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PubMed2004

A comparison of dermoscopic features among lentigo senilis/initial seborrheic keratosis, seborrheic keratosis, lentigo maligna and lentigo maligna melanoma on the face.

Clinical differentiation of facial lentigo senilis/initial seborrheic keratosis (LS/ISK), seborrheic keratosis (SK), lentigo maligna (LM), and lentigo maligna melanoma (LMM) can be difficult. Dermoscopy improves the diagnoses in pigmented skin lesions (PSLs), but it is not helpful for the sun-exposed face because of the flat rete ridges without network-derived features. Therefore, development of new diagnostic criteria for this particular localization is a current issue of dermatology. In this retrospective study, dermoscopic slides of facial pigmented skin lesions of 66 patients referred to two clinics in Turkey were evaluated. Our aim was to determine the reliability of dermoscopy in the differentiation of these entities. The facial PSLs of 66 patients (34 males and 32 females) (median age: 58.2) were photographed with a Dermaphot (Heine, Hersching, Germany) over a five year period from November of 1995 to May of 2000. All of the dermoscopic slides were analysed according to 27 dermoscopic criteria developed by Schiffner et al. This data set contained 22 histologically proven malignant (14 LM, 8 early LMM) and 44 benign (18 SK, 26 LS/ISK) PSLs. In general, asymmetric pigmented follicular openings, dark streaks, slate-gray streaks, dark globules, slate-gray globules, dark dots, dark rhomboidal structures, light brown rhomboidal structures, dark homogeneous areas and dark pseudonetworks were statistically significant for malignant growth. On the other hand, milia-like cysts, pseudofollicular openings, cerebriform structures, light brown globules, light brown dots, light brown homogeneous areas, yellow opaque homogeneous areas, and light brown pseudonetworks were statistically significant for benign growth. This research emphasizes that dermoscopic features on the face differ from criteria used in other locations of the body. Analysis of the data suggests that dermoscopy can be used in the differentiation of LS/ISK, SK, LM and LMM from each other.

Color↗

PubMed2006

Correlation with digital dermoscopic images can help dermatopathologists to diagnose equivocal skin tumours.

BACKGROUND: A variety of pigmented skin tumours can lead to diagnostic difficulties in dermatopathology. OBJECTIVES: To investigate whether the interobserver agreement between histopathological diagnoses of equivocal pigmented tumours made by two referral centres can be improved by additional use of dermoscopic images. MATERIAL AND METHODS: Retrospective study using 160 tumours excised in the pigmented skin lesions clinic in Graz and 141 from Tübingen. Tumours were diagnosed in the referring centres using clinical data, histopathology and, if required, immunohistochemistry. The tumours were initially diagnosed as 74 melanomas, 218 melanocytic naevi and nine nonmelanocytic tumours. Haematoxylin and eosin sections, patients' age and sex, tumour localization and digital dermoscopic images were then exchanged between the participating centres. Then, diagnoses were made initially based solely on dermatopathology and clinical information. After a washout phase, the same sections were reevaluated with the additional use of dermoscopic images. The main outcome measures were the Cohen's kappa-coefficients of the initial diagnoses of the centre submitting the cases and the diagnoses of the other centre without and with dermoscopy. RESULTS: The kappa-coefficient between the initial diagnoses with those made by the second centre without dermoscopy was 0.90 in Graz, 0.73 in Tübingen, and 0.81 overall. With the additional use of dermoscopy the kappa-value was invariably high with 0.89 in Graz, and improved to 0.87 in Tübingen, and to 0.88 overall. CONCLUSIONS: The additional use of digital dermoscopic images further improved the overall very good agreement of histopathological diagnoses between two referral centres.

Adolescent↗

PubMed2004

Dermoscopic patterns of benign volar melanocytic lesions in patients with atypical mole syndrome.

