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3.
Dermatol Pract Concept ; 10(4): e2020093, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33150034
4.
Dermatol Pract Concept ; 10(2): e2020047, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32363109
8.
Artigo em Inglês | MEDLINE | ID: mdl-31417071

RESUMO

Background: The diagnosis of basal cell carcinoma is histopathological, but there are dermatoscopic criteria that confer high sensitivity and specificity to help the clinician improve its identification. However, the basal cell carcinoma blue-white variant does not totally meet these dermatoscopic criteria, and thus can be confused with other pigmented tumors. In the literature reviewed, we found only five cases of this variant. Aims: The present objective is to describe the dermatoscopic characteristics of the blue-white variant of basal cell carcinoma observed in a tertiary dermatology institute. Methods: The dermatoscopy files of patients with a histopathological diagnosis of basal cell carcinoma between January 1, 2006 and December 31, 2015 were reviewed. Results: A total of 32 cases with blue-white variant of basal cell carcinoma were observed over a period of 10 years. Of these cases, 97% presented dermatoscopic findings not included in the aforementioned criteria, such as whitish septa, structureless white areas, homogenous blue pigmentation and shiny white structures. Limitations: The small sample size and the retrospective nature of the design. Conclusion: We consider it important for dermatologists to know this rare variant of basal cell carcinoma and to familiarize themselves with their dermatoscopic findings, in order to prevent erroneous diagnoses or inadequate treatments.

10.
Am J Clin Dermatol ; 19(Suppl 1): 3-14, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30374899

RESUMO

In the 1980s, the increasing incidence of skin cancers prompted the development of noninvasive medical devices to improve skin cancer diagnosis in daily dermatology practice. As a result of the development of these noninvasive techniques, diagnosis is now established earlier and with better accuracy. These advances are of great benefit to high-risk patients, who previously would have had to undergo several excisions. In this review, we focus on the classic technique of dermoscopy and the more recent digital version, as well as on advanced noninvasive imaging techniques, such as reflectance confocal microscopy and optical coherence tomography. On the basis of their specific features, these noninvasive medical devices can be used not only to diagnose and monitor melanoma and nonmelanoma skin cancers but also to choose the best therapy and follow the patient's response to treatment in vivo.


Assuntos
Dermatologia/métodos , Oncologia/métodos , Neoplasias Cutâneas/diagnóstico por imagem , Dermatologia/instrumentação , Dermoscopia/instrumentação , Dermoscopia/métodos , Humanos , Oncologia/instrumentação , Microscopia Confocal/instrumentação , Microscopia Confocal/métodos , Fotoquimioterapia/métodos , Cuidados Pré-Operatórios/métodos , Prognóstico , Pele/diagnóstico por imagem , Neoplasias Cutâneas/terapia , Tomografia de Coerência Óptica/instrumentação , Tomografia de Coerência Óptica/métodos , Resultado do Tratamento
12.
Dermatol Pract Concept ; 7(3): 44-46, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29085719

RESUMO

Malignant fibrous histiocytoma (MFH), currently classified as undifferentiated pleomorphic sarcoma, is the most frequent soft tissue sarcoma in adulthood, but it is not as common as a primary skin tumor. MFH affects mostly the thighs and trunk, head and neck is an infrequent presentation in adults. MFH is often diagnosed in advanced stages, with a tendency to local recurrence and systemic metastasis. Since tumor thickness and size are identified as major prognostic factors, early recognition becomes crucial to improve prognosis. We present a case of a cutaneous malignant fibrous histiocytoma located on the face in which dermoscopy was useful in clinical management and definition.

16.
Dermatol Pract Concept ; 4(4): 39-46, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25396084

RESUMO

BACKGROUND: Early recognition is the most important intervention to improve melanoma prognosis. OBJECTIVE: To report the value of dermoscopy and digital dermoscopy in the clinical diagnosis of malignant melanoma (MM). METHODS: Retrospective analysis of 99 consecutive primary MMs diagnosed between 2010 and 2013. The MMs were divided into 3 groups: 1) the MM was the reason for consultation (MMC), 2) the MM was detected during routine control of nevi (MMRC), and 3) the MM was detected due to changes observed during digital dermoscopy follow-up (MMDFU). Clinical, dermoscopic and histologic features were assessed. RESULTS: A total of 99 MMs were diagnosed in 89 patients (55% male) with a mean age of 50.8 (18-93) years. Of all the MMs, 35 were the reason for patient consultation (MMC), 52 were detected during routine control of nevi (MMRC) and 12 were diagnosed due to changes observed with digital dermoscopy (MMDFU). On clinical examination, 74.2 % of MMC met the 4 ABCD criteria, while only 30.7 % of MMRC and 8.3 % of MMDFU. Most MMC were correctly classified as malignant according to dermoscopy, but 44.2% of MMRC and only 16.7% of MMDFU. 22.9% of MMC, 50% of MMRC and 58.3% of MMDFU were in situ. Mean Breslow thickness was significantly lower in the MMDFU group (0.52 mm) than in the MMRC and MMDFU groups (0.77 and 1.43 mm respectively). CONCLUSIONS: The use of dermoscopy and digital dermoscopy allows the detection of MMs in early stages, even in the absence of specific criteria for malignancy.

