ABSTRACT
INTRODUCTION: Dermoscopic algorithms for melanoma diagnosis could be time-expending, and their reliability in daily practice lower than expected. OBJECTIVE: To propose a simplified dermoscopic algorithm for melanoma diagnosis. MATERIAL AND METHODS: A multicenter retrospective analysis of 1,120 dermoscopic images of atypical melanocytic tumors (320 melanomas and 800 non-melanomas) was performed. An algorithm based on polychromia, asymmetry in colors or structures, and some melanoma-specific structures was designed. Univariate and multivariate logistic regression analysis was calculated to estimate the coefficients of each potential predictor for melanoma diagnosis. A score was developed based on the dermoscopic evaluations performed by four experts blinded to histological diagnosis. RESULTS: Most melanomas had ≥3 colors (280; 84.5%), asymmetry in colors or structures (289; 90.3%), and at least one melanoma-specific structure (316; 98.7%). PASS score ≥3 had a 91.9% sensibility, 87% specificity, and 88.4% diagnostic accuracy for melanoma. PASS algorithm showed an area under the curve (AUC) of 0.947 (95% CI 0.935-0.959). LIMITATIONS: This study was retrospective. A comparison between the performances of different dermoscopic algorithms is difficult because of their designs. CONCLUSION: PASS algorithm showed a very good diagnostic accuracy, independently of the observers' experience, and it seems easier to perform than previous dermoscopic algorithms.
Subject(s)
Melanoma , Skin Neoplasms , Humans , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/pathology , Retrospective Studies , Reproducibility of Results , Dermoscopy/methods , Melanoma/diagnostic imaging , Melanoma/pathology , Algorithms , SyndromeABSTRACT
Abstract Eruptive disseminated Spitz nevi is a rare clinical presentation that features an abrupt widespread eruption of Spitz nevi. Spontaneous regression of these nevi has been rarely reported in previous literature. The authors of the present study report the case of a 30-year-old man who presented eruptive disseminated Spitz nevi that appeared within a week and started regression in the following years.
Subject(s)
Humans , Male , Adult , Young Adult , Skin Neoplasms/diagnosis , Nevus, Epithelioid and Spindle Cell , Exanthema , Diagnosis, DifferentialABSTRACT
Abstract Large defects in plantar surface secondary to acral melanoma excision can be difficult to repair with local flaps, and skin grafts in weight-bearing surfaces often suffer necrosis causing prolonged disability. Acellular dermal matrices represent an easy alternative to cover deep wounds or those with bone or tendon exposure. Despite their high cost and the requirement of two surgical procedures, this alternative may offer excellent functional and aesthetic results in acral defects.
Subject(s)
Humans , Skin Neoplasms/surgery , Plastic Surgery Procedures , Acellular Dermis , Melanoma/surgery , Surgical Flaps , Skin TransplantationABSTRACT
Eruptive disseminated Spitz nevi is a rare clinical presentation that features an abrupt widespread eruption of Spitz nevi. Spontaneous regression of these nevi has been rarely reported in previous literature. The authors of the present study report the case of a 30-year-old man who presented eruptive disseminated Spitz nevi that appeared within a week and started regression in the following years.
Subject(s)
Exanthema , Nevus, Epithelioid and Spindle Cell , Skin Neoplasms , Adult , Diagnosis, Differential , Humans , Male , Skin Neoplasms/diagnosis , Young AdultABSTRACT
Large defects in plantar surface secondary to acral melanoma excision can be difficult to repair with local flaps, and skin grafts in weight-bearing surfaces often suffer necrosis causing prolonged disability. Acellular dermal matrices represent an easy alternative to cover deep wounds or those with bone or tendon exposure. Despite their high cost and the requirement of two surgical procedures, this alternative may offer excellent functional and aesthetic results in acral defects.
Subject(s)
Acellular Dermis , Melanoma , Plastic Surgery Procedures , Skin Neoplasms , Humans , Melanoma/surgery , Skin Neoplasms/surgery , Skin Transplantation , Surgical FlapsABSTRACT
INTRODUCTION: The literature regarding the association of dermoscopic structures with Breslow thickness in melanoma is scarce, limited to small case series, and mostly outdated. OBJECTIVE: This study determined the dermoscopic patterns, colors and structures that are associated with melanoma in situ, thin melanomas (<0.8 mm) and thick melanomas potentially requiring sentinel lymph node biopsy according to current guidelines (≥0.8 mm). METHODS: A retrospective evaluation of 245 dermoscopic images of primary cutaneous melanoma located on the trunk or limbs was performed by consensus of 2 dermoscopists. RESULTS: Red-pink, blue-gray and white color, blue-white veil, shiny white streaks, irregular vessels, blue-black pigmentation, milky red areas, pseudolacunae, ulceration and rainbow pattern were associated with thickness ≥0.8 mm, whereas atypical pigmented network, regression and hypopigmented areas were significantly associated with early melanomas. LIMITATIONS: This is a retrospective study performed in a single institution. Melanomas of special sites were excluded from our evaluation. Dermoscopy is based on subjective evaluations that depend largely on the observers' experience. CONCLUSIONS: The identification of certain dermoscopic structures and colors might help in the discrimination between thin and thick melanomas.
ABSTRACT
Topical timolol has been shown to be effective on treatment of Kaposi sarcoma. We present the case of a 72-year-old man with classic Kaposi sarcoma on upper limbs, treated with topical timolol 0.5% twice a day with a pruritic eruption on areas of application.
Subject(s)
Dermatitis, Allergic Contact/etiology , Sarcoma, Kaposi/drug therapy , Skin Neoplasms/drug therapy , Timolol/adverse effects , Administration, Topical , Aged , Humans , Male , Timolol/administration & dosageABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Dermatomyositis/diagnosis , Skin Diseases, Vesiculobullous/diagnosis , Edema/diagnosis , Diagnosis, Differential , Hypoalbuminemia/etiology , Deglutition Disorders/etiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Young Adult , Lymphoma, Non-Hodgkin/complications , Melanoma/secondary , Skin Neoplasms/secondary , Carcinoma, Papillary/secondary , Diagnostic Imaging/methods , Thyroid Neoplasms/pathologyABSTRACT
No disponible
Subject(s)
Humans , Female , Adolescent , Exanthema/diagnosis , Skin Diseases, Infectious , Thorax/virologyABSTRACT
No disponible