BACKGROUND: Acral benign melanocytic lesions in white populations, particularly in subjects with atypical mole syndrome, have been poorly characterized until recently. The advent of dermoscopy has enabled more specific diagnoses of these pigmented skin lesions. OBJECTIVE: To evaluate the clinical and dermoscopic features of benign volar lesions in a group of white patients with atypical mole syndrome. SETTING: A private medical center specializing in early diagnosis of malignant melanoma and a melanoma unit in a university hospital. METHODS: Acral melanocytic lesions in 511 patients with atypical mole syndrome were studied using standard clinical assessment and dermoscopy. RESULTS: Two hundred ten acral melanocytic lesions were observed in 156 of the patients: 165 lesions were present on the soles of 121 patients and 45 lesions on the palms of 35 patients. No acral malignant lesions were detected. We observed the following patterns of lesions: parallel furrow in 111 lesions (52.9%), latticelike in 26 lesions (12.4%), fibrillar or filamentous in 13 lesions (6.2%), and nontypical in 29 lesions (13.8%). In 31 lesions (14.8%), we observed 3 previously undefined patterns: a globular pattern in 11 lesions (5.2%), a homogeneous pattern in 15 lesions (7.1%), and an acral reticular pattern in 5 lesions (2.4%). CONCLUSIONS: We observed a greater number of benign melanocytic lesions in glabrous skin than expected, probably related to our cohort selection of patients with atypical mole syndrome, although the lesions generally exhibited patterns on dermoscopy similar to those seen in Japanese studies. We defined 3 new benign dermoscopic patterns, which will enable better characterization of acral lesions.

Adolescent↗

PubMed2004

The Framingham school nevus study: a pilot study.

OBJECTIVES: To (1). describe nevus patterns using digital photography and dermoscopy; (2). evaluate the relationship between host and environmental factors and prevalence of nevi in schoolchildren; and (3). demonstrate the feasibility of conducting a longitudinal study. DESIGN: Cross-sectional survey and 1-year prospective follow-up study. PARTICIPANTS: Students from 2 classrooms, grades 6 and 7, in the Framingham, Mass, school system (N = 52). MAIN OUTCOME MEASURES: A survey was completed by students and 1 of their parents that included questions on demographic and phenotypic characteristics, family history of skin cancer, and sun exposure and protection practices. An examination of nevi on the back was performed that included digital photography and digital dermoscopy. Follow-up child and parent surveys and examinations were conducted at 1-year follow-up. RESULTS: At baseline, the median number of back nevi was 15 (mean [SD], 21.9 [15.3]). Older age, male sex, fair skin, belief that a tan is healthier, tendency to burn, and sporadic use of sunscreen were positively associated with mole count, although age was the only statistically significant factor. Predominant dermoscopic patterns for the index nevus were as follows: 38% globular, 14% reticulated, 38% structureless, and 10% combinations of the above patterns with no predominant characteristic. The overall participation rate from baseline to follow-up was 81% (42/52) for the skin examination process. At the 1-year follow-up examination, new nevi were identified in 36% of students (n = 15), while 9.6% of baseline index nevi had changes in the dermoscopic pattern. Dominant dermoscopic pattern was related to nevus size: smaller nevi tended to be structureless, while larger nevi were of mixed pattern. CONCLUSION: This study supports the feasibility and utility of digital photography and dermoscopy for the longitudinal study of nevus evolution in early adolescence.

Adolescent↗

PubMed2002

Clinically and dermoscopically featureless melanoma: when prevention fails.

We report a case of amelanotic melanoma that was clinically and dermoscopically featureless; it was repeatedly missed during examination at a pigmented lesion clinic. Dermoscopy evidenced a peculiar vascular pattern, and only the adoption of a specific diagnostic algorithm including the atypical vascular pattern among the major diagnostic criteria would have helped the observer make the correct diagnosis. The risk of false-negative diagnosis by both clinical examination and dermoscopy during melanoma screening as well as the possible role of dermoscopy in the diagnosis of amelanotic melanoma are discussed.

Dermatology↗

PubMed2004

Dermoscopic features of mucosal melanosis.

BACKGROUND: Melanosis (lentiginosis, labial melanotic macula) is a benign pigmented lesion of mucosa characterized by pigmentation of basal keratinocytes with melanocytic normal or slightly increased in number. Melanosis, particularly when occurring on genitalia, can clinically mimic mucosal melanoma thus creating concern in both the patient and the physician. OBJECTIVE: In this study dermoscopic features from a series of clinically equivocal (n=11) or clinically typical (n=10) mucosal melanosis were analyzed. METHODS: All the women consecutively seen at the Vulva Clinic of the Department of Obstetrics and Gynecology, University of Florence, Italy, from May 1, 2002 to June 30, 2002, were examined. RESULTS: Three major dermoscopic patterns were identified: (1) a "structureless" pattern, predominantly found in clinically equivocal vulvar melanosis, with a blue hue, associated with the presence of melanophages in the upper dermis, present in the majority of these lesions; (2) a "parallel pattern," often found in clinically typical melanotyc macules of the lips and penis; and (3) a "reticular-like" pattern associated with clinically equivocal melanosis occurring at peculiar sites such as the areola (all the three cases occurred at that site) or, rarely, on the lip. CONCLUSIONS: Dermoscopy can play a role in the noninvasive classification of mucosal melanosis. The risk of misclassification with melanoma is probably dependent on dermoscopy pattern shown by the lesion. Prospective studies including early melanomas are needed to establish diagnostic performance of dermoscopy in pigmented lesions of the mucosa.

