SEARCH · PubMed Health

Results for “Dermoscopy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

PubMed2005

Microscopic in vivo description of cellular architecture of dermoscopic pigment network in nevi and melanomas.

OBJECTIVE: To characterize the microscopic aspects of the dermoscopic pigment network in vivo, by means of confocal scanning laser microscopy. DESIGN: Confocal imaging was performed on melanocytic lesions characterized by pigment network at dermoscopy. Some confocal architectural and cytologic features, as observed at the dermoepidermal junction, were morphologically described and quantified by means of a dedicated program. SETTING: University medical department. STUDY POPULATION: We studied confocal images of 15 melanomas, 15 dermoscopic atypical nevi, and 15 common nevi. MAIN OUTCOME MEASURES: Features referring to aspect, size, regularity, homogeneity, and infiltration of dermal papillae and to cellular size, regularity, and atypia were described by 2 observers on confocal images. Mean dermal papillary diameter, mean cell area, and shape irregularity were quantified by drawing papillae and cell contours on confocal images and measured with the use of a computer program. RESULTS: Pigment network in melanomas consisted of large basal cells that circumscribed small to medium-sized dermal papillae with marked cellular atypia, sometimes infiltrating dermal papillae. On the other hand, common acquired nevi were characterized by lack of atypical cells and edged dermal papillae. Atypical nevi presented intermediate characteristics between clearly benign and malignant lesions. CONCLUSION: Cellular atypia was the most sensitive feature for melanoma diagnosis, whereas the presence of nucleated cells infiltrating dermal papillae was the most specific one.

Biopsy, Needle↗

PubMed2005

Dysplastic pointillist nevus.

BACKGROUND: Three cases of pointillist nevus, which is a distinctive clinical type of benign melanocytic nevus with variegated pigment, have been described in the literature to date. OBSERVATIONS: A 24-year-old man presented with an acquired melanocytic lesion composed of multiple tiny pigmented dots. Dermoscopy revealed multiple brown globules on a reddish skin-colored background, and histologic examination demonstrated architectural disorder with cytologic atypia. Conclusion To the best of our knowledge, we report a case of dysplastic pointillist nevus.

Adult↗

PubMed2025

Cost-Effectiveness Analysis of 3D Total-Body Photography for People at High Risk of Melanoma.

IMPORTANCE: Greater use of novel digital technologies could be associated with improved health outcomes and save health care costs by detecting smaller melanomas earlier (needing less treatment) or benign tumors (needing no treatment). OBJECTIVE: To compare costs and health effects of 3-dimensional (3D) total-body photography (TBP) and sequential digital dermoscopy imaging (SDDI) vs usual care for early detection of melanoma. DESIGN, SETTING, AND PARTICIPANTS: This prespecified cost-effectiveness analysis using randomized clinical trial (n = 309) data with 2 years of follow-up was conducted at a research hospital in Brisbane, Australia, and took a health system perspective. It included adults 18 years or older at high risk of developing a primary or subsequent melanoma. INTERVENTION: The intervention group received usual care plus clinical skin examinations by junior clinicians at baseline and 6, 12, 18, and 24 months with 3D TBP-SDDI reviewed by a teledermatologist. The control group continued to receive usual care and completed online surveys every 6 months. MAIN OUTCOMES AND MEASURES: Government health care costs, patient out-of-pocket costs, numbers of benign and malignant skin tumor excisions, and quality-adjusted life-years. Skin biopsy, excisions, pathology, and their costs were collected using administrative claims data. Quality of life was collected using the EuroQol-5D-5L. RESULTS: The trial included 314 participants (mean [SD] age, 51.6 [12.8] years; 194 female individuals [62%]) who completed all of the study procedures (158 in the intervention and 156 in the control groups). Compared with controls, intervention group participants had fewer melanoma excisions, more keratinocyte carcinomas and benign excisions, and more biopsy specimens. Over 24 months, mean per-person costs (analyzed in Australian dollars and converted to US$) for the intervention group were $1708 (95% CI, $1455-$1961) vs $763 (95% CI, $655-$870) for controls, an incremental cost of $945 (95% CI, $738-$1157) to provide the intervention. Total quality-adjusted life-years per person were similar for the intervention (1.84; 95% CI, 1.82-1.86) and control groups (1.84; 95% CI, 1.83-1.86). The incremental cost per additional malignant skin tumor excised was $40 (95% CI, $34-$48). CONCLUSIONS AND RELEVANCE: Over 2 years of the trial, the 3D TBP-SDDI model by junior clinicians and teledermatologist review generated higher costs and detected similar numbers of malignant tumors than usual care in a high-risk melanoma cohort. Cost-effectiveness is a necessary but not sufficient consideration for implementation. Other benefits of 3D TBP-SDDI may arise once artificial intelligence clinician support systems are integrated, and more research is needed to understand factors associated with costs and whether there are other benefits of 3D TBP-SDDI.

