Two controversies confronting dermoscopy or dermatoscopy: nomenclature and results

Conforti, Claudio; Giuffrida, Roberta; Retrosi, Chiara; Meo, Nicola di; Zalaudek, Iris

doi:10.1016/j.clindermatol.2019.07.001

Cited by 15 publications

(13 citation statements)

References 11 publications

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“…Dermoscopy has shown to improve the diagnostic accuracy for basal cell carcinoma. Numerous dermoscopic criteria have been described in literature, including arborizing vessels, ulceration, blue‐grey globules, maple leaf‐like structure, blue‐ovoid nests and spoke‐wheel structures 8,9 …”

Section: Discussionmentioning

confidence: 99%

Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features

Conforti

Pizzichetta

Vichi

et al. 2020

Acad Dermatol Venereol

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BackgroundAmong the various types of basal cell carcinoma, the sclerodermiform variant has a high risk of recurrence and local invasiveness. A systematic description of the dermatoscopic features associated with specific body localization is lacking.ObjectivesTo describe the clinical and dermoscopic features of sclerodermiform basal cell carcinoma (BCC) according to localization in the body confronting with superficial and nodular types.MethodsClinical and dermoscopic images of sclerodermiform, nodular and superficial BCCs were retrospectively evaluated to study the location in the various body districts, maximum diameter, clinical appearance of the lesion, features of edges and presence or absence of specific dermatoscopic criteria of BCCs.ResultsWe examined 291 histopathologically proven BCCs showing that in nodular BCCs, classical arborizing vessels were more frequently found in the body macro‐area (trunk and limbs; n = 46, 97.9%) than in the head/neck area (n = 43, 82.7%); within sclerodermiform BCCs, short arborizing vessels were found more frequently in the head/neck district (n = 35, 49.3%) than in the body (n = 6, 23.1%; P‐value 0.02); within nodular BCCs, multiple blue‐grey dots and globules were more frequently found on the trunk (n = 23, 48.9%) than in the head/neck district (n = 12, 23.1%; P‐value 0.01). In sclerodermiform BCCs, ulceration was found more frequently in the head/neck district (n = 38, 53.5%) than in the body (n = 4, 15.4%; P‐value > 0.01), and in superficial BCCs, ulceration was found more frequently in the head/neck district (n = 5, 38.5%) than in the body (n = 8, 9.8%; P‐value 0.02).ConclusionOur study shows that superficial BCC are found frequently in the head/neck district dermoscopically characterized by ulceration and arborizing vessels; nodular BCCs are more frequently found in the body than in the head/neck district, and the dermoscopic pattern is characterized by the combination of three features: (i) classical arborizing vessels, (ii) multiple blue‐grey dots and (iii) globules. Instead, sclerodermiform BCC is preferentially located in areas at high–moderate risk of recurrence; if pink‐white areas and/or fine arborizing vessels are seen, clinicians should consider this diagnosis. Furthermore, location‐specific dermatoscopic criteria have been described.

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Section: Discussionmentioning

confidence: 99%

Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features

Conforti

Pizzichetta

Vichi

et al. 2020

Acad Dermatol Venereol

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“…From 1975 to 2015, the incidence of melanoma increased approximately 6-fold in the US. The cause of this increase, according to some authors, is not due to UV-induced sun damage or to personal risk factors but to an increased clinical and histological ability to diagnose melanoma [38,39]. In fact, according to some studies, although the incidence of melanoma has increased in most continents, mortality has remained stable.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Risk Factors of Melanoma: A Review

Conforti¹,

Zalaudek²

2021

Dermatol Pract Concept

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We are currently witnessing a worldwide increase in the incidence of melanoma. Incidence in Europe is about 25 cases per 100,000 population, while in Australia it reaches a rate of 60 new cases per 100,000. While the epidemiological curves of the 1980's and 1990's suggested an increase in the incidence of melanoma across all age groups, the last 10 years’ data indicates a 5% reduction in the incidence of thin melanoma in young individuals aged between 15 and 24. This suggests a positive impact of primary prevention campaigns [1-2]. The risk factors associated with melanoma are different and multifactorial: on one hand, there is a genetic predisposition, as evidenced by the increased risk in patients with dysplastic nevus syndrome, with familial melanoma or familial melanoma syndromes; on the other hand, the unprotected interaction between UV rays and phototypes I-II increases the risk of developing melanoma, especially in case of sunburns in pediatric age. This review aims to summarize melanoma epidemiology and risk factors.