Adult↗

PubMedDate not supplied

Micro-melanoma detection. A clinical study on 22 cases of melanoma with a diameter equal to or less than 3 mm.

BACKGROUND AND AIMS: Very small pigmented lesions may represent an extreme diagnostic challenge to the clinician. Our aim was to describe the clinical and dermoscopic features in a series of cutaneous melanomas with a maximum clinical diameter of 3 mm. METHODS: We conducted a retrospective study of the 924 primary melanomas seen and treated during a period of five years at the Unit for Melanoma Detection of the Istituto Nazionale Tumori of Milan, Italy. The size characteristics of the considered lesions allowed the identification of 22 (2.4%) cases of micro-melanoma (clinical diameter of 3 mm or less). Sixteen of these cases were subjected to dermoscopy. The clinical and dermoscopic features as well as the corresponding diagnoses were recorded. RESULTS: The typical lesion presents as a small, dark, often black macule, generally evenly colored, with well-defined borders; it may be asymmetric or symmetric in shape. These features prompted a correct clinical diagnosis in nearly half of the cases. Dermoscopy lead to a correct diagnosis in all cases subjected to the technique. CONCLUSION: Dermoscopy appears to be an efficient aid to the diagnosis of micro-melanomas, provided that clinicians are aware of this type of lesion and maintain the index of suspicion at a high level.

Adult↗

PubMedDate not supplied

Difference between real and perceived power of dermoscopical methods for detection of malignant melanoma.

Clear proceedings in detection of malignant melanoma and monitoring of melanocytic nevi (MN) have been achieved by dermoscopy in recent years: sensitivity to 95% is possible for experts. Does patients' confidence in methods for detection of malignant melanoma most important for adherence in follow-up reflect this diagnostic power? A self-administered survey was performed in 210 consecutive patients at 13 private dermatological practices and the department of Dermatology of the University of Regensburg. Confidence was assessed by a 5-step ordinal scale ranging from 1 to 5 (higher values indicate higher confidence) and willingness-to-pay (wtp) as health-economic instrument for naked-eye inspection (NEI), handheld dermoscopy (HHD), digital dermoscopy (DD), and teledermoscopy (TD); additional, wtp for a hypothetical method promising 100% accuracy. Data of 143 patients (response rate 69.5%; mean age 37 years, 58% female) could be analysed. Mean confidence was 1.9 0.9 for NEI, 2.8 0.9 for HHD, 4.5 0.7 for DD, and 4.7 0.5 for TD. Mean wtp per examination was 0.64% 1.1 of monthly income for NEI, 1.1% 1.9 for HHD, 2.8% 3.3 for DD, 3.1% 4.6 for TD, and 5.0% 7.8 for hypothetical method. Differences between methods were statistically significant. Compared to the hypothetical method, NEI achieved only 14.9%, HHD 24.8%, DD 58.4%, and TD 60% of maximum confidence. This study was performed without any influence on routine information for patients. Results therefore represent patients' actual knowledge of dermoscopical methods in daily dermatological practices. Patients' confidence was highest for TD, HHD was clearly underestimated. Willingness-to-pay in HHD, DD, and TD was at least 40% below a hypothetical method promising 100% accuracy. Better information about diagnostic accuracy of methods available is necessary to increase patients' knowledge and confidence.

Adult↗

PubMed2004

A portable digital microphotography unit for rapid documentation of periungual nailfold capillary changes in autoimmune connective tissue diseases.