17.
Dermatol Pract Concept ; 4(4): 65-7, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25396089

RESUMO

Digital mucous cysts are benign ganglion cysts of the digits typically located on the dorsal aspect of the interphalangeal joint and distal phalanx of the digits. Usually the clinical diagnosis is straightforward, though sometimes it may mimic other lesions and diagnosis becomes a challenge. We present a series of three digital mucous cysts with a repeatable dermoscopic pattern consisted of linear branched and serpentine vessels when no compression is applied and translucent aspect with white bright areas and loss of vascular pattern when compression is applied.

18.
JAMA Dermatol ; 149(9): 1060-7, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23863988

RESUMO

IMPORTANCE: In the era of targeted therapy for cancer, translational research identifying molecular targets in melanoma offers novel opportunities for potential new treatments. OBJECTIVES: To describe a method for sampling fresh tissue from primary melanoma and to test whether the area of maximal thickness can be identified with dermoscopy to ensure it remains available for routine histopathological diagnosis. DESIGN, SETTING, AND PARTICIPANTS: Tumors clinically suspicious for melanoma with diameter exceeding 5 mm were included. Dermoscopy-guided sampling was performed using a 2-mm to 3-mm punch through not the thickest part of the tumor. In vivo and ex vivo dermoscopic images obtained were available to the diagnosing pathologist. Melanoma samples were obtained in a referral melanoma unit. MAIN OUTCOMES AND MEASURES: In study 1, Breslow thickness in 10 melanomas was compared between sampled tissue and the remaining specimen to confirm that the area of maximal thickness remained available for the histopathological diagnosis. In study 2, forty-three additional melanomas were sampled for biobanking prospectively. Agreement between 2 independent observers on dermoscopic identification of the thickest part of the melanoma was studied. RESULTS: In study 1, the area of maximal Breslow thickness in all 10 melanomas was not sampled and remained in the main specimen. In study 2, sampling was performed by one of the investigators. Concordance was 93% between 2 independent observers for the dermoscopic selection of the thickest portion of the melanoma. Pathologists asserted that the sampling procedure did not compromise their ability to evaluate melanoma specimens. A limitation is that this is a single-center study. Each case required joint evaluation by expert dermoscopists and dermatopathologists. CONCLUSIONS AND RELEVANCE: In applying the dermoscopy-guided sampling protocol, we make the following 5 recommendations: Samples should only be obtained from areas that will not interfere with the pathologist's diagnosis and prognostic information. Sampling should not be obtained from tumors for which one suspects that the histopathological evaluation may prove difficult. Sampling should not be performed on small melanomas; we recommend a minimum diameter of 10 mm. All the dermoscopy-guided sampling should be documented with images, available to pathologists and clinicians, and reflected in the pathology report. Finally, the frozen biobank samples should be made available for routine hematoxylin-eosin histopathological evaluation until the final pathology report is produced. Ex vivo dermoscopy may serve to guide the procurement of small samples from primary melanoma for fresh tissue biobanking without compromising the histopathological evaluation.


Assuntos
Bancos de Espécimes Biológicos , Dermoscopia/métodos , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Amarelo de Eosina-(YS) , Corantes Fluorescentes , Hematoxilina , Humanos , Melanoma/patologia , Estudos Prospectivos , Neoplasias Cutâneas/patologia , Manejo de Espécimes/métodos
20.
J Am Acad Dermatol ; 67(5): 836-45, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22521205

RESUMO

BACKGROUND: The combined use of total-body photography and digital dermatoscopy, named "two-step method of digital follow-up," allowed the detection of incipient melanoma as a result of dermatoscopic or macroscopic changes during follow-up. OBJECTIVE: We sought to assess dermatoscopic features and dynamic changes leading to excision of melanocytic lesions during our 10-year experience of monitoring patients at high risk for melanoma. METHODS: We analyzed 1152 lesions excised during the surveillance of 618 patients at high risk for melanoma from 1999 to 2008. RESULTS: A total of 779 excised lesions had been previously recorded: 728 were removed because of dermatoscopic changes during follow-up and 51 were removed even though no significant change was noted. The remaining 373 excised lesions were new or undetected on previous total-body photography. A total of 98 melanomas were detected, 60 in the monitored lesions, and 38 among the "new" lesions. The most frequent dermatoscopic changes detected were asymmetric enlargement in almost 60% (n = 418), focal changes in structure in 197 (27%) and in pigmentation in 122 (17%), the latter two being more frequently seen in melanomas than in nevi (both P < .001). No significant differences were detected between dermatoscopic or histopathological characteristics of the melanomas in each group, with a considerable proportion of melanomas misclassified as benign in both groups (26.3% and 38.3%, respectively). LIMITATIONS: The dermatoscopy pattern of stable lesions and the histopathology of lesions not removed were not included in the study. CONCLUSION: The most frequent dermatoscopic features associated with melanoma were focal change in pigmentation or structure. Melanomas detected by dermatoscopic changes were remarkably similar to those detected in total-body photography. Almost 40% of melanomas diagnosed in individuals at high risk corresponded to lesions that were not under dermatoscopic surveillance.


Assuntos
Dermoscopia , Síndrome do Nevo Displásico/patologia , Melanoma/patologia , Nevo Pigmentado/patologia , Fotografação , Neoplasias Cutâneas/patologia , Adulto , Síndrome do Nevo Displásico/cirurgia , Feminino , Humanos , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Nevo Pigmentado/cirurgia , Vigilância da População , Neoplasias Cutâneas/cirurgia
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