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Results for “Dermoscopy”

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At least 307 records · Page 17Linked to original sources

PubMed2006

Dermoscopic findings of haemosiderotic and aneurysmal dermatofibroma: report of six patients.

BACKGROUND: The clinical diagnosis of dermatofibroma is commonly easy. However, the differentiation of dermatofibroma from other cutaneous tumours is difficult in some instances, primarily in atypical cases and rare variants. Haemosiderotic dermatofibroma is a variant composed of numerous small vessels, extravasated erythrocytes and intra- and extracellular haemosiderin deposits. Aneurysmal dermatofibroma is a variant composed of large, blood-filled spaces without endothelial lining. Some authors consider that haemosiderotic dermatofibroma is an early stage in the development of aneurysmal dermatofibroma. The clinical differential diagnosis of haemosiderotic or aneurysmal dermatofibroma must include melanoma and other melanocytic tumours, vascular neoplasms, adnexal tumours and nonspecific cysts. Dermoscopy improves the diagnostic accuracy in pigmented and nonpigmented skin lesions. OBJECTIVES: To evaluate specific dermoscopic criteria. METHODS: Dermoscopic examination (using the DermLite Foto; 3Gen, LLC, Dana Point, CA, U.S.A.) of six patients with haemosiderotic or aneurysmal dermatofibromas was performed to evaluate specific dermoscopic criteria. RESULTS: A multicomponent pattern with a central bluish or reddish homogeneous area in combination with white structures and a peripheral delicate pigment network along with vascular structures was noted in five of six lesions. CONCLUSIONS: This dermoscopic pattern yielded the diagnosis of haemosiderotic or aneurysmal dermatofibroma in most cases. However, this multicomponent pattern may present in some melanomas and although it is useful in determining a clinical diagnosis of aneurysmal dermatofibroma, it may not be specific to this entity.

Adult↗

PubMed2006

Dermoscopic findings in pyogenic granuloma.

BACKGROUND: To the best of our knowledge, no specific dermoscopic criteria have been described in the medical literature for the diagnosis of pyogenic granuloma. OBJECTIVES: To evaluate the morphological findings of pyogenic granuloma under dermoscopic observation. METHODS: Dermoscopic examination (using the DermLite Foto; 3Gen, LLC, Dana Point, CA, U.S.A.) of 13 patients with pyogenic granulomas was performed to evaluate specific dermoscopic criteria. RESULTS: The most frequently occurring dermoscopic features were found to be: reddish homogeneous area (92%), white collarette (85%), "white rail" lines that intersect the lesion (31%) and ulceration (46%). The results of our study reveal that the absence of specific dermoscopic criteria for other skin tumours and a reddish homogeneous area surrounded by a white collarette are the most frequent dermoscopic pattern in pyogenic granulomas (85%). CONCLUSIONS: Dermoscopy is a useful tool for improving the recognition of pyogenic granuloma.

Adolescent↗

PubMed2006

Dermoscopic examination of the nail bed and matrix.

Abstract Background Dermoscopy has furthered advances in the differential diagnosis of longitudinal melanonychia; however, fewer details observed in the nail, as compared to skin lesions, make interpretation difficult. Methods Ten cases of longitudinal melancholia, from several etiologies, were submitted to direct dermoscopic examination of the nail bed and matrix. Results We observed the presence of globules, streaks, and pigment network in the nail bed and matrix, which are dermoscopic features not seen in the nail plate. Conclusions This procedure enables visualization of dermascopic features not seen in the nail plate, making the diagnosis of melanocytic lesions easier.

Adolescent↗

PubMed2006

Features of regression in dermoscopic diagnosis: a confounding factor? Two clinical, dermoscopic-pathologic case studies.

BACKGROUND: In dermoscopy, the presence of regression areas is generally associated with melanocytic lesions and is often considered a clue of malignancy. However, some lesions included in the differential diagnosis of melanoma may show dermoscopic regression parameters. Regression may indeed be one of the most confounding dermoscopic parameters because it tends to cover, or rather to destroy, other parameters, thus often hindering a correct diagnosis. OBJECTIVE: We propose to raise the issue of the actual diagnostic role of this parameter. METHODS: We discuss two clinical cases (melanoma and basal cell carcinoma) with major dermoscopic regression features. CONCLUSION: Dermoscopic regression parameters should not be regarded as almost pathognomonic signs of melanocytic lesions. Rather, they should be taken into account only after having considered other dermoscopic parameters of greater diagnostic significance and just as signs that may better typify the lesion.