OBJECTIVE: While employing a DermLite dermoscopy unit to assess pigment pattern networks in melanocytic skin lesions, it was observed that this compact, portable dermoscopy unit can also be used to quickly detect nailfold capillary changes when entertaining a diagnosis of autoimmune connective tissue diseases (CTD) such as dermatomyositis (DM), scleroderma/systemic sclerosis (SSc), or systemic lupus erythematosus. Aware that the suppliers of the DermLite dermoscopy unit also market a portable digital microphotography unit based on the DermLite optical principles for efficiently documenting cutaneous pigment network patterns, we investigated whether this unit (DermLite Foto flash unit attached to a Nikon Coolpix digital camera) might be used to photographically document nailfold capillary changes in patients with autoimmune CTD. METHODS: A DermLite Foto flash unit attached to a Nikon Coolpix digital camera was used in a controlled observational study to obtain digital photographs of nailfold capillaries in a small sequential sample of patients with autoimmune CTD attending a rheumatic skin disease subspecialty clinic in an academic department of dermatology. RESULTS: The digital microphotography system proved to be highly useful in documenting the nailfold vascular changes observed in a small sample of patients with DM. We observed that the nailfold capillary changes seen in patients with clinically amyopathic DM were qualitatively and quantitatively similar to those seen in patients with classical DM. CONCLUSION: Digital microphotography systems designed for examining pigmented skin lesions can be used easily to document nailfold capillary changes often observed in DM and SSc. Nailfold capillary changes documented in this manner appear to be indistinguishable in clinically amyopathic DM and classical DM.

Autoimmune Diseases↗

PubMed2005

Comparative performance of 4 dermoscopic algorithms by nonexperts for the diagnosis of melanocytic lesions.

OBJECTIVE: To assess 4 dermoscopy methods in a nonexpert setting. DESIGN: Sixty-one medical practitioners, mainly primary care physicians in Australia, were trained in 4 dermoscopy algorithms. Participants then assessed macroscopic and dermoscopic images of 40 melanocytic skin lesions. Each of the dermoscopic images was assessed with pattern analysis, the 7-point checklist, the ABCD rule, and the Menzies method. RESULTS: The Menzies method showed the highest sensitivity, 84.6%, for the diagnosis of melanoma, followed by the 7-point checklist (81.4%), the ABCD rule (77.5%), pattern analysis (68.4%), and assessment of a macroscopic image (60.9%). Pattern analysis and assessment of the macroscopic image showed the highest specificity, 85.3% and 85.4%, respectively. The ABCD rule showed a specificity of 80.4%; the Menzies method, 77.7%; and the 7-point checklist, 73%. The Menzies method had a diagnostic accuracy of 81.1%; the ABCD rule, 79.0%; the 7-point checklist, 77.2%; pattern analysis, 76.8%; and clinical assessment, 73.2%. CONCLUSIONS: All algorithms performed well in the hands of relatively inexpert practitioners who had undertaken self-guided training provided on compact disc. The Menzies method showed the highest diagnostic accuracy and sensitivity for melanoma diagnosis and was preferred by study participants.

Algorithms↗

PubMed2004

Dermoscopic features of melanoma on the scalp.

There is a need to improve the early detection of melanoma of the scalp because it is characterized by a poorer prognosis compared with melanoma on other body sites. Dermoscopy is a useful tool for the early detection of melanoma but no previous reports on dermoscopic features of scalp melanoma have been published. We describe the first case of melanoma of the scalp seen by dermoscopy exhibiting a multicomponent global pattern with atypical pigment network, irregular streaks, and regression structures. In contrast to the dermoscopic features usually seen in melanoma occurring on the face, the same morphologic type of pigment network usually seen in melanoma of the trunk was observed in our case of scalp melanoma.

Dermoscopy↗

PubMed2004

Dermoscopic patterns of cutaneous melanoma metastases.

Although the long experience acquired with the widespread use of dermoscopy has allowed the establishment of criteria for the recognition of benign and malignant skin lesions, very few data are available on cutaneous melanoma metastases. As the characteristic clinical aspects are multiform and even histological evaluation may sometimes be difficult, we have studied and characterized the patterns of cutaneous melanoma metastases in dermoscopy. In this paper, we report dermoscopic data on 130 histologically confirmed metastases observed in 32 patients affected by melanoma, with particular emphasis on dermoscopic features. Nine dermoscopic elements (homogeneous, saccular, amelanotic, polymorphic and vascular patterns, colour, perilesional erythema, pigmentary halo, peripheral grey spots) were studied in 130 cutaneous melanoma metastases and compared with those of 350 melanomas, 150 common naevi, 40 blue naevi, 40 haemangiomas and 50 basal cell carcinomas. The saccular and vascular patterns (especially polymorphic atypical vessels and winding vessels), as well as pigmentary halo and peripheral grey spots, seem to be the most significant elements suggestive of cutaneous melanoma metastases. The interest in and importance of the dermoscopic aspects of cutaneous melanoma metastases cannot be neglected if the American Joint Committee has determined that microsatellitosis and micrometastases are fundamental in the new TNM staging classification for cutaneous melanoma.

