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[PMID]: 28954115
[Au] Autor:Volpini BMF; Maia M; Agi J; Vital J; Lellis RF
[Ad] Address:Dermatology Clinic in the Department of Medicine at Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brazil.
[Ti] Title:Synchronous conjunctival melanoma and lentigo maligna melanoma.
[So] Source:An Bras Dermatol;92(4):565-567, 2017 Jul-Aug.
[Is] ISSN:1806-4841
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Lentigo maligna has an extensive and neoplastic character. It typically progresses slowly and may eventually develop into an invasive melanoma, which is called lentigo maligna melanoma. Ocular melanoma is the second most common type of melanoma. The uvea is the most common site of origin of ocular melanomas, while conjunctival melanoma accounts for about 1-5% of cases. In this article, we describe a rare case of synchronic conjunctival melanoma and lentigo maligna on the face.
[Mh] MeSH terms primary: Conjunctiva/pathology
Conjunctival Neoplasms/pathology
Hutchinson´s Melanotic Freckle/pathology
Melanoma/pathology
Neoplasms, Multiple Primary/pathology
Skin Neoplasms/pathology
[Mh] MeSH terms secundary: Aged, 80 and over
Biopsy
Conjunctiva/diagnostic imaging
Conjunctival Neoplasms/diagnostic imaging
Dermoscopy
Face
Female
Humans
Hutchinson's Melanotic Freckle/diagnostic imaging
Male
Melanoma/diagnostic imaging
Neoplasms, Multiple Primary/diagnostic imaging
Skin Neoplasms/diagnostic imaging
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1710
[Cu] Class update date: 171010
[Lr] Last revision date:171010
[Js] Journal subset:IM
[Da] Date of entry for processing:170928
[St] Status:MEDLINE

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[PMID]: 28564685
[Au] Autor:Gómez-Martín I; Moreno S; Andrades-López E; Hernández-Muñoz I; Gallardo F; Barranco C; Pujol RM; Segura S
[Ad] Address:Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Univesitat Autònoma de Barcelona, Barcelona, Spain.
[Ti] Title:Histopathologic and Immunohistochemical Correlates of Confocal Descriptors in Pigmented Facial Macules on Photodamaged Skin.
[So] Source:JAMA Dermatol;153(8):771-780, 2017 Aug 01.
[Is] ISSN:2168-6084
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: Pigmented facial macules on photodamaged skin are a clinical, dermoscopic, and histopathologic challenge. Objectives: To clinically and dermoscopically characterize, by means of reflectance confocal microscopy (RCM), ambiguous pigmented facial macules and establish a correlation between RCM, histopathologic, and immunohistochemical findings. Design, Setting, and Participants: A prospective study of ambiguous pigmented facial macules on photodamaged skin was conducted in a tertiary referral center for dermatology between January 1, 2009, and December 31, 2015. Sixty-one patients with 63 ambiguous pigmented facial macules and 12 control photodamaged facial areas were included in the study. Melanocyte density in 1-mm basal layers was determined in skin biopsy specimens from all lesions stained with hematoxylin-eosin and immunohistochemical markers (melan-A, microphthalmia-associated transcription factor, and SRY-related HMG-box gene 10). Dermoscopic, RCM images, and histopathologic preparations were systematically evaluated for the presence of lentigo maligna (LM) criteria. Confocal evaluation was blinded to clinical and dermoscopic diagnosis. Sensitivity and specificity of RCM for LM diagnosis and κ value to establish correlations between dermoscopy, RCM, and histopathology were performed. Main Outcomes and Measures: Sensitivity and specificity of RCM for LM diagnosis. Results: Of the 61 patients included in the study, 31 (51%) were women; mean (SD) age was 71.8 (13.1) years. Twenty-four of the 63 (38%) lesions were diagnosed as LM or LM melanoma (LMM) and 39 (62%) as benign pigmented lesions. Reflectance confocal microscopy enhanced the diagnosis of pigmented facial macules with 91.7% sensitivity and 86.8% specificity. Multivariate analysis showed 2 dermoscopic and 2 confocal features associated with LM or LMM: (1) asymmetric follicular pigmentation and targetlike structures, and (2) round, large pagetoid cells and follicular localization of atypical cells, respectively. Continuous proliferation of atypical melanocytes was found in 21 (88%) LM or LMM and in 3 (77%) benign lesions. Asymmetric pigmented follicular openings by dermoscopy correlated with follicular localization of pagetoid cells by RCM (κ = 0.499, P < .001). The presence of 3 or more atypical cells at the dermal-epidermal junction (DEJ) by RCM correlated with hyperplasia of melanocytes in hematoxylin-eosin sections (κ = 0.422, P < .001). Conclusions and Relevance: Reflectance confocal microscopy improves LM diagnosis in photodamaged skin with good histopathologic correlation although false-positive and false-negative cases exist. False-positives obtained with RCM in photodamaged skin are due to the presence of basal melanocyte hyperplasia and intraepidermal Langerhans cells. Histopathologic features of these lesions sometimes are not enough for a definite diagnosis and immunohistochemical studies may be required.
[Mh] MeSH terms primary: Dermoscopy/methods
Hutchinson´s Melanotic Freckle/diagnosis
Microscopy, Confocal/methods
Skin Aging/pathology
Skin/pathology
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Biopsy
Face
False Negative Reactions
False Positive Reactions
Female
Humans
Hutchinson's Melanotic Freckle/pathology
Immunohistochemistry
Male
Melanocytes/metabolism
Middle Aged
Prospective Studies
Sensitivity and Specificity
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170822
[Lr] Last revision date:170822
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170601
[St] Status:MEDLINE
[do] DOI:10.1001/jamadermatol.2017.1323

