Dermoscopic and clinical features of head and neck melanoma

AbstractBACKGROUND:The dermoscopic criteria of extrafacial melanomas are well-known.OBJECTIVE:To determine the frequency of dermatoscopic findings in head and neck melanomas (HNM) and to assess the distinguishing dermoscopic criteria of facial and extrafacial melanoma.METHODS:This observational study included 108 patients with HNM (63% male, mean age 64 years). Participants underwent individual dermoscopic imaging of clinically melanoma. All lesions were excised, and histopathological examination was performed on all specimens.RESULTS:Drawing on histopathological analysis, lentigo maligna melanoma or lentigo maligna was diagnosed in 60 lesions, superficial spreading melanoma in 18, nodular in 10, desmoplastic in 8, superficial spreading melanoma in situ in 12. The most frequent location for head and neck melanoma was the cheek (60 patients, 55.6%). Eight prominent dermatoscopic features were observed in facial melanoma: annular-granular pattern (18%); rhomboidal structures (29%); pseudonetwork (29%); asymmetrical, pigmented, follicular openings (51%); obliterated hair follicles (8%); red rhomboidal structures (18%); increased density of the vascular network (32%); scar-like depigmentation (59%).CONCLUSIONS:HNM has specific dermoscopic features, and classical extrafacial dermoscopic rules are less useful for diagnosis of facial melanoma. In our study, further characteristic dermatoscopic findings were detected in facial melanoma such as low frequencies of irregular dots, 2 or fewer colors in lesions, the presence of pseudonetwork, increased density of the vascular network, red rhomboidal structures, in addition to dermatoscopic findings of extrafacial melanoma. Thus, it is concluded that the prediction and identification of HNM may be evident with the help of these signs.

Dermoscopic and Clinical Features of Pigmented Skin Lesions of the Genital Area

BACKGROUND: The dermoscopic features of vulvar melanosis lesions are well known. To our knowledge, there are only a few case reports about dermoscopic features of pigmented genital lesions in male patients. OBJECTIVE: To evaluate dermoscopic and clinical characteristics of benign lesions of the genital area in both males and females, and to assess the distinguishing dermoscopic criteria of vulvar melanosis and atypical melanocytic nevi of the genital type. METHODS: 68 patients with pigmented genital lesions were included in this observational study (28 male and 40 female). A punch biopsy was taken from all pigmented lesions and histopathological examination was performed on all specimens. RESULTS: We histopathologically diagnosed: genital melanosis in 40 lesions, atypical melanocytic nevi of the genital type in 15 lesions, melanocytic nevi in 9 lesions, seborrheic keratosis in 4 lesions. The most frequent locations were the glans penis (19 patients, 67.9%) in males and the labia minora (19 patients, 47.5%) in females. The mean age of patients with atypical nevi (28,6 ± 11,36) was significantly lower than the mean age of patients with genital melanosis (47,07 ± 15,33). CONCLUSIONS: Parallel pattern is prominent in genital melanosis, ring-like pattern is only observed in genital melanosis. Most pigmented lesions on the genital area are solitary. Blue-white veil and irregular dots are only observed in AMNGT. According to these results, we propose that histopathological examination is performed, especially if blue-white veil and irregular dots are found by dermoscopy. .

Nonbilharzial squamous cell carcinoma and transitional cell carcinoma with squamous differentiation of the lower and upper urinary tract

Urinary tract squamous cell carcinoma and transitional cell carcinoma with squamous differentiation are rare entities. To characterize tumour biology, prognosis, and therapy, we reviewed our data with squamous cell carcinoma [SCC] and transitional cell carcinoma [TCC/SCC]. We performed a retrospective single-center analysis of 53 patients with SCC and TCC/SCC treated at our urology department from 30.05.1989 to 30.09.2004. SCC was found in 2% [42/1573] of bladder carcinoma and 7% [11/130] of renal pelvis specimen. Stage pT3 was present in 55% of our patients, indicating a tendency to deep muscular invasion. Nodal and distant metastases appeared in 26%. The overall 5-year survival rate was 26% [tumor specific 46%], with a median survival of 10.5 months. We found that three of four patients with pT2N0 bladder carcinoma could be cured by cystectomy. Lymphnode status was identified as a significant prognostic parameter. For renal pelvis carcinoma, median survival was 7.35 months, with an overall 5-year-survival of 30%. Adjuvant therapy modalities were only performed in a minority of cases, although a therapeutic response was often noticed. SCC is characterized by poor prognosis and individual tumor biology. Survival is related to local tumor extension, indicating the necessity of an early radical surgery. To adequately discuss the role of adjuvant therapy on SCC and TCC/SCC further trials are needed