Adult↗

PubMed2005

[Diagnostic dermoscopic algorithms].

Dermatoscopy (reflective light microscopy, dermoscopy) is a noninvasive technique with high sensitivity and specificity for in vivo visualization of melanocytic and non-melanocytic pigmented and non-pigmented skin tumors. To this end, knowledge of various algorithms and scores is important. The first part of this contribution in continuing education deals with differentiation between melanocytic and non-melanocytic skin tumors on the trunk and extremities. The second part describes the different diagnostic dermatoscopic algorithms.

Algorithms↗

PubMed2004

Detection of pigment network in dermatoscopy images using texture analysis.

Dermatoscopy, also known as dermoscopy or epiluminescence microscopy (ELM), is a non-invasive, in vivo technique, which permits visualization of features of pigmented melanocytic neoplasms that are not discernable by examination with the naked eye. ELM offers a completely new range of visual features. One such prominent feature is the pigment network. Two texture-based algorithms are developed for the detection of pigment network. These methods are applicable to various texture patterns in dermatoscopy images, including patterns that lack fine lines such as cobblestone, follicular, or thickened network patterns. Two texture algorithms, Laws energy masks and the neighborhood gray-level dependence matrix (NGLDM) large number emphasis, were optimized on a set of 155 dermatoscopy images and compared. Results suggest superiority of Laws energy masks for pigment network detection in dermatoscopy images. For both methods, a texel width of 10 pixels or approximately 0.22 mm is found for dermatoscopy images.

Algorithms↗

PubMed2004

Dermoscopic assessment of long-term topical therapies with potent steroids in chronic psoriasis.

We investigated the value of the dermoscope for monitoring the long term safety of high potency topical steroids in patients with chronic psoriasis. We observed for the first time that the overuse of topical steroids resulted in the appearance of clinically unapparent but dermoscopically apparent "red lines" (linear telangiectasias) in the treated plaques and/or skin adjacent to the treated plaques (P < .03). We concluded that dermoscopy may help reveal the early signs of impending steroid-induced atrophy ("red lines") before they become clinically evident with the naked eye and before the atrophy becomes permanent.

Administration, Topical↗

PubMed2005

Pitfalls in the clinical and dermoscopic diagnosis of pigmented actinic keratosis.

Pigmented actinic keratosis and melanoma may exhibit overlapping clinical features, thus representing a diagnostic challenge for dermatologists. Although the differentiation between these two entities is traditionally done by histopathology, dermoscopy has been utilized as a useful additional aid for improving the clinical diagnostic accuracy of such pigmented skin lesions. We report the clinical and dermoscopic features of two pigmented actinic keratoses to discuss the difficulties in their preoperative differential diagnosis.

Aged↗

PubMed2006

Noninvasive techniques for the evaluation of skin color.

Visual assessment remains one of the "gold standard" methods of assessing skin color and a number of tools are currently available to reduce the interobserver variability. Ultraviolet light examination remains a mainstay of the assessment of pigmentary disorders, while polarized light photography is useful for the appraisal of dermal changes, in particular those related to vascularity. With the introduction of modern instruments, reflectance spectroscopy using tristimulus colorimeters or narrowband spectrophotometers provides a convenient, objective, and reproducible methodology for the evaluation of pigmentation and skin color. In vivo confocal scanning laser microscopy is a powerful technique for the examination of pigmented lesions, which shows promise in the detection and diagnosis of early melanoma. Dermoscopy is also useful for the differential diagnosis of benign melanocytic lesions and melanoma, and its use has been shown to significantly improve diagnostic accuracy.

Colorimetry↗

PubMed2006

Videodermoscopy in the evaluation of hair and scalp disorders.