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[PMID]: 28504388
[Au] Autor:Swetter SM
[Ad] Address:Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, 900 Blake Wilbur Drive, W3045, Stanford, CA, 94028, U.S.A.
[Ti] Title:Challenges of treating melanoma in situ, lentigo maligna type: is pathological clearance the gold standard?
[So] Source:Br J Dermatol;176(5):1115-1116, 2017 05.
[Is] ISSN:1365-2133
[Cp] Country of publication:England
[La] Language:eng
[Mh] MeSH terms primary: Hutchinson´s Melanotic Freckle
Melanoma
[Mh] MeSH terms secundary: Humans
Lentigo
Skin Neoplasms
[Pt] Publication type:JOURNAL ARTICLE; COMMENT
[Em] Entry month:1711
[Cu] Class update date: 171107
[Lr] Last revision date:171107
[Js] Journal subset:IM
[Da] Date of entry for processing:170516
[St] Status:MEDLINE
[do] DOI:10.1111/bjd.15512

  4 / 597 MEDLINE  
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[PMID]: 28430732
[Au] Autor:Laimer M; Arzberger E; Kirchner CA; Prodinger C; Hofmann-Wellenhof R; Ahlgrimm-Siess V
[Ad] Address:*Department of Dermatology, Paracelsus Medical University of Salzburg, Salzburg, Austria; †Department of Dermatology, Medical University of Graz, Graz, Austria, Europe.
[Ti] Title:Noninvasive RCM for Differentiation of Melanotic Macules From Melanocytic Lesions-Blinded Evaluation of a Series of 42 Pigmented Macules.
[So] Source:Dermatol Surg;43(7):911-919, 2017 Jul.
[Is] ISSN:1524-4725
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Differentiation of melanotic macules from melanocytic lesions, most importantly of melanoma, is a common problem on clinical-dermoscopic examination. OBJECTIVE: To assess the value of noninvasive reflectance confocal microscopy (RCM) in the differential diagnosis of melanotic macules and melanocytic lesions. PATIENTS AND METHODS: Reflectance confocal microscopy images of 42 pigmented macules on mucocutaneous junctions of genitalia and lips, including 31 melanotic macules, 6 nevi, and 5 melanomas, were retrospectively and independently assessed in a blinded manner by one expert observer and 2 less experienced observers together. RESULTS: The authors differentiated 3 subtypes of melanotic macules; 2 subtypes ("solar lentigo type" and regular subtype of "dendritic type" melanotic macules) could be classified with confidence as benign by all RCM investigators, comprising 64% of melanotic macules. The third subtype (irregular subtype of "dendritic type" melanotic macules; 36%) displaying RCM features overlapping with melanoma was difficult to differentiate and should be biopsied not to miss a melanoma. The RCM differentiation between melanotic macules and nevi was easily performed. CONCLUSION: RCM has the potential to increase the diagnostic accuracy in the noninvasive differentiation of pigmented macules on mucocutaneous junctions.
[Mh] MeSH terms primary: Hutchinson´s Melanotic Freckle/pathology
Melanoma/pathology
Melanosis/pathology
Microscopy, Confocal
Skin Neoplasms/pathology
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Retrospective Studies
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170721
[Lr] Last revision date:170721
[Js] Journal subset:IM
[Da] Date of entry for processing:170422
[St] Status:MEDLINE
[do] DOI:10.1097/DSS.0000000000001110