Aged↗

PubMed2006

Dermoscopic features of cutaneous lymphangioma circumscriptum.

BACKGROUND: Cutaneous lymphangioma circumscriptum (CLC) is clinically characterized by clusters of translucent vesicles that may be filled by blood. OBJECTIVE: To evaluate the dermoscopic features of CLC. MATERIALS AND METHODS: Dermoscopic examination was performed in two cases presenting with discrete translucent and blood-tinged lesions. RESULTS: Lesions filled with clear fluid were dermoscopically characterized by light brown lacunas surrounded by paler septa. Lesions tinged with blood were associated with different dermoscopic features depending on the amount of blood content: focal reddish areas inside the lagoons, pink diffuse coloration, reddish to violaceous lacunar structures. CONCLUSIONS: On dermoscopy, CLC was characterized by a lacunar pattern. Lesions with a marked hematic content show dermoscopic findings indistinguishable from those of hemangioma.

Adolescent↗

PubMed2006

Cutaneous metastatic breast carcinoma with melanocyte colonization: a clinical and dermoscopic mimic of malignant melanoma.

BACKGROUND: Melanocyte colonization of breast carcinoma cells may occur in those tumors that breach the epidermal-dermal interface. The resultant melanin deposition in tumor cells rarely leads to clinical pigmentation of the tumor. Typically, selective staining methods are required to detect the pigment. OBSERVATION: The authors describe a 60-year-old woman with a history of mammary carcinoma and an irregularly pigmented nodule with peripheral globules and a blue-white veil on dermoscopy, which was a clinical and dermoscopic mimic of malignant melanoma. CONCLUSIONS: Awareness of melanocyte colonization of non-melanocytic tumor cells and the dermoscopic-histologic correlations can aid in avoiding a potential pitfall, and emphasize the importance of such relationships, when using this tool.

Adenocarcinoma↗

PubMed2006

Blue-whitish veil-like structure as the primary dermoscopic feature of combined nevus.

The combined nevus is a clinical simulator of melanoma, and clinical examination alone can be inadequate to diagnose this melanocytic pigmented skin lesion. Dermoscopy is a useful tool to differentiate the features related to each type of nevus. We report two cases of combined nevi dermoscopically characterized by a diffuse blue-whitish pigmentation similar to the blue-whitish veil, suggesting the diagnosis of melanoma.

Adolescent↗

PubMed2004

Diagnosis and categorization of acral melanocytic lesions using teledermoscopy.

We performed a multicentre study to test the validity of teledermoscopy for diagnosing acral melanoma and to evaluate inter-observer agreement on the classification of acral melanocytic lesions. Dermoscopic images of 77 acral melanocytic lesions (71 common melanocytic naevi and 6 melanomas) were sent by email to 11 dermatologists with different degrees of experience in dermoscopy. The observers analysed the images on a computer monitor to diagnose acral melanoma or atypical lesions and to categorize all lesions. All 11 observers, regardless of their degree of experience, obtained high values for sensitivity (mean 0.91, SD 0.09) and specificity (mean 0.95, SD 0.04) with regard to the diagnosis of melanoma. The inter-observer agreement was good to excellent (kappa 0.49-0.88) for the categorization of acral melanocytic lesions. All six melanomas were correctly classified as 'atypical pattern' and all observers recommended surgical excision. Teledermoscopy represents a useful tool for the diagnosis of acral melanoma and for the categorization of patterns that suggest benign or potentially malignant acral melanocytic lesions.

Adolescent↗

PubMed2006

Asymmetry in dermoscopic melanocytic lesion images: a computer description based on colour distribution.

Digital dermoscopy improves the accuracy of melanoma diagnosis. The aim of this study was to develop and validate software for assessment of asymmetry in melanocytic lesion images, based on evaluation of colour symmetry, and to compare it with assessment by human observers. An image analysis program enabling numerical assessment of asymmetry in melanocytic lesions, based on the evaluation and comparison of CIE L*a*b* colour components (CIE L*a*b* is the name of a colour space defined by the Commission Internationale de l'Eclairage) inside image colour blocks, was employed on the recorded lesion images. Clinical evaluation of asymmetry in dermoscopic images was performed on the same image set employing a 0-1 scoring system. Asymmetry judgement was expressed by the clinicians for 12.8% of benign naevi, 44.7% of atypical naevi and 64.2% of malignant melanomas, whereas the computer identified as asymmetric 6.3%, 33.3% and 82.2%, respectively. Numerical parameters referring to malignant melanomas were significantly higher, both with respect to benign naevi and atypical naevi. The numerical parameters produced could be effectively employed for computer-aided melanoma diagnosis.