Adult↗

PubMed2004

Digital image analysis for diagnosis of cutaneous melanoma. Development of a highly effective computer algorithm based on analysis of 837 melanocytic lesions.

BACKGROUND: Digital image analysis has been introduced into the diagnosis of skin lesions based on dermoscopic pictures. OBJECTIVES: To develop a computer algorithm for the diagnosis of melanocytic lesions and to compare its diagnostic accuracy with the results of established dermoscopic classification rules. METHODS: In the Department of Dermatology, University of Tuebingen, Germany, 837 melanocytic skin lesions were prospectively imaged by a dermoscopy video system in consecutive patients. Of these lesions, 269 were excised and examined by histopathology: 84 were classified as cutaneous melanomas and 185 as benign melanocytic naevi. The remaining 568 lesions were diagnosed by dermoscopy as benign. Digital image analysis was performed in all 837 benign and malignant melanocytic lesions using 64 different analytical parameters. RESULTS: For lesions imaged completely (diameter < or = 12 mm), three analytical parameters were found to distinguish clearly between benign and malignant lesions, while in incompletely imaged lesions six parameters enabled differentiation. Based on the respective parameters and logistic regression analysis, a diagnostic computer algorithm for melanocytic lesions was developed. Its diagnostic accuracy was 82% for completely imaged and 84% for partially imaged lesions. All 837 melanocytic lesions were classified by established dermoscopic algorithms and the diagnostic accuracy was found to be in the same range (ABCD rule 78%, Menzies' score 83%, seven-point checklist 88%, and seven features for melanoma 81%). CONCLUSIONS: A diagnostic algorithm for digital image analysis of melanocytic lesions can achieve the same range of diagnostic accuracy as the application of dermoscopic classification rules by experts. The present diagnostic algorithm, however, still requires a medical expert who is qualified to recognize cutaneous lesions as being of melanocytic origin.

Algorithms↗

PubMed2006

Instrument-, age- and site-dependent variations of dermoscopic patterns of congenital melanocytic naevi: a multicentre study.

BACKGROUND: Recently, we identified and described dermoscopic aspects, present with a higher frequency in congenital melanocytic lesions with respect to acquired naevi. We also classified small- and medium-sized congenital naevi (CN) into nine subtypes according to their macroscopic and dermoscopic aspects. OBJECTIVES: Because the recognition of dermoscopic features may be instrument dependent, in this study, we wanted to check whether dermoscopic patterns specific for CN can be identified in digital images acquired by means of different instruments. We also wanted to check the validity of our previously proposed classification and assess possible age- and site-dependent variations of dermoscopic patterns and naevus subtypes. PATIENTS/METHODS: Images corresponding to 384 small- or medium-sized CN were collected in eight different centres employing four different instruments. Lesion images were evaluated and checked for the presence of specific dermoscopic criteria, classified, and compared with a database of 350 acquired naevi. RESULTS: Specific and unspecific dermoscopic features were identifiable in images acquired by means of all four instrument types. The mean number of identified features per lesion did not vary according to the instrument employed for the acquisition of the images; however, it was lower for lesions recorded employing low magnifications. The previously proposed classification was easily applied to the whole image database. The variegated naevus type was identified as a highly specific clinical/dermoscopic pattern. Dermoscopic features varied according to age and location. The globular type prevailed in subjects under 11 years of age and on the trunk, whereas the majority of reticular lesions were located on the limbs. CONCLUSIONS: Because definite clinical and histological criteria for the diagnosis of the congenital nature of naevi are lacking, the use of dermoscopy can be of great help in identifying those lesions where the presence of specific dermoscopic features makes the diagnosis of CN more likely. Moreover, dermoscopy can be useful both for the classification of lesions already identified as congenital according to definite clinical and anamnestic data and for a possible correlation of naevus phenotype and dermoscopic patterns to the risk of developing a malignant melanoma in prospective studies.

Adolescent↗

PubMed2006

Micro-melanoma detection: a clinical study on 206 consecutive cases of pigmented skin lesions with a diameter < or = 3 mm.