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[PMID]: 28375969
[Au] Autor:Redondo P; Bernad I; Moreno E; Ivars M
[Ad] Address:*All authors are affiliated with the Department of Dermatology, University Clinic of Navarra, Pamplona, Spain.
[Ti] Title:Elongated Dorsal Nasal Flap to Reconstruct Large Defects of the Nose.
[So] Source:Dermatol Surg;43(8):1036-1041, 2017 Aug.
[Is] ISSN:1524-4725
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The typical reconstructive option for closing large-sized defects of the distal half of the nose is the paramedian forehead flap. Other alternatives are a melolabial interpolation flap and bilobed or trilobed flaps. The dorsal nasal (Rieger) flap is suitable for closing small-sized defects at this location, especially when they are medially located. OBJECTIVE: The authors describe a modified dorsal nasal flap reconstruction for large nasal defects. The novelty of this study lies in lengthening the leading edge of flap rotation, which may provide tissue either from the adjacent nasal skin, the nasofacial groove, or the cheek. MATERIALS AND METHODS: The authors performed a retrospective chart review of all patients with large defects (>20 mm) of the nose who underwent modified dorsal nasal flap repair between January 2004 and March 2015 at a single academic center. RESULTS: Twenty-seven patients (16 male, 11 female; ages 44-88, mean age 62 years) had defects (the smallest 15 × 21 mm, and the largest 32 × 37 mm) on the lower portion of the nasal pyramid. Follow-up ranged from 12 months to 11 years with good or excellent results in all cases. CONCLUSION: Elongated dorsal nasal flap is a reproducible one-stage flap for large defects of the nose, with minimal risk of aesthetic or functional complications.
[Mh] MeSH terms primary: Nose/surgery
Reconstructive Surgical Procedures/methods
Surgical Flaps
[Mh] MeSH terms secundary: Adult
Aged
Carcinoma, Basal Cell/surgery
Carcinoma, Squamous Cell/surgery
Esthetics
Female
Follow-Up Studies
Humans
Hutchinson's Melanotic Freckle/surgery
Male
Middle Aged
Mohs Surgery
Nose Neoplasms/surgery
Retrospective Studies
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170830
[Lr] Last revision date:170830
[Js] Journal subset:IM
[Da] Date of entry for processing:170405
[St] Status:MEDLINE
[do] DOI:10.1097/DSS.0000000000001149

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[PMID]: 28369728
[Au] Autor:Maher NG; Guitera P
[Ad] Address:Melanoma Institute Australia, Sydney, Australia.
[Ti] Title:Imiquimod treatment for lentigo maligna: LIMIT-1 trial.
[So] Source:Br J Dermatol;177(1):324-325, 2017 07.
[Is] ISSN:1365-2133
[Cp] Country of publication:England
[La] Language:eng
[Mh] MeSH terms primary: Aminoquinolines
Hutchinson´s Melanotic Freckle
[Mh] MeSH terms secundary: Antineoplastic Agents
Humans
Lentigo
Skin Neoplasms
[Pt] Publication type:LETTER; COMMENT
[Nm] Name of substance:0 (Aminoquinolines); 0 (Antineoplastic Agents); P1QW714R7M (imiquimod)
[Em] Entry month:1711
[Cu] Class update date: 171107
[Lr] Last revision date:171107
[Js] Journal subset:IM
[Da] Date of entry for processing:170404
[St] Status:MEDLINE
[do] DOI:10.1111/bjd.15511

