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PloS One 2023Dermoscopy is a safe, rapid, and non-invasive tool that aids in the clinical examination of pigmented and non-pigmented lesions. The upward trend in the use of...
INTRODUCTION
Dermoscopy is a safe, rapid, and non-invasive tool that aids in the clinical examination of pigmented and non-pigmented lesions. The upward trend in the use of dermoscopy can be attributed to the availability of compact hand-held and sophisticated dermoscopes, that are small enough to be carried around in a pocket. The extent of dermoscopy is not only limited to the evaluation of cutaneous lesions but also involves its use in the assessment of mucosal lesions along with lesions of hair and nails.
METHODS
In a descriptive cross-sectional study, subjects (n = 100) with oral or genital mucosal lesions will be enrolled. Following a thorough clinical examination, a dermoscopy of the lesion will be performed with Dermlite DL4© Dermoscope, having a magnification of 10x. Images obtained would be stored and evaluated for observing specific morphologic patterns on dermoscopy which would be utilized to describe those patterns and arrive at a specific diagnosis. Descriptive statistics will include mean and standard deviation to summarise quantitative variation. Dermoscopic features of oral and genital mucosal lesions will be estimated in percentage.
PURPOSE OF STUDY
Mucosal lesions several times mimic each other morphologically. Performing a biopsy is not always feasible for oral and genital lesions because they may be difficult to reach and tend to bleed more profusely compared to the skin surface due to its rich vascular nature. Dermoscopy is a non-invasive tool that helps in the diagnosis that is used mostly for the evaluation of non-mucosal lesions. For the same reason, there is no or minimal information in the published literature with regard to dermoscopic patterns of mucosal lesions. The current study intends to describe dermoscopic patterns in oral and genital mucosal diseases so that this important information would assist the diagnosis in a non-invasive manner thereby reducing the need for invasive investigations like mucosal biopsy.
EXPECTED CLINICAL OUTCOMES
To summarize, this research is intended to add to the scarce literature on dermoscopic findings of oral and genital mucosal lesions. The study findings would establish the diagnosis and eliminate the need for unwarranted invasive biopsies of mucosal lesions and, if need be, help in the selection of the biopsy site.
Topics: Humans; Skin Neoplasms; Cross-Sectional Studies; Dermoscopy; Biopsy; Genitalia
PubMed: 37582080
DOI: 10.1371/journal.pone.0289562 -
Clinical and Experimental Dermatology May 2022Around 70% of cutaneous malignant melanomas (MMs) develop de novo, and small-diameter or 'tiny' lesions are expected to represent the earliest manifestation of most MMs.
BACKGROUND
Around 70% of cutaneous malignant melanomas (MMs) develop de novo, and small-diameter or 'tiny' lesions are expected to represent the earliest manifestation of most MMs.
AIM
To describe the clinical, histopathological and dermoscopic features of tiny MMs, and to investigate the impact of imaging tools, including total body photography (TBP) and sequential digital dermoscopy imaging (SDDI) in their detection.
METHODS
Consecutive MMs diagnosed over 2 years in a referral centre were retrospectively included. Tiny MMs were defined as MMs with a diameter of ≤ 5 mm on dermoscopy. Dermoscopic features and the performance of four imaging methods were evaluated.
RESULTS
Of the 312 MMs included, 86 (27.6%) measured ≤ 5 mm, and 44.2% of these were invasive. Tiny MMs were more frequently excised for being new and/or changing compared with nontiny MMs (77.9% vs. 50.9%; P < 0.001). Half of the tiny MMs would have been missed by the dermoscopic seven-point checklist (48.2%) or the three-point checklist (49.4%), while Menzies' method and the revised pattern analysis correctly identified respectively 65.9% and 63.5% of the tiny MMs. The most frequent positive features for tiny MMs were asymmetry in structure or colour (77.6%), brown dots (65.9%), irregular dots and globules (76.5%) and atypical pigment network (44.7%). Dermoscopic features predictive of invasion in tiny MMs were atypical vascular pattern (OR = 26.5, 95% CI 1.5-475.5, P < 0.01), shiny white lines (OR = 12.4, 95% CI 0.7-237.8, P = 0.04) and grey/blue structures (OR = 3.7, 95% CI 1.3-10.5, P = 0.01).