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“…30 Dermatoscopically, they every so often exhibit the well-known "strawberry pattern". 7,31 Vascular pattern analysis can aid in the differentiation between AKs and seborrheic keratoses, Bowen's disease and non-pigmented BCCs. 32,33 Additionally, it can identify the first signs of invasive SCC, typified by the presence of dotted vessels around hair follicles, as well as in situ SCC, in which dotted/coiled vessels evolve into glomerular vessels and the follicular openings miniaturize and finally disappear.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and tolerability of treatment for isolated actinic keratoses: A retrospective comparison between cryotherapy, CO ₂ laser and 5‐fluorouracil 0.5%/salicylic acid 10%

Conforti

Giuffrida

Dianzani

et al. 2021

Dermatologic Therapy

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Actinic keratoses (AK) have been described as either intraepithelial keratinocytic dysplasia that can evolve into invasive squamous cell carcinoma (SCC) or as in situ SCC that can progress into an invasive form. A retrospective study was conducted to compare outcomes of three different topical therapies for patients with single AK (<4): cryotherapy, CO 2 laser and 5-fluorouracil 0.5%/salicylic acid 10%. We included 72 patients who presented at the Dermatology Clinic of Maggiore Hospital of Trieste between 1 November 2019 and 31 January 2020 for the treatment of AKs. All treatments led to a significant reduction in the average diameter of AK. Pain felt by patients was significantly lower after 5-FU 0.5%/SA 10%. Side effects appeared similarly distributed among the three groups, with erythema and crusts being the most frequent. Aesthetic outcomes were highest in the 5-FU 5%/SA 10% group, as evaluated by both the patient and the operator. Cryotherapy, CO 2 laser and 5-FU 5%/SA 10% were all effective, with no significant efficacy differences among them. Additionally, 5-FU 5%/SA 10% was proved to have the best aesthetic result and to cause the least pain, while necessitating long-term administration. This should be taken into account for patients with low pain tolerance and low treatment adherence. Cryotherapy and CO 2 laser have the advantage of requiring a single session, which might be more suitable for uncooperative patients. K E Y W O R D S5-fluorouracil, actinic keratoses, CO 2 laser, cryotherapy, salicylic acid, treatment | INTRODUCTIONActinic keratoses (AK) have been described as either intraepithelial keratinocytic dysplasia that can evolve into invasive squamous cell carcinomas (SCC) or as in situ SCC that might progress to an invasive stage. 1,2 Rates of malignization vary between 0.025% and 16% and the risk of progression to SCC is greater in patients with multiple AKs. [3][4][5] AKs rarely develop as a single lesion; there are usually several AKs affecting an entire area of photodamaged skin. 6,7 They can appear as rough, scaly papules, plaques or patches on an erythematous basis, 8 varying from a few millimeters to more than 2 cm. 9 The Olsen clinical classification system is based on the thickness of AKs: grade 1 lesions are slightly palpable, grade 2 are moderately thick and grade 3 are very thick, hyperkeratotic lesions. 10 The relationship between AK and SCC is supported by common histological and genetic pathomechanisms. Additionally, more than Claudio Conforti and Roberta Giuffrida authors have equally contributed.

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Two controversies confronting dermoscopy or dermatoscopy: nomenclature and results

Cited by 15 publications

References 11 publications

Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features

Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features

Epidemiology and Risk Factors of Melanoma: A Review

Effectiveness and tolerability of treatment for isolated actinic keratoses: A retrospective comparison between cryotherapy, CO ₂ laser and 5‐fluorouracil 0.5%/salicylic acid 10%

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Two controversies confronting dermoscopy or dermatoscopy: nomenclature and results

Cited by 15 publications

References 11 publications

Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features

Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features

Epidemiology and Risk Factors of Melanoma: A Review

Effectiveness and tolerability of treatment for isolated actinic keratoses: A retrospective comparison between cryotherapy, CO 2 laser and 5‐fluorouracil 0.5%/salicylic acid 10%

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Resources

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Effectiveness and tolerability of treatment for isolated actinic keratoses: A retrospective comparison between cryotherapy, CO ₂ laser and 5‐fluorouracil 0.5%/salicylic acid 10%