  7 / 597 MEDLINE  
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[PMID]: 28346250
[Au] Autor:Martínez-Palmer A; Calsina-Prat M; Ormaechea N; Toll A
[Ad] Address:*Department of Ophthalmology, Hospital de l´Espearnça, Parc de Salut Mar, Barcelona, Spain; †Department of Dermatology, Hospital Universitario de Donostia, San Sebastian, Spain; and ‡Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
[Ti] Title:Reconstruction of Combined Upper and Lower Eyelid Defects in a Patient With Lentigo Maligna.
[So] Source:Dermatol Surg;43 Suppl 1:S111-S114, 2017 05.
[Is] ISSN:1524-4725
[Cp] Country of publication:United States
[La] Language:eng
[Mh] MeSH terms primary: Blepharoplasty/methods
Eyelid Neoplasms/surgery
Hutchinson´s Melanotic Freckle/surgery
Skin Neoplasms/surgery
[Mh] MeSH terms secundary: Aged
Eyelid Neoplasms/pathology
Female
Humans
Hutchinson's Melanotic Freckle/pathology
Skin Neoplasms/pathology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171113
[Lr] Last revision date:171113
[Js] Journal subset:IM
[Da] Date of entry for processing:170328
[St] Status:MEDLINE
[do] DOI:10.1097/DSS.0000000000000787

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[PMID]: 28341252
[Au] Autor:Annessi G; Bono R; Abeni D
[Ad] Address:Melanoma Unit, Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Luigi Maria Monti (IRCCS-FLMM), Rome, Italy; Laboratory of Dermatopathology, Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Luigi Maria Monti (IRCCS-FLMM), Rome, Italy. Electronic address: g.annessi@idi.it.
[Ti] Title:Correlation between digital epiluminescence microscopy parameters and histopathological changes in lentigo maligna and solar lentigo: A dermoscopic index for the diagnosis of lentigo maligna.
[So] Source:J Am Acad Dermatol;76(2):234-243, 2017 Feb.
[Is] ISSN:1097-6787
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The clinical and dermoscopic differentiation between lentigo maligna (LM) and solar lentigo (SL)/initial seborrheic keratosis (SK) may be difficult. OBJECTIVE: Our aim was to identify digital epiluminescence microscopy (DELM)-specific criteria that can be helpful in distinguishing LM from SL/SK and to propose a new model of LM dermoscopic progression based on a study of DELM-histopathological correlation. METHODS: A total of 167 consecutive doubtful pigmented lesions of the head (105 LM and 62 SL/SK) were studied. DELM assessment was based on the presence or absence of 15 DELM parameters that were subsequently examined histologically. Statistical analysis was performed to determine which DELM parameters were most strongly associated with LM. RESULTS: The finding of at least 1 of 4 parameters (ie, brown globules, a "necklace" pigment network, an atypical pigment network, and dark-brown/blue-gray ribbonlike structures) showed to be an extremely sensitive (99%) and specific (83.9%) DELM criterion to discriminate between LM and SL/SK. LIMITATIONS: Our findings were obtained by examining medium-high magnification DELM images. CONCLUSIONS: The finding of 1 or more among the 4 above-mentioned DELM parameters allows for the correct identification of 99.0% of the LM lesions, and - when the score is 0 - the correct classification as non-LM, of 83.9% of the SL/SK lesions.
[Mh] MeSH terms primary: Dermoscopy
Head and Neck Neoplasms/diagnostic imaging
Hutchinson´s Melanotic Freckle/diagnostic imaging
Keratosis, Seborrheic/diagnostic imaging
Skin Neoplasms/diagnostic imaging
[Mh] MeSH terms secundary: Aged
Dermoscopy/methods
Diagnosis, Differential
Female
Head and Neck Neoplasms/pathology
Humans
Hutchinson's Melanotic Freckle/pathology
Keratosis, Seborrheic/pathology
Male
Skin Neoplasms/pathology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170419
[Lr] Last revision date:170419
[Js] Journal subset:IM
[Da] Date of entry for processing:170326
[St] Status:MEDLINE