BACKGROUND: Very small pigmented lesions may represent an important diagnostic challenge to the clinician. OBJECTIVES: The aim of the present study was to establish the diagnostic value, in terms of sensitivity and specificity, of both clinical and dermoscopic examinations in a population of patients with unselected consecutive pigmented lesions with a maximum clinical diameter of 3 mm. PATIENTS AND METHODS: Two hundred and four consecutive patients bearing 206 pigmented skin lesions with a maximum diameter of 3 mm were seen and operated on. Twenty-three of these lesions were melanomas. Each lesion was subjected to both clinical and dermoscopic evaluation before surgery. The results were expressed in terms of sensitivity and specificity of both kinds of evaluation. RESULTS: Clinical evaluation produced a diagnostic sensitivity of 43% and a specificity of 91%. Dermoscopy resulted in a sensitivity of 83% and in a specificity of 69%. The comparison between the sensitivity values of the two diagnostic methods showed a significant difference (P < 0.01). A high value of significance was also obtained comparing the respective specificity values (P < 0.001). CONCLUSIONS: Detection of very small melanomas is feasible by accurate visual inspection. Dermoscopy appears to be an important aid to diagnosis, provided that physicians are aware of this type of lesion and maintain the index of suspicion at a high level.

Adolescent↗

PubMed2005

Pigmented seborrheic keratoses of the vulva clinically mimicking a malignant melanoma: a clinical, dermoscopic-pathologic case study.

The diagnosis of seborrheic keratosis is, in general, a clinical one, but in some cases, the differential diagnosis between pigmented seborrheic keratosis and malignant melanoma is difficult. Dermoscopy may improve the early diagnosis of vulvar melanoma and thus play a role in the preoperative classification of pigmented lesions at this particular site. We report the first case of a pigmented seborrheic keratosis of the vulva clinically mimicking a malignant melanoma, whose dermoscopic features have been investigated together with their pathologic correlates. Dermoscopically our case shows the absence of comedo-like openings and the presence of the pseudo-network. Dermoscopy is therefore a useful method for the differential diagnosis of pigmented lesions even in the vulva.

Aged↗

PubMed2006

High-resolution epiluminescence colorimetry of striae distensae.

BACKGROUND: Colours of striae distensae are often different from that of the surrounding skin. A close look using dermoscopy discloses distinct patterns of melanized networks at these sites. The aim of the study was to design a method of high-\resolution analytical analysis of the skin colours using the combination of photographic dermoscopy and small field reflectance colorimetry. METHODS: Clinical photographs were taken from striae distensae and their surrounding skin using a Dermaphot (Heine Optotechnik, Hersching, Germany). A final magnification of 125x was obtained on paper photographs. The reflectance colorimeter Visi-Chroma VC-100 (Biophotonics, Lessines, Belgium) was used to measure colours of the pigmentary networks in the L*a*b* system. Differential colour parameters (deltaE*ab, deltaL*, deltaa*, deltab*) were calculated for each case between the lesional and the surrounding normal skin, and between the melanized reticulated pattern and the enclosed lighter areas. RESULTS: Objective colorimetric assessments distinguished four distinct types, namely striae albae, striae rubrae, striae caeruleae and striae nigrae. The latter peculiar hyperpigmented type of striae distensae was specifically identified by epiluminescence examination in dark-skinned subjects. The fine-melanized honeycomb network present on the adjacent intact skin was reshaped inside striae in a streaky pattern perpendicular to the striae axis. Strong linear correlations were found between all combinations of deltaL* and deltab* evaluating colours of the reticulated and the honeycomb alveolar patterns both inside and outside the striae distensae. By contrast, no correlations were found between deltaa* and the other colorimetric parameters. CONCLUSION: The direct and/or indirect influences of melanocyte mechanobiology appear to have a prominent effect on the various colours of striae distensae.

Adult↗

PubMedDate not supplied

Cutaneous melanoma: making a clinical diagnosis, present and future.

The minimum requirement for the general dermatologist for clinically assessing pigmented skin lesions is dermoscopy. In expert hands, this technique has been shown to improve both the sensitivity and specificity for the diagnosis of melanoma. This is also reflected by lower benign melanoma excision ratios and decreased excision rates. Evidence is mounting for the routine use of total body skin photography for patients with a very high risk of developing cutaneous melanoma. Both long-term (12 months) and short-term (3 months) digital dermoscopy monitoring has been shown to allow the detection of dermoscopically featureless melanoma and is central for the clinical assessment of melanocytic lesions at the Sydney Melanoma Diagnostic Center. The use of automated instruments for the diagnosis of cutaneous melanoma is still in an experimental phase, and its utility is dependent on the evidence that such instruments give a clinically useful expert second opinion. Currently, other noninvasive diagnostic techniques, such as in vivo confocal scanning laser microscopy, are reserved for clinical research settings.

Australia↗