Never perform laser treatment of skin tumors with clinical "EFG" criteria.

Laser treatment is a common procedure for the treatment of cosmetically troubling skin lesions but has the limitation that histopathologic diagnosis is usually not obtained prior to treatment. Laser treatment of melanomas with benign clinical features may delay or make more difficult the correct diagnosis of such tumors. A helpful tool to identify clinically innocent appearing melanomas is the "EFG" rule, summarizing the common clinical features as "elevated, firm skin lesions showing continuous growth". We report a 42-year-old woman who presented with a recurrent and metastatic melanoma after laser treatment of a tumor which was apparently clinically innocent and highlight the clinical features of such benign-looking melanomas.

Dermoscopy of eccrine poroma.

Eccrine poroma (EP) may clinically mimic a number of benign and malignant skin tumors. Dermoscopy improves the clinical diagnosis of many pigmented and nonpigmented skin tumors, but to date little is known about the impact of dermoscopy in the diagnosis of EP. We report 2 patients with EP and discuss the diagnostic significance of the observed dermoscopic findings.

Slow-growing melanoma: Report of five cases.

BACKGROUND: Epidemiologic data on melanoma reveal a considerable increase in incidence, especially of the early forms (melanoma in situ and early invasive melanoma), but the mortality rates are relatively stable. These data suggest the hypothesis of the existence of a melanoma with less aggressive biological behaviour. This hypothesis is, however, hard to be proven if the assumption is true that more and less aggressive melanomas very often exhibit overlapping clinical and histopathologic features. Digital dermoscopic imaging techniques permit today a detailed documentation of lesions over time and, therefore, represent an optimal tool to disclose the natural evolution of a given lesion. We present five case of slow-growing melanomas observed during a long-term period of follow-up. MAIN OBSERVATION: Five pigmented skin lesions from five patients with multiple atypical melanocytic nevi were examined at the baseline consultation and digital pictures were taken for monitoring purposes. The lesions have been followed-up for a long time because of the absence of significant changes over time. After a variable period of follow-up (1 to 10 years) all lesions were finally removed and subsequent histopathologic examination revealed early stage melanoma in all cases. CONCLUSION: Dermoscopy and digital follow up might be the key factors to improve the knowledge about the natural evolution of nevi and melanoma and the spectrum of undefined melanocytic proliferations.