  9 / 597 MEDLINE  
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[PMID]: 28296789
[Au] Autor:Connolly KL; Hibler BP; Lee EH; Rossi AM; Busam KJ; Nehal KS
[Ad] Address:*Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; †Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
[Ti] Title:Locally Recurrent Lentigo Maligna and Lentigo Maligna Melanoma: Characteristics and Time to Recurrence After Surgery.
[So] Source:Dermatol Surg;43(6):792-797, 2017 Jun.
[Is] ISSN:1524-4725
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Various studies have reported local recurrence (LR) rates after surgical treatment of lentigo maligna (LM) and lentigo maligna melanoma (LMM). However, the time to LR of LM/LMM is not currently known, as few studies report time to LR and have long-term follow-up. OBJECTIVE: To define time to LR in LM/LMM after surgical treatment, and to describe features of observed LR. MATERIALS AND METHODS: Retrospective single-center study of consecutive patients presenting with locally recurrent LM/LMM. RESULTS: Six hundred forty-nine cases of LM/LMM were reviewed; 29 (21 LM, and 8 LMM) of 41 locally recurrent cases had original histology reports and were included. The mean time to LR was 57.5 months (range 7-194). For cases presenting as primary LM, LR was also in situ in 14/21 (67%) of cases. Seven of 21 LM recurred as LMM. Of the 8 primary LMM, 3/8 (37.5%) presented with subsequent LMM and all were slightly deeper on re-excision. CONCLUSION: The mean time to LR of LM/LMM is at least 57.5 months, underscoring the importance of long-term follow-up. Seven of 21 LM recurred as invasive disease, but the lack of development of LMM from LM in most recurrent cases confirms LM is slowly progressive.
[Mh] MeSH terms primary: Hutchinson´s Melanotic Freckle/pathology
Hutchinson´s Melanotic Freckle/surgery
Neoplasm Recurrence, Local/pathology
Skin Neoplasms/pathology
Skin Neoplasms/surgery
[Mh] MeSH terms secundary: Aged
Female
Humans
Hutchinson's Melanotic Freckle/epidemiology
Male
Neoplasm Recurrence, Local/epidemiology
Retrospective Studies
Skin Neoplasms/epidemiology
Time Factors
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170721
[Lr] Last revision date:170721
[Js] Journal subset:IM
[Da] Date of entry for processing:170316
[St] Status:MEDLINE
[do] DOI:10.1097/DSS.0000000000001118

  10 / 597 MEDLINE  
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[PMID]: 28224656
[Au] Autor:Hawkey S; Affleck A
[Ad] Address:University of Dundee School of Medicine, Dundee, UK.
[Ti] Title:Diagnosis and management of lentigo maligna: an observational study comparing 2005 with 2014 data in one institution.
[So] Source:Clin Exp Dermatol;42(3):320-323, 2017 Apr.
[Is] ISSN:1365-2230
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The incidence, clinical characteristics and management of lentigo maligna (LM) were assessed in a university hospital setting in 2005 and 2014. Multiple clinical variables were compared, and 28 and 43 cases, respectively were identified during the two time periods. The most common site of presentation was the cheek (50% vs. 44%), and an accurate clinical diagnosis of LM was made in 60% vs. 72%) of cases. Most of the patients received surgical treatment (75% in 2005 vs. 97% in 2014), with 47% and 33% of excisions, respectively, remaining involved at the peripheral surgical margin. During the 10-year follow-up for the 2005 cohort, 7 of the 28 patients had recurrence (3 of whom already had previously involved margins following surgery). This study shows that making an accurate clinical diagnosis of LM remains a significant challenge. Although surgery has become the preferred management option, achieving clear excision remains difficult, with involved margins increasing the risk of local recurrence and need for further intervention.
[Mh] MeSH terms primary: Hutchinson´s Melanotic Freckle
Skin Neoplasms
[Mh] MeSH terms secundary: Adult
Aminoquinolines/therapeutic use
Antineoplastic Agents/therapeutic use
Female
Hospitals, University/statistics & numerical data
Humans
Hutchinson's Melanotic Freckle/diagnosis
Hutchinson's Melanotic Freckle/epidemiology
Hutchinson's Melanotic Freckle/therapy
Incidence
Male
Middle Aged
Radiotherapy/methods
Retrospective Studies
Skin Neoplasms/diagnosis
Skin Neoplasms/epidemiology
Skin Neoplasms/therapy
Surgical Procedures, Operative
Watchful Waiting
[Pt] Publication type:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Name of substance:0 (Aminoquinolines); 0 (Antineoplastic Agents); P1QW714R7M (imiquimod)
[Em] Entry month:1710
[Cu] Class update date: 171013
[Lr] Last revision date:171013
[Js] Journal subset:IM
[Da] Date of entry for processing:170223
[St] Status:MEDLINE
[do] DOI:10.1111/ced.13057


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