Databases as Topic↗

PubMedDate not supplied

Highlighting the rim of the perifollicular epidermal unit.

The perifollicular and interfollicular areas of normal skin may look similar. However, some physiological and pathological processes may specifically involve a thin perifollicular rim. This review illustrates some of the methods available for highlighting the rim of the perifollicular epidermal unit. Non invasive methods rely on dermoscopy, ultraviolet light enhanced visualization (ULEV), skin capacitance imaging and cyanoacrylate skin surface strippings (CSSS). Conventional histology and immunohistochemistry may also show specific perifollicular features without, however, revealing the aspects highlighted by the specific non invasive methods. The clinically relevant modifications consist of pigmentary and hyperkeratotic perifollicular changes.

Dermoscopy↗

PubMed2000

Surface microscopy of pigmented basal cell carcinoma.

OBJECTIVES: To describe the relevant morphologic features and to create a simple diagnostic method for pigmented basal cell carcinoma (BCC) using in vivo cutaneous surface microscopy (ie, dermoscopy, dermatoscopy, or oil epiluminescence microscopy). DESIGN: Pigmented skin lesions were photographed in vivo using immersion oil (surface microscopy). All pigmented skin lesions were excised and reviewed for histological diagnosis. Photographs of 142 pigmented BCCs, 142 invasive melanomas, and 142 benign pigmented skin lesions were randomly divided into 2 equally sized training and test sets. Images from the training set were scored for 45 surface microscopy features. From this a model was derived and tested on the independent test set. SETTING: All patients were recruited from the primary case and referral centers of the Sydney Melanoma Unit, Sydney, Australia, and the Skin and Cancer Unit, Skin and Cancer Associates, Plantation, Fla. PATIENTS: A random sample (selected from a larger database) of patients whose lesions were excised. MAIN OUTCOME MEASURES: Sensitivity and specificity of the model for diagnosis of pigmented BCCs. RESULTS: The following model was created. For a pigmented BCC to be diagnosed it must not have the negative feature of a pigment network and must have 1 or more of the following 6 positive features: large gray-blue ovoid nests, multiple gray-blue globules, maple leaflike areas, spoke wheel areas, ulceration, and arborizing "treelike" telangiectasia. On an independent test set the model had a sensitivity of 97% for the diagnosis of pigmented BCCs and a specificity of 93% for the invasive melanoma set and 92% for the benign pigmented skin lesion set. CONCLUSION: A robust surface microscopy method is described that allows the diagnosis of pigmented BCCs from invasive melanomas and benign pigmented skin lesions. Arch Dermatol. 2000;136:1012-1016

Basal Cell Carcinoma↗

PubMed2001

Short-term digital surface microscopic monitoring of atypical or changing melanocytic lesions.

OBJECTIVE: To examine the outcome of short-term digital surface microscopic monitoring of suspicious or changing atypical melanocytic lesions. DESIGN: Digital surface microscopic (oil epiluminescence microscopy, and dermoscopy) images of clinically melanocytic lesions were taken with a color calibrated 3 CCD video instrument. In general, lesions were moderately atypical, flat or only slightly raised, without a history of change or surface microscopic evidence of melanoma, or were mildly atypical lesions with a history of change. Lesions were monitored during a 2.5- to 4.5-month period (median, 3.0 months). With the exception of overall change in pigmentation consistent with that seen in surrounding skin (solar exposure changes), any morphologic change after monitoring was considered an indication to excise. SETTING: Sydney Melanoma Unit, Sydney, Australia (a referral center). PATIENTS: A consecutive sample of 318 lesions from 245 patients (aged 4-81 years). MAIN OUTCOME MEASURE: Specificity for the diagnosis of melanoma. RESULTS: Of the 318 lesions, 81% remained unchanged. Of the 61 lesions that showed morphologic changes, 7 (11% of changed and 2% of total lesions) were found to be early melanoma (5 in situ and 2 invasive with a Breslow thickness of 0.25 mm and 0.28 mm, respectively). None of these melanomas developed any classic surface microscopic features of melanoma and therefore could be identified only by morphologic change. The specificity for the diagnosis of melanoma by means of short-term digital monitoring was 83%. CONCLUSION: On the assumption that all melanoma will change during the monitored period, surface microscopy digital monitoring is a useful adjunct for the management of melanocytic lesions.