BACKGROUND: The standard methods used to diagnose scalp and hair disorders (eg, simple clinical inspection, pull test, biopsy) vary in sensitivity, reproducibility, and invasiveness. Studies on a few entities suggest that use of dermoscopy can improve clinical accuracy, but further investigation is needed. OBJECTIVES: We sought to: (1) characterize features of several nontumoral scalp and hair conditions using videodermoscopy; and (2) assess the potential usefulness of videodermoscopy in the clinical evaluation of these conditions. METHODS: Images (x20-70 magnification) obtained with videodermoscopy from 220 patients with various scalp and hair disorders and 15 unaffected control subjects were reviewed for distinguishing features. RESULTS: Conditions evaluated included psoriasis (23), seborrheic dermatitis (26), alopecia areata (58), androgenetic alopecia (64), chronic telogen effluvium (7), trichotillomania (12), and primary cicatricial alopecia (30). Clinical features evident to the naked eye were seen in great detail when videodermoscopy was used. Novel features (eg, yellow dots in alopecia areata) were also identified. LIMITATIONS: Findings require confirmation by blinded, prospective investigation. CONCLUSIONS: Use of videodermoscopy in the clinical evaluation of scalp and hair disorders improves diagnostic capability beyond simple clinical inspection and reveals novel features of disease, which may extend clinical and pathogenetic understanding.

Case-Control Studies↗

PubMed2003

Amelanotic/Hypomelanotic melanoma--is dermatoscopy useful for diagnosis?

BACKGROUND: Amelanotic/hypomelanotic melanoma often leads to delayed clinical diagnosis because its clinical appearance can mimic other hypopigmented skin conditions. Dermatoscopy (dermoscopy, epiluminescence microscopy) is thought to be a helpful diagnostic tool in pigmented skin lesions, but it can be used also in non-pigmented skin tumors due to the recognition of vascular structures not visible to the naked eye. OBJECTIVE: 7 amelanotic/hypomelanotic melanomas in 6 patients were analyzed in order to define their dermatoscopic findings using standard pattern analysis. METHODS: Clinical and dermoscopic images of each lesion were obtained using Dermaphot (Heine Optotechnik, Herrsching, Germany), with 10-fold magnification of the lesion and the color slides were converted to digital format using a Kodak Photo CD system. RESULTS: All 7 amelanotic/hypomelanotic melanomas revealed peculiar dermatoscopic findings, namely, atypical vessels, dotted vessels, and a central pink to white veil. In addition, in 2 patients a slight brownish homogenous pigmentation at the periphery of the lesion was observed. In one case the correct diagnosis was done by an experienced dermatologist using dermatoscopy, whereas in the remaining 6 cases the clinical diagnoses included squamous cell carcinoma, Bowen disease, pyogenic granuloma and basal cell carcinoma. In 2 of 6 patients amelanotic/hypomelanotic melanoma was associated with a previous history of melanoma. CONCLUSION: Amelanotic/hypomelanotic melanoma exhibits as a common dermatoscopic denominator atypical vessels, varying in size and shape, usually associated with a central pink to white veil.

Adult↗

PubMed2005

Dermoscopic features of eruptive melanocytic naevi in an adult patient receiving immunosuppressive therapy for Crohn's disease.

The induction of multiple eruptive melanocytic naevi has frequently been reported to occur in association with chemotherapy or immunosuppressive regimens, particularly in children and adolescents. We describe the dermoscopic features of eruptive melanocytic naevi in an adult non-transplanted patient receiving immunosuppressive therapy for Crohn's disease. By dermoscopy, we observed a peripheral rim of large brown globules in most of the lesions. We have previously identified a group of patients characterized by this dermoscopic feature. These patients were children, adolescents and young adults with renal allografts receiving immunosuppressive therapy. The findings of our case strongly suggest that this dermoscopic feature may be associated with eruptive naevi developed in association with immunosuppression from any cause.

Adult↗

PubMed2006

Structural correlations between dermoscopic features of cutaneous melanomas and histopathology using transverse sections.