CONCLUSION
Tiny MMs are frequently invasive and represent a clinical, dermoscopic and histopathological challenge. Dermoscopy alone has suboptimal diagnostic accuracy. Early diagnosis relies on the detection of new or changing lesions aided by TBP and SDDI.
Topics: Dermoscopy; Humans; Melanoma; Research; Retrospective Studies; Skin Neoplasms
PubMed: 34997617
DOI: 10.1111/ced.15094 -
Skin Research and Technology : Official... Mar 2022Melanocytic nevi (MN) can be classified into three subtypes according to the depth of the nests of nevus cells which is important for management. High-frequency...
BACKGROUND
Melanocytic nevi (MN) can be classified into three subtypes according to the depth of the nests of nevus cells which is important for management. High-frequency ultrasound (HF-US) can clearly reveal the lesion size, contour, depth, and internal structures. However, the HF-US studies of MN according to subtypes are limited. We aimed to describe the HF-US features of MN and explore its value in accurate classification.
MATERIALS AND METHODS
This retrospective study was conducted from January 2018 to November 2019. Eighty-five patients with MN were included and examined by 50 and 20 MHz HF-US. The HF-US features were recorded including morphological flatness, depth, shape, boundary, internal echogenicity, hyperechoic spots, lateral acoustic shadow, posterior echoic patterns, mushroom signs, and straw-hat signs. Each image was evaluated by two physicians independently, and the consistency was tested.
RESULTS
Eleven lesions could not be detected by HF-US. The rest 74 lesions underwent ultrasonic analysis. MN appeared as strip-shaped or oval, hypoechoic areas localized in the epidermis and dermis under ultrasonography. A strong consistency between HF-US and dermoscopy of determining the lesion depth was achieved (κ = 0.935, p < 0.001). The hyperechoic spots were found in 57.6% intradermal nevi. The mushroom signs were seen in 34.8% intradermal nevi, and the straw-hat signs were seen in all the compound nevi.
CONCLUSION
MN can be correctly classified using HF-US, and it had a strong correlation with dermoscopic and clinical classification. HF-US could further reveal the internal morphological features of MN, which may support more precise classification and management.
Topics: Dermoscopy; Humans; Melanoma; Nevus, Pigmented; Retrospective Studies; Skin Neoplasms; Ultrasonography
PubMed: 34865255
DOI: 10.1111/srt.13123 -
Journal of Primary Health Care Mar 2020Dermoscopy in primary care enhances clinical diagnoses and allows for risk stratifications. We have compiled 25 recommendations from our experience of dermoscopy in a...
Dermoscopy in primary care enhances clinical diagnoses and allows for risk stratifications. We have compiled 25 recommendations from our experience of dermoscopy in a wide range of clinical settings. The aim of this study is to enhance the application of dermoscopy by primary care clinicians. For primary care physicians commencing dermoscopy, we recommend understanding the aims of dermoscopy, having adequate training, purchasing dermoscopes with polarised and unpolarised views, performing regular maintenance on the equipment, seeking consent, applying contact and close non-contact dermoscopy, maintaining sterility, knowing one algorithm well and learning the rules for special regions such as the face, acral regions and nails. For clinicians already applying dermoscopy, we recommend establishing a platform for storing and retrieving clinical and dermoscopic images; shooting as uncompressed files; applying high magnifications and in-camera improvisations; explaining dermoscopic images to patients and their families; applying toggling; applying scopes with small probes for obscured lesions and lesions in body creases; applying far, non-contact dermoscopy; performing skin manipulations before and during dermoscopy; practising selective dermoscopy if experienced enough; and being aware of compound lesions. For clinicians in academic practice for whom dermatology and dermoscopy are special interests, we recommend acquiring the best hardware available with separate setups for clinical photography and dermoscopy; obtaining oral or written consent from patients for taking and publishing recognisable images; applying extremely high magnifications in search of novel dermoscopic features that are clinically important; applying dermoscopy immediately after local anaesthesia; and further augmenting images to incorporate messages beyond words to readers.
Topics: Algorithms; Dermoscopy; Diagnosis, Differential; Humans; Information Storage and Retrieval; Melanoma; Physical Examination; Primary Health Care; Risk Assessment; Risk Factors; Sensitivity and Specificity; Skin Neoplasms
PubMed: 32223845
DOI: 10.1071/HC19057 -
Postepy Higieny I Medycyny... May 2013Subungual melanoma is a rare, but one of the diagnostically most difficult variants of melanoma. Unfortunately