Videodermatoscopy‐assisted <scp>M</scp>ohs micrographic surgery vs. other treatments for lentigo maligna in 54 patients with a long‐term follow‐up

Dika, Emi; Fanti, Pier ­Alessandro; Christman, Holly; Piraccini, Bianca Maria; Misciali, Cosimo; Vaccari, Sabina; Patrizi, Annalisa

doi:10.1111/jdv.13280

Cited by 12 publications

(22 citation statements)

References 10 publications

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“…Further inclusion criteria were lesion diameter, ranging from 1 cm to 2 cm (± 0.1–0.2 cm) and conventional surgical excision, respecting a surgical margin of 0.5 cm ± 1 cm. The study criteria specified the exclusion of mucosal and ocular MMs as well as lesions of the ears and eyelids (low density of follicles) and patients treated with Mohs surgery (horizontally cut sections do not include sufficient information on hair follicle histopathology) [17].…”

Section: Methodsmentioning

confidence: 99%

Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma

Dika

Lambertini

Patrizi

et al. 2020

J Deutsche Derma Gesell

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Summary Background Lentigo maligna (LM) and lentigo maligna‐melanoma (LMM) are histotypes of melanoma arising in skin with cumulative solar radiation damage. The extension of atypical melanocytes to the hair follicle (folliculotropism) is a histopathological feature of LM/LMM. Its role has not been totally clarified, but it may be correlated to treatment response in LM or to progression in LMM. Objective This retrospective, multicentric study aims to identify dermatoscopic features associated with folliculotropism in LMs/LMMs. Patients and Methods We analyzed cases of head and neck LMs/LMMs diagnosed between 2005–2014 at Melanoma Units, University of Bologna/Modena/Florence/Siena (Italy), Nice (France): 25 LMs and 73 LMMs were included. Results Grey circles (44 %) indicated an isthmic/bulb level of involvement, which were completely absent in the infundibular LM lesions (P = 0.041). In the group of LMMs, light/dark brown pseudonetwork and light brown structureless areas were an indicator of diffuse distribution of malignant melanocytes in the follicular units (P < 0.001 and P = 0.001, respectively), while grey circles indicated focal or diffuse distribution (P < 0.001). Conclusions A better understanding of the extension of malignant melanocytes is helpful, aiding clinicians in their decision to perform a radical excision or obtaining a biopsy in the most invasive area of the lesion, which includes potential folliculotropism.

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Section: Methodsmentioning

confidence: 99%

Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma

Dika

Lambertini

Patrizi

et al. 2020

J Deutsche Derma Gesell

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“…Thus, we suggest considering the OCT‐assisted‐MMS and the VDS‐assisted‐MMS as second line options, particularly indicated for nodular tumors and horizontal spreading lesions, respectively. Furthermore, since VDS is a widely distributed technology, VDS‐assisted‐MMS should be preferred to MMS alone in any case guaranteeing a better definition of neoplastic margins and reducing required MMS stages, as evidenced by our data 19,21 . In the end, BS‐assisted‐MMS, HFUS‐assisted‐MMS and MSOT‐assisted‐MMS should be considered as ancillary techniques with great potential but must be validated by larger case studies and through multicenter trials.…”

Section: Discussionmentioning

confidence: 83%

“…Furthermore, since VDS is a widely distributed technology, VDS-assisted-MMS should be preferred to MMS alone in any case guaranteeing a better definition of neoplastic margins and reducing required MMS stages, as evidenced by our data. 19,21 In the end, BS-assisted-MMS, HFUS-assisted-MMS and MSOT-assisted-MMS should be considered as ancillary techniques with great potential but must be validated by larger case studies and through multicenter trials. Nonetheless, each technique involves certain consideration.…”

Section: Discussionmentioning

confidence: 99%

“…Dika et al 19 described a statistically significant difference between patient treated with VDS-assisted-MMS and curettage-assisted-MMS in the number of the required procedure stages, especially for pigmented-BCCs and lentigo maligna melanoma (LMM; Figure 1). 21 For sure, a clear result is difficult to achieve given the intraoperator and interoperator reliability of these techniques. 15 μm.…”

Section: Dermoscopy and Videodermoscopymentioning

confidence: 99%

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Noninvasive diagnostic techniques in the preoperative setting of Mohs micrographic surgery: A review of the literature