Interpretation of dermoscopic features of cutaneous melanoma is based on histologic description of perpendicular sections of the lesions that does not reflect the overview achieved by epiluminescence. We describe the utilization of transverse sections as a tool to define the histopathology of features that are the dermoscopic hallmarks of cutaneous melanoma. From a collection of 23 pigmented lesions with the dermoscopic diagnosis of cutaneous melanoma submitted for surgical excision we selected, from each specimen, one dermoscopic feature (black dots and globules, brown dots, blues dots and globules, depigmentation, broadened network, radial streams or pseudopods) that was sampled with a 4-mm punch (specimen) to obtain perpendicular and transverse sections. Using this strategy, it was possible to correlate the histopathology of all features that are often used as criteria for diagnostic dermoscopy. The black dots were pigmented neoplastic cells at the dermal-epidermal junction (DEJ) and within the epidermis in heavily pigmented columns. Similar findings were seen in brown dots, however there was slightly less pigment. No statistical difference was observed between brown dots and black dots regarding size, area and number of atypical cellnests. Blue dots correlated to melanophages, surrounding the superficial vascular plexus. Depigmentation was characterized by intense fibrosis of the papillary dermis. The pigmented network showed atypical pigmented or non-pigmented melanocytes at the DEJ and epidermis as well as heavily pigmented keratinocytes in the basal cell layer. The radial streaming and pseudopods had neoplastic cells in nests, a stratified growth pattern arranged in centrifugal linear extensions, resembling a arborescent branching. The results represented herein, are an important tool for understanding histopathological alterations responsible for dermoscopic features and for improving the efficacy of this diagnostic method.

Biopsy↗

PubMed2006

Melanocytic nevus with atypical dermoscopic features at the site of radiodermatitis.

BACKGROUND: Radiation therapy can cause acute and chronic damage of the skin. OBJECTIVE: A 71-year-old woman presented with an atrophic and sclerotic plaque at a site previously treated with radiotherapy because of lung cancer. Inside the area affected by chronic radiodermatitis, she reported that a preexisting pigmentary lesion had gradually undergone morphologic changes after radiation therapy. MATERIALS AND METHODS: On dermoscopy, the lesion showed features highly suspicious for malignant melanoma. The lesion was excised and examined histopathologically. RESULTS: The histopathologic diagnosis was compound congenital melanocytic nevus associated with prominent dermal sclerosis and epidermal atrophy. CONCLUSIONS: The existence of melanocytes within an atrophic and fibrotic area is a finding typically associated with recurrent or persistent melanocytic lesions. It is likely that the "pseudomelanoma" features of the lesion observed in our patient might have been secondary to the skin changes induced by radiation therapy.

Aged↗

PubMed2007

Atypical melanosis of the foot showing a dermoscopic feature of the parallel ridge pattern.

A 62-year-old male Turkish patient had a pigmented lesion on the sole with a 10-year history. It was an asymmetrical macular lesion with an irregular border and irregular brown pigmentation and had a diameter of 1.2 cm x 1.7 cm. Dermoscopy revealed a parallel ridge pattern and an abrupt cut-off of pigmentation on the upper edge. Histologically lentiginous hyperplasia decorated by innocent melanocytes and scattered melanocytic proliferation with slight to moderate cytological atypia were seen. Atypical melanocytes were very scattered and it was insufficient to call it a melanoma in situ. A second finding was a microvascular proliferation located in the papillary dermis. There was no sign of regression such as fibrous tissue or host reaction. Atypical melanosis of the foot has rarely been reported in the published work, which are from Japan and Korea. This case is presented to emphasize the significance of this rare entity which has recently been reported to be a very early phase of acral melanoma.

Dermoscopy↗

PubMed2005

Androgenetic alopecia in children: report of 20 cases.

Androgenetic alopecia (AGA) is the most common type of hair loss in adults. Although there are differences in the age at onset, the disease starts after puberty when enough testosterone is available to be transformed into dihydrotestosterone. We report 20 prepubertal children with AGA, 12 girls and eight boys, age range 6-10 years, observed over the last 4 years. All had normal physical development. Clinical examination showed hair loss with thinning and widening of the central parting of the scalp, both in boys and girls. In eight cases frontal accentuation and breach of frontal hairline were also present. The clinical diagnosis was confirmed by pull test, trichogram and dermoscopy in all cases, and by scalp biopsy performed in six cases. There was a strong family history of AGA in all patients. The onset of AGA is not expected to be seen in prepubertal patients without abnormal androgen levels. A common feature observed in our series of children with AGA was a strong genetic predisposition to the disease. Although the pathogenesis remains speculative, endocrine evaluation and a strict follow-up are strongly recommended.

