In Vivo Microscopic Features of Nodular Melanomas

Segura, Sònia; Pellacani, Giovanni; Puig, Susana; Longo, Caterina; Bassoli, Sara; Guitera, Pascale; Palou, Josep; Menzies, Scott W.; Seidenari, Stefania; Malvehy, Josep

doi:10.1001/archderm.144.10.1311

Cited by 90 publications

(25 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On RCM, the architectural disarray at the dermal-epidermal junction, the diffuse dendritic and small bright cells corresponded to inflammation, and the large irregular blood vessels were not suggestive of either melanocytic or keratinocytic malignancy [2,3]. However, the presence of multinucleated keratinocytes with high refractile dots, distributed at the periphery close to the nuclear envelope, potentially suggested a viral infection.…”

Section: Discussionmentioning

confidence: 99%

“…The slight architectural disarray also showed bright nucleated cells with dendritic-like branches, and diffuse small bright cells and particles. A proliferation of melanocytes, bulging within the dermal papilla, were organized as solitary units and oval demarcated nests [3]. Because the patient reported a recurrent infection of Herpes simplex virus on her upper lip, we allowed five days of follow-up, instead of a surgical approach.…”

Section: Casementioning

confidence: 99%

See 1 more Smart Citation

Nevus changed by recurrent <i>Herpes</i> simplex infection: Reflectance confocal microscopy

Palla¹,

Ayala²,

Botti³

et al. 2014

CRCM

View full text Add to dashboard Cite

During a screening program, a 24-year-old woman presented an itchy nodule above the upper lip, 5 × 5 mm in size with irregular pigmentation, which had enlarged over the previous three weeks. Personal clinical history revealed a recurrent Herpes virus infection. Dermoscopy showed light brown irregular pigmentation, milia-like cysts and an atypical vascular pattern. Reflectance confocal microscopy revealed architectural, cytologic and vascular features suggestive of melanoma. A Tzanck test revealed multinucleated keratinocytes with the typical nuclei infected by Herpes virus. Our case shows that dermoscopy alone, despite its sensitivity and specificity, may not provide adequate diagnostic accuracy on which to base a surgical decision. Epiluminescence criteria should be considered together with a clinical evaluation of the lesion and the patient's clinical history. Reflectance-mode confocal microscopy confirmed the difficulty of presurgical diagnosis in this case, which highlights the importance of traditional cytological analysis in order to avoid unnecessary surgical treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Casementioning

confidence: 99%

Nevus changed by recurrent <i>Herpes</i> simplex infection: Reflectance confocal microscopy

Palla¹,

Ayala²,

Botti³

et al. 2014

CRCM

View full text Add to dashboard Cite

show abstract

“…NM findings more frequently seen include cerebriform nests (Figure 4), which are highly specific of deep/NM but rarely found [33,34] and enlarged dermal vessels [3,35]. Pure NMs will lack typical pagetoid cells and show a preserved epidermal architecture [35].…”

Section: Background: Reflectance Technologymentioning

confidence: 99%

Advances in the use of Reflectance Confocal Microscopy in Melanoma

2018

Self Cite

View full text Add to dashboard Cite

In vivo reflectance confocal microscopy (RCM) is a noninvasive high-resolution skin imaging tool that has become an important adjunct to clinical exam, dermoscopy and histopathology assessment, in the diagnosis and management of melanoma. RCM generates a horizontal view of the skin, whereby cellular and subcellular (e.g., nuclei, melanophages, collagen) structures, to the level of the upper dermis, are projected onto a screen at near-histological resolution. Morphologic descriptors, standardized terminology, and diagnostic algorithms are well established for the RCM assessment of melanoma, melanocytic, and nonmelanocytic lesions. Clinical applications of RCM in melanoma are broad and include diagnosis, assessment of large lesions on cosmetically sensitive areas, directing areas to biopsy, delineating margins prior to surgery, detecting response to treatment and assessing recurrence. This review will provide an overview of RCM technology, findings by melanoma subtype, clinical applications, as well as explore the accuracy of RCM for melanoma diagnosis, pitfalls and emerging uses of this technology ex vivo.

show abstract

“…However, since RCM has a limit in the visualization in depth (depth penetration is up to 300 µm under the skin surface), currently the evaluation of nodular lesions is not considered an indication for RCM [7,15]. Only a few studies have evaluated the effectiveness of RCM in the assessment of pigmented nodular lesions [16,17,18,19]. …”

Section: Introductionmentioning

confidence: 99%

Reflectance Confocal Microscopy for the Evaluation of Solitary Red Nodules

et al. 2012

View full text Add to dashboard Cite

The correct assessment of a solitary red nodule in clinical practice is of crucial importance, amelanotic melanoma being the most important differential diagnosis. Dermoscopy is nowadays a pivotal tool in the management of skin tumors, however it has some limitations in the evaluation of nonpigmented lesions, in which the diagnosis is merely based on the evaluation of the vascular pattern. Recently, reflectance confocal microscopy has been introduced as a new, noninvasive technique for the diagnosis of skin lesions. Confocal microscopy provides skin imaging in vivo at cellular level resolution, close to conventional histology. We present a series of clinical scenarios of red nodules, including melanoma metastasis, pyogenic granuloma, eccrine poroma, Spitz nevus and dermatofibroma. Reflectance confocal microscopy examination added important information to the clinical diagnosis and subsequent management in all cases except for dermatofibroma. We discuss the advantages and limitations of this technique in this particular field of application.

show abstract

In Vivo Microscopic Features of Nodular Melanomas

Cited by 90 publications

References 41 publications

Nevus changed by recurrent <i>Herpes</i> simplex infection: Reflectance confocal microscopy

Nevus changed by recurrent <i>Herpes</i> simplex infection: Reflectance confocal microscopy

Advances in the use of Reflectance Confocal Microscopy in Melanoma

Reflectance Confocal Microscopy for the Evaluation of Solitary Red Nodules

Contact Info

Product

Resources

About

In Vivo Microscopic Features of Nodular Melanomas

Cited by 90 publications

References 41 publications

Nevus changed by recurrent &lt;i&gt;Herpes&lt;/i&gt; simplex infection: Reflectance confocal microscopy

Nevus changed by recurrent &lt;i&gt;Herpes&lt;/i&gt; simplex infection: Reflectance confocal microscopy

Advances in the use of Reflectance Confocal Microscopy in Melanoma

Reflectance Confocal Microscopy for the Evaluation of Solitary Red Nodules

Contact Info

Product

Resources

About

Nevus changed by recurrent <i>Herpes</i> simplex infection: Reflectance confocal microscopy

Nevus changed by recurrent <i>Herpes</i> simplex infection: Reflectance confocal microscopy