Dermoscopy of Malignant Skin Tumours: What's New?

Russo, Teresa; Piccolo, Vincenzo; Lallas, Aimilios; Jacomel, Jason; Moscarella, Elvira; Alfano, Roberto; Argenziano, Giuseppe

doi:10.1159/000472253

Cited by 40 publications

(26 citation statements)

References 38 publications

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“…Amelanotic and hypopigmented skin lesions represent one of the most challenging clinical scenarios for dermatologists because many benign and malignant tumours, as well as inflammatory or infectious diseases, may look similar at clinical and dermoscopic examination. About 2% of melanomas may present as pink lesions, and this peculiar clinical presentation is often responsible for delayed diagnosis and poorer overall survival as compared to pigmented melanoma . Moreover, some of the most aggressive primary skin tumours, such as Merkel cell carcinoma, as well as cutaneous metastasis, are commonly characterized by a pink appearance.…”

Section: Introductionmentioning

confidence: 99%

The prevalent dermoscopic criterion to distinguish between benign and suspicious pink tumours

Russo

Pampena

Piccolo

et al. 2019

Acad Dermatol Venereol

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Background Pink skin tumours are difficult to differentiate, clinically and dermoscopically. In previous studies, mainly focused on pigmented lesions, pattern analysis provided the best sensitivity and specificity values, as compared to other algorithms. These findings suggest that the global dermoscopic appearance, based on the evaluation of prevalent features, could represent a valuable and practical approach even when dealing with pink lesions.Objective In this study, we aimed to evaluate the diagnostic accuracy of a new dermoscopic approach for pink tumours based on the prevalent criterion, as compared to a standard diagnostic method (Menzies algorithm).Methods The databases of two referral centres were retrospectively evaluated to retrieve dermoscopic images of amelanotic/hypomelanotic skin lesions. Two experts in dermoscopy, blinded for the final diagnosis and for clinical and demographic information, evaluated separately dermoscopic pictures of 1000 lesions according to the Menzies score and to the prevalent criterion method.Results According to the high sensitivity model of the Menzies score, 129 (12.9%) lesions were considered as nonsuspicious (of which 16 were false negative) and 871 (87.1%) as suspicious (of which 212 were false positive), with 97.6% sensitivity and 34.8% specificity. According to the high specificity model, 370 (37%) lesions were evaluated as non-suspicious (of which 105 were false negative) and 630 (63%) as suspicious (of which 60 were false positive), with 84.4% sensitivity and 81.5% specificity. Concerning the prevalent criterion method, 316 (31.6%) lesions were evaluated as non-suspicious (of which 46 were false negative) and 684 (68.4) as suspicious (of which 55 were false positive), with 93.2% sensitivity and 83.1% specificity.Conclusions This study demonstrated that focusing on the prevalent dermoscopic features could allow to detect malignant pink tumours with similar sensitivity but higher specificity than using the conventional Menzies scoring system.These authors equally contributed to this work and share the first authorship.

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Section: Introductionmentioning

confidence: 99%

The prevalent dermoscopic criterion to distinguish between benign and suspicious pink tumours

Russo

Pampena

Piccolo

et al. 2019

Acad Dermatol Venereol

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“…As a routine procedure in our center, a clinical and dermoscopic diagnosis of BCC is usually adequate to warrant a direct treatment, while the pretreatment confirmation of the diagnosis with a partial biopsy is only optional for the attending clinician. This is mainly associated with the introduction and widespread use of dermoscopy, which is known to significantly improve the clinical recognition of BCC 12‐15 . Indeed, our results revealed that in 77.5% of tumors the final treatment was applied based only on clinical and dermoscopic diagnosis.…”

Section: Discussionmentioning

confidence: 84%

Real‐life data on basal cell carcinoma treatment: Insights on clinicians' therapeutic choices from an institutional hospital registry

Manoli

Moutsoudis

Papageorgiou

et al. 2020

Dermatologic Therapy

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Basal cell carcinoma (BCC) is the most common skin cancer in white skin individuals. The treatment of choice is surgical excision, but several other therapeutic choices are available and might also be efficient and cost-effective in selected cases of low-risk BCC or when surgery is complicate or contraindicated. The aim of the current study was to analyze the applied treatments for BCC in the real-life practice of a tertiary hospital, and investigate factors associated to the tumor and the patients that might influence the treatment selection of clinicians. Data on all BCCs treated from 1st January 2018 to 31st December 2019 were extracted. A total of 751 BCCs from 585 patients were included. The baseline characteristics of patients and tumors, the type of applied treatment and the histopathologic report when available were analyzed. Most tumors were located on the head/neck (64.2%). The most frequently applied treatment was surgical excision (580/751, 77.2%). In 22.8% of tumors a nonsurgical treatment was selected. The most frequently selected alternative treatments were, imiquimod, cryosurgery, their combination (immunocryosurgery), and vismodegib. A pretreatment diagnosis of superficial BCC was associated with a 12-fold increased probability of selecting a nonsurgical treatment except of vismodegib. Every added year of age increased the probability of selecting a nonsurgical treatment by 3-fold. Every added mm of diameter increased the possibility of vismodegib use by 4%. Surgery is the most frequently applied BCC treatment, but nonsurgical modalities do also have an essential role in real settings.

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“…A red nodule mimicking a benign tumor could be due to AM, whose dermatoscopy usually shows negative network, white shiny structures, milky red areas, polymorphous vessels, and residual areas of pigmentation [9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%