Suspicion

Advances in the use of Reflectance Confocal Microscopy in Melanoma

Diagnostic spectrum of nodular melanoma

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