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2.
Dermatol Online J ; 25(5)2019 May 15.
Article in English | MEDLINE | ID: mdl-31220892

ABSTRACT

The Pigmented Lesion Assay (PLA, sensitivity 91-95%, specificity 69-91%, negative predictive value ?99%) is a commercially available, non-invasive gene expression test that helps dermatologists guide pigmented lesion management decisions and rule out melanoma. Earlier studies have demonstrated high clinical utility and no missed melanomas in a 3-6-month follow-up period. We undertook the current investigations to provide 12-month follow-up data on PLA(-) tests, and to further confirm utility. A 12-month chart review follow-up of 734 pigmented lesions that had negative PLA results from 5 US dermatology centers was performed. Thirteen of these lesions (1.8%) were biopsied in the follow-up period and submitted for histopathologic review. None of the lesions biopsied had a histopathologic diagnosis of melanoma. The test's utility was studied further in a registry (N=1575, 40 US dermatology offices, 62 participating providers), which demonstrated that 99.9% of PLA(-) lesions were clinically monitored, thereby avoiding a surgical procedure, and 96.5% of all PLA(+) lesions were appropriately biopsied, most commonly with a tangential shave. This long-term follow-up study confirms the PLA's high negative predictive value and high utility in helping guide the management of pigmented lesions to avoid unnecessary surgical procedures.


Subject(s)
Melanoma/diagnosis , Nevus, Pigmented/diagnosis , Skin Neoplasms/diagnosis , Biopsy/statistics & numerical data , Diagnosis, Differential , Female , Follow-Up Studies , Gene Expression Profiling , Genetic Testing/methods , Humans , Male , Melanoma/genetics , Melanoma/pathology , Middle Aged , Practice Patterns, Physicians'/statistics & numerical data , Predictive Value of Tests , Registries , Sensitivity and Specificity , Skin Neoplasms/genetics , Skin Neoplasms/pathology , United States
3.
Dermatol Online J ; 15(7): 8, 2009 Jul 15.
Article in English | MEDLINE | ID: mdl-19903436

ABSTRACT

A mucocele is one of the more commonly encountered disorders of the oral mucosa. It develops when a minor salivary duct is injured or blocked, resulting i n the escape of mucus into the adjacent submucosal connective tissue. We present two cases that were clinically diagnosed as mucoceles that were removed because of patient anxiety. However, histological examination revealed dissimilar and medically significant pathologies. Oral cysticercosis and salivary gland adenocarcinoma are rare diseases of the oral mucosa. It is important to consider these and other uncommon diagnoses when evaluating an oral nodule presumed to be a mucocele. We will discuss the natural history and pathogenesis of these disease processes.


Subject(s)
Adenocarcinoma/diagnosis , Cysticercosis/diagnosis , Diagnostic Errors , Lip Diseases/diagnosis , Mucocele/diagnosis , Salivary Gland Neoplasms/diagnosis , Adenocarcinoma/psychology , Adenocarcinoma/surgery , Adult , Aged , Anxiety , Biopsy , Costa Rica , Cysticercosis/surgery , Humans , Lip Diseases/parasitology , Lip Diseases/surgery , Male , Mohs Surgery , Puerto Rico , Salivary Gland Neoplasms/psychology , Salivary Gland Neoplasms/surgery , Salivary Glands, Minor , Travel
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