Age of Onset↗

PubMed2005

Cutaneous collision tumour (melanocytic naevus, basal cell carcinoma, seborrhoeic keratosis): a clinical, dermoscopic and pathological case report.

The association of contiguous or 'collision' tumours in the same biopsy specimen is not uncommon and is often reported in the literature. The most common association, basal cell carcinoma (BCC) and naevus, is very difficult to diagnose clinically. We describe a 38-year-old woman with a previous history of melanoma, who presented with a modified pigmented lesion of the hip that had begun to change 6 months earlier. Histologically, the lesion was a melanocytic compound naevus and a BCC with a seborrhoeic keratosis. The case was investigated clinically and by focusing on the dermoscopic features and their pathological correlates. Cutaneous collision tumours are extremely difficult to diagnose preoperatively, even with the help of dermoscopy, in particular when one of the lesions is melanocytic.

Adult↗

PubMed2005

Epidermolysis bullosa naevi reveal a distinctive dermoscopic pattern.

BACKGROUND: Large, asymmetrical and irregularly pigmented naevi in patients with epidermolysis bullosa (EB) have been reported often to mimic cutaneous melanoma clinically. OBJECTIVES: As the biological course of these peculiar moles is benign, we assessed EB naevi with a dermatoscope to determine whether they could be reliably differentiated from cutaneous melanoma. METHODS: We evaluated digital dermoscopic images of 23 EB naevi from 11 patients with EB and analysed these pigmented lesions according to pattern analysis, ABCD rule of dermoscopy and the seven-point checklist. RESULTS: Melanoma-associated dermoscopic criteria such as multicomponent pattern (20 of 23), atypical pigment network (17 of 23), irregular dots/globules (16 of 23), irregular pigmentation (22 of 23) and an atypical vascular pattern (seven of 23) were frequently seen in EB naevi. In contrast, other criteria frequently associated with melanoma progression, such as irregular streaks, blue-whitish veil, regression structures (blue-whitish areas) or black dots, were rarely seen. Most lesions gave false-positive results when the scores of the dermoscopic diagnostic algorithms were calculated. CONCLUSIONS: Recurring dermoscopic structures in EB naevi reveal a distinctive dermoscopic pattern of this recently defined entity. Although EB naevi represent an exception to dermoscopic diagnostic algorithms, their dermoscopic evaluation most often allows us to estimate their benign nature. Nevertheless, as an unequivocal discrimination from malignant melanoma in vivo is sometimes not possible, regular clinical follow up of EB naevi with histopathological evaluation of highly suspicious lesions is mandatory.

Dermoscopy↗

PubMed2005

Multimodal in vivo optical imaging, including confocal microscopy, facilitates presurgical margin mapping for clinically complex lentigo maligna melanoma.

Knowledge of the accurate margins of a lentigo maligna melanoma (LMM) is crucial in the presurgical evaluation of the patient. Towards this end clinicians have utilized the Wood's lamp and dermoscopy to help delineate the borders of the LMM. However, many LMMs arise on photodamaged skin, making it difficult to determine the border of the LMM and separate it from the background lentiginous skin. We present a case of a patient with a recurrent LMM on the scalp that developed in a background of photodamage with diffuse melanocytic atypia and lentigines, making it virtually impossible to determine the precise margins of the LMM by clinical, Wood's lamp or dermoscopic examination. To avoid subjecting the patient to multiple staged excisions we attempted to determine the margins of the LMM by utilizing in vivo confocal laser scanning reflectance microscopy. Using this, it was apparent that there were increased numbers of atypical/dendritic intraepidermal melanocytes in all layers of the epidermis within the LMM. In contrast, skin not involved with the LMM, as viewed under confocal laser examination, had normal honeycomb architecture and no abnormal melanocytes. The confocally determined border was further confirmed by obtaining multiple punch biopsies that were evaluated by haematoxylin and eosin histology and immunohistochemistry. Based on this information, the presurgical margins were marked and the tumour excised accordingly. The excised tissue was examined with multiple-step sections and the margins were determined to be clear. There has been no evidence of tumour recurrence after 1 year. In conclusion, this case illustrates that confocal reflectance microscopy, in conjunction with other in vivo optical instruments, can be utilized to enhance the accuracy for the presurgical margin mapping of LMM.

Aged↗