Adolescent↗

PubMed2002

Dermoscopic examination of nail pigmentation.

BACKGROUND: Diagnosis of longitudinal melanonychia is usually difficult, and neither a single clinical criterion nor a combination of symptoms currently can be used to clearly distinguish malignant from benign bandlike pigmented nail lesions. Biopsy is painful and often leaves definitive dystrophic scars. OBJECTIVES: To describe and evaluate dermoscopic patterns associated with longitudinal nail pigmentation. PATIENTS AND METHODS: A total of 148 unselected consecutive cases of longitudinal melanonychia were included over a period of 4 years (20 melanoma, 37 nevi, 16 drug-induced nail pigmentation, 45 nail apparatus lentigo of various types, 8 ethnic-type nail pigmentation, and 22 subungual hemorrhages). All patients were recruited from the dermatology unit outpatient clinic of the Hôtel Dieu de Lyon. All cases were photographed in vivo under oil immersion (dermoscopy). Patterns were recorded prior to final pathologic diagnosis. An independent biostatistics unit performed statistical evaluation using 7 semiologic patterns. RESULTS: Melanoma cases were significantly associated with a brown coloration of the background and the presence of irregular longitudinal lines (P =.001). Blood spots were mostly observed in subungual hemorrhages (P =.001); however, their presence could not rule out melanoma. Micro-Hutchinson sign was observed only in melanoma, but its rare occurrence did not allow any statistical evaluation of its specificity. Nail apparatus nevi were significantly associated with a brown coloration of the background and the presence of regular lines (P =.001). Nail apparatus lentigo, ethnic-type pigmentation, and drug-induced pigmentation were significantly associated with homogeneous longitudinal thin gray lines and gray coloration of the background (P =.001). Microscopic longitudinal grooves were unspecific, occurred in several conditions, and were associated with any type of ungual discoloration. CONCLUSIONS: We believe that dermoscopic examination of the nail plate in cases of longitudinal melanonychia provides useful information that could help clinicians to more accurately decide if a nail apparatus biopsy should be performed; however, histopathologic diagnosis remains the gold standard in doubtful cases.

Adult↗

PubMed2004

Significance of dermoscopic patterns in detecting malignant melanoma on acral volar skin: results of a multicenter study in Japan.

OBJECTIVE: To determine diagnostic variables such as sensitivity and specificity of the major dermoscopic patterns observed in melanocytic lesions on acral volar skin, with particular attention to the significance of the parallel ridge pattern and irregular diffuse pigmentation in detecting acral melanoma. DESIGN: Multicenter, retrospective study. SETTING: University hospitals in Japan. PATIENTS: Patients with melanocytic lesions on acral volar skin. A total of 712 melanocytic lesions (103 malignant melanomas, including 36 in situ lesions, and 609 melanocytic nevi) were consecutively collected from the files of 3 hospitals. Diagnoses of all the lesions had been determined histopathologically. INTERVENTIONS: Dermoscopic examination. MAIN OUTCOME MEASURES: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the major dermoscopic patterns seen in benign and malignant melanocytic lesions on acral volar skin. RESULTS: The parallel ridge pattern and irregular diffuse pigmentation showed extremely high specificity (99.0% and 96.6%, respectively) and very high negative predictive value (97.7% and 97.5%, respectively) in malignant melanoma. For melanoma in situ, the positive predictive value and diagnostic accuracy of the parallel ridge pattern were significantly higher than those of irregular diffuse pigmentation (P = .009 and P = .006, respectively). In melanocytic nevi, the specificity and positive predictive value of the parallel furrow pattern and/or the latticelike pattern were found to be very high (93.2% and 98.3%, respectively). CONCLUSIONS: Dermoscopy is immensely helpful in differentiating malignant melanomas from melanocytic nevi on acral volar skin. Moreover, the parallel ridge pattern aids in detecting acral melanomas in early, curable stages.

Adult↗

PubMed2004

Use of digital epiluminescence microscopy to help define the edge of lentigo maligna.

