Biomedical subjects

Ligia Teban

Publications and source records attributed to Ligia Teban.

4 recordsLinked to original sources

PubMed2006

Identification of clinically featureless incipient melanoma using sequential dermoscopy imaging.

OBJECTIVES: To examine the role of sequential dermoscopy imaging in detecting incipient melanoma and to elucidate the impact of length of follow-up on the relevance of observed changes. DESIGN: Baseline and follow-up images of melanomas and melanocytic nevi excised only because of changes across time were inspected on a computer screen and assessed according to prospectively defined criteria. Lesions were stratified into 3 groups according to the length of follow-up. SETTING: Three hospital-based referral centers in Europe and Australia. Patients Four hundred sixty-one patients selected for digital dermoscopy monitoring. MAIN OUTCOME MEASURES: Description and comparison of dermoscopy features and changes in melanomas and melanocytic nevi at baseline and after follow-up. RESULTS: We inspected baseline and follow-up images of 499 melanocytic skin lesions from 461 patients. The histopathologic diagnosis was melanoma in 91 cases and melanocytic nevus in 408. Most melanomas (58.2%; n = 53) were in situ, and the median thickness of invasive melanomas was 0.38 mm. Dermoscopy features of melanomas and nevi did not differ significantly at baseline. After follow-up of 1.5 to 4.5 months, 61.8% of the melanomas showed no specific dermoscopy features for melanoma. This value declined to 45.0% after follow-up of 4.5 to 8.0 months and to 35.1% after more than 8.0 months. We could not differentiate melanomas and changing nevi by means of observed changes or dermoscopy features when follow-up was shorter than 4.5 months. With longer follow-up, melanomas tended to enlarge asymmetrically with architectural and color changes, and nevi tended to enlarge symmetrically without architectural and color changes. CONCLUSIONS: Sequential dermoscopy imaging detects incipient melanomas when they are still featureless. Interpretation of changes observed during follow-up depends on the length of follow-up.

Austria↗

PubMed2005

Prospective, randomized, multicenter, double-blind placebo-controlled trial comparing adjuvant interferon alfa and isotretinoin with interferon alfa alone in stage IIA and IIB melanoma: European Cooperative Adjuvant Melanoma Treatment Study Group.

PURPOSE: The combination of interferon alfa (IFNalpha) and isotretinoin has shown a direct antiproliferative effect on human melanoma cell lines, but it remained unclear whether this combination is more effective than IFNalpha alone in patients with metastatic melanoma. We evaluated safety and efficacy of IFNalpha and isotretinoin compared with IFNalpha alone as adjuvant treatment in patients with primary malignant melanoma stage IIA and IIB. PATIENTS AND METHODS: In a prospective, randomized, double-blind, placebo-controlled trial, 407 melanoma patients in stage IIA (301 patients) and IIB (106 patients) were randomly assigned to either IFNalpha and isotretinoin (isotretinoin group; 206 patients) or IFNalpha and placebo (placebo group; 201 patients) after excision of the primary tumor. IFNalpha was administered three times a week at a dose of 3 million units subcutaneously for 24 months. Isotretinoin at a dose of 20 mg for patients < or = 73 kg, 30 mg for patients greater than 73 kg, or placebo daily for 24 months. RESULTS: A scheduled interim analysis revealed no significant differences in survival rates, with the isotretinoin group and the placebo group showing 5-year disease-free survival rates of 55% (95% CI, 46% to 65%) and 67% (95% CI, 59% to 75%), respectively, and overall 5-year survival rates of 76% (95% CI, 67% to 84%) and 81% (95% CI, 74% to 88%), respectively. The trial was stopped for futility. CONCLUSION: The addition of isotretinoin to an adjuvant treatment of low-dose IFNalpha in patients with stage IIA and IIB melanoma had no significant effect on disease-free or overall survival and is therefore not recommended.

Adolescent↗

PubMed2005

Limitations of dermoscopy in the recognition of melanoma.

OBJECTIVE: To compare dermoscopic features of melanocytic nevi with those of early melanomas that were not excised initially because of their uncharacteristic clinical and dermoscopic appearance. DESIGN: Retrospective study of the baseline images of 325 melanocytic skin lesions that were observed by digital dermoscopy and finally excised because of changes over time. SETTING: A dermatologic clinic and a dermatologic department at a university hospital. MAIN OUTCOME MEASURES: Comparison of baseline images of melanomas and melanocytic nevi by pattern analysis, the ABCD rule of dermoscopy, and the 7-point checklist. RESULTS: Baseline dermoscopic images of 262 melanocytic nevi and 63 melanomas from 315 patients were included in the analysis. The patterns of dermoscopic features observed in the baseline images of melanocytic lesions finally diagnosed as melanomas during follow-up did not differ substantially from the patterns observed in the baseline images of melanocytic nevi. Pattern analysis, the ABCD rule of dermoscopy, and the 7-point checklist failed to achieve adequate diagnostic accuracy for melanoma. In retrospect, no dermoscopic feature or pattern of features could be identified that reliably differentiated between melanomas and melanocytic nevi at the time of the first presentation. CONCLUSION: Dermoscopy depends on the appearance of classic dermoscopic features and is therefore limited in the diagnosis of very early and mainly featureless melanomas.

Biopsy, Needle↗

PubMed2003

[Clinical value of a dermatoscopic classification of Clark nevi].

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the practical value of the dermatoscopic classification of Clark nevi PATIENTS AND METHODS: Dermatoscopic images of 268 lesions clinically and dermatoscopically diagnosed as Clark nevi were presented to 2 dermatologists without knowledge of the histological diagnosis. The dermatologists evaluated the lesions according to a simplified version of the classification scheme for Clark nevi proposed by Hofmann-Wellenhof and differentiated between 12 different types of Clark nevi. RESULTS: The most common type of Clark nevus was the reticular-homogenous type (n = 64, 23.9%), followed by the globular-homogeneous type (n = 32, 12%) and by the homogenous type (n = 30, 11.2%). The overall inter-rater agreement between the examiners was moderate to good (kappa = 0.58). The highest level of agreement was found for the peripheral hyperpigmented type (kappa = 0.83). Histologically, 17 lesions (6.3%) were diagnosed as melanomas. The frequency of melanoma was highest among the peripheral-hyperpigmented type for one observer and among the homogenous type for the other observer. No melanoma was found among the globular, reticular-globular, and the central-hyperpigmented types. CONCLUSIONS: A dermatoscopic classification of Clark nevi is practically feasible and allows--to some extent--a risk stratification of Clark nevi, which could be useful for clinical management.

Dermoscopy↗