Venturi

Pellacani

Farnetani

et al. 2022

Dermatologic Therapy

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Mohs micrographic surgery (MMS) is considered the gold standard treatment for skin cancers. Though the high cure rates it offers, MMS presents some disadvantages, as it is a relatively time-consuming procedure involving several professionals (physicians and technicians). A better definition of tumor margins in the preoperative setting with any optical noninvasive diagnostic method may reduce the numbers of MMS steps and the overall duration of the procedure. The present review was conducted and reported using validated search strategies from the following databases: PUBMED and Ovid MEDLINE. Our review describes the use of procedures such as dermoscopy, optical coherence tomography, reflectance confocal microscopy and fluorescent confocal microscopy to determine tumor extension in the preoperative setting of Mohs surgery for the treatment of skin cancers. Presurgical margin assessment with noninvasive diagnostic techniques seem to provide a benefit in the patients' management, especially for tumors located in critical areas with a high risk of recurrence. The use is limited to the high costs and limited availability of new technologies.

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“…Weitere Einschlusskriterien waren der Durchmesser der Läsion (zwischen 1 cm und 2 cm, ± 0,1–0,2 cm) und eine konventionelle operative Exzision mit einem Sicherheitsabstand von 0,5 cm ± 1 cm. Die Studienkriterien sahen den Ausschluss von Patienten mit mukosalen oder okulären Melanomen vor, ebenso von Patienten mit Läsionen an den Ohren oder Augenlidern (geringe Follikeldichte) und von Patienten, die mittels Mohs‐Chirurgie behandelt wurden (horizontal geschnittene Sektionen liefern nicht genügend Informationen über die Histopathologie der Haarfollikel) [17].…”

Section: Materials Und Methodenunclassified

Follikulotropismus bei Lentigo maligna und Lentigo‐maligna‐Melanom im Kopf‐Hals‐Bereich

Dika

Lambertini

Patrizi

et al. 2021

J Deutsche Derma Gesell

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Zusammenfassung Hintergrund Lentigo maligna (LM) und das Lentigo maligna‐Melanom (LMM) sind Histotypen des Melanoms, die in Hautarealen mit kumulativer Schädigung durch Sonneneinstrahlung entstehen. Atypische Melanozyten in den Haarfollikeln (Follikulotropismus) sind ein typisches Merkmal von LM/LMM. Die Bedeutung dieses Phänomens ist noch nicht vollständig aufgeklärt. Bei LM könnte es jedoch mit dem Ansprechen auf die Behandlung und beim LMM mit der Progression korrelieren. Ziel Diese retrospektive Multicenterstudie hat das Ziel, dermatoskopische Merkmale im Zusammenhang mit Follikulotropismus bei LM/LMM zu identifizieren. Patienten und Methoden Wir haben insgesamt 25 Fälle von LM und 73 Fälle von LMM analysiert, die in den Jahren 2005–2014 an den Melanomzentren der Universitäten Bologna, Modena, Florenz und Siena in Italien sowie der Universität Nizza in Frankreich diagnostiziert wurden. Ergebnisse Graue Kreisformationen (44 %) deuteten auf einen Befall auf der Ebene des Isthmus/Bulbus hin; bei LM‐Läsionen am Infundibulum fehlten sie völlig (p= 0,041). In der Gruppe der LMM deuteten hell/dunkelbraune Pseudonetzwerke und hellbraune strukturlose Bereiche auf eine diffuse Verteilung maligner Melanozyten in den follikulären Einheiten hin (p< 0,001 bzw. p= 0,001), während graue Kreisformationen auf eine fokale oder diffuse Verteilung schließen ließen (p< 0,001). Schlussfolgerungen Ein besseres Verständnis der Ausbreitung maligner Melanozyten kann Ärzten bei der Entscheidung helfen, ob die Läsion radikal exzidiert oder in dem am stärksten invasiven Anteil (mit potenziellem Follikulotropismus) biopsiert werden soll.

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Videodermatoscopy‐assisted Mohs micrographic surgery vs. other treatments for lentigo maligna in 54 patients with a long‐term follow‐up

Cited by 12 publications

References 10 publications

Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma

Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma

Noninvasive diagnostic techniques in the preoperative setting of Mohs micrographic surgery: A review of the literature

Follikulotropismus bei Lentigo maligna und Lentigo‐maligna‐Melanom im Kopf‐Hals‐Bereich

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