OBJECTIVE: To compare identification of the border of lentigo maligna (LM) with digital epiluminescence microscopy (DELM) with clinical and Wood light assessment. DESIGN: The borders of lesions identified clinically with the Wood light, with DELM, and after excision by Mohs micrographic surgery were traced onto plastic sheets. The borders defined on the tracings were compared for congruence and mean surface area. SETTING: Cardinal Bernardin Cancer Center for Skin Cancer, Loyola University Health System, Maywood, Ill. PATIENTS: Twenty-six consecutive patients with LM of the head and neck. MAIN OUTCOME MEASURES: Results of the comparison of the outlines of the borders and the mean surface area identified by the 4 methods. RESULTS: The border determined by clinical examination was smaller than that determined with the Wood lamp or by DELM. Most lesions underwent an additional excision 5 mm beyond the DELM-defined border. The DELM pattern of LM with asymmetric follicular openings and dark brown rhomboidal structures changed at the periphery and became a pigmented thin mesh that was associated with the histopathological features of melanoma in situ. More homogeneous pigmented areas extending from the LM were associated with the pathologic features of melanocytic hyperplasia. CONCLUSIONS: Visualization of LM by DELM (dermoscopy) helps to guide resection. Because LM arises in sun-damaged skin with melanocytic hyperplasia, determining the tumor-free margin requires the judgment of an experienced physician.

Adult↗

PubMed2005

National appraisal of dermatology residency training: a Canadian study.

OBJECTIVES: To provide the first comprehensive assessment of dermatology residency training in Canada based on the residents' perspective; to examine and elucidate trends in current residents' envisioned career paths and aspirations. DESIGN: A national survey conducted in June 2004. PARTICIPANTS: All Canadian dermatology residents. MAIN OUTCOME MEASURES: Cross-sectional analysis of (1) satisfaction with and importance placed by the trainees on the various curriculum components as measured by a 5-point Likert-type scale and (2) current residents' career and practice plans. RESULTS: One hundred percent of dermatology residents across the country (n = 48) responded to the survey. The greatest discrepancies between ranked importance and corresponding satisfaction were observed for the teaching from faculty (both didactic and clinic based) and for the practice management exposure and training. Residents were most satisfied with dermatopathology education (score, 4.4 of 5.0) and least satisfied with cosmetic dermatology (2.7 of 5.0) and dermoscopy training (2.8 of 5.0). Men indicated more interest than women in academics (71% [n = 12] vs 45% [n = 14]), research (41% [n = 7] vs 16% [n = 5]), and teaching (71% [n = 12] vs 42% [n = 13]), while female residents were more inclined toward pediatric dermatology (42% [n = 13] vs 29% [n = 5]) and cosmetic dermatology (48% [n = 15] vs 29% [n = 5]). An overall trend of decreased interest in academic and hospital-based practice was noted with progression through residency training. CONCLUSIONS: This study provides a current picture of dermatology postgraduate education in Canada from the residents' perspective. Above all, dermatology residents desire more teaching (clinic, didactic, and practice management) and mentorship from their faculty. Recruitment and retention of women in academic dermatology may benefit from early intervention during residency. The data are intended to assist dermatology programs with development, evaluation, and improvement of their curricula and can serve as a reference point to gauge future trends.

Attitude of Health Personnel↗

PubMed1995

Techniques of cutaneous examination for the detection of skin cancer.

Skin cancers are the most common cancers in humans. The American Cancer Society estimates that in the United States more than 700,000 new skin cancers are diagnosed annually. Although the majority of nonmelanoma skin cancers occur on visibly exposed anatomic areas, most malignant melanomas occur on body sites obscured by clothing. The high mortality associated with advanced melanomas emphasizes the importance of performing regular total cutaneous examinations in all patients to detect early, easily curable lesions. A number of techniques aid in these examinations: (1) physical and psychologic preparation of the patient; (2) appropriate lighting and a suitable examination table; (3) when indicated, use of Wood's light, dermoscopy, and photography. In addition, any suspicious lesion should be biopsied promptly either in parte or in toto. Lastly, the patient should be educated about the signs and symptoms of skin cancer, the role of sunlight in causing skin cancer, and the need for sun avoidance and/or protection. By heightening public awareness of the high incidence of cancers of the skin and by emphasizing the need for routine examination of the entire cutaneous surface, most cutaneous malignancies can be diagnosed early when they can be cured by simple surgical procedures.

Biopsy↗

PubMed2006

In vivo confocal scanning laser microscopy in dermatology.

The need to improve the diagnostic accuracy and sensitivity for skin tumours has led to the development of new non-invasive, in vivo techniques including ultrasound, dermoscopy, digital photography, confocal scanning laser microscopy, magnetic resonance imaging and optical coherence tomography. Of all these in vivo techniques, only confocal scanning laser microscopy allows for the examination of the epidermis and papillary dermis at a resolution approaching histological detail. This review article looks at some of the most important applications of this new technology, highlighting its qualities and limitations.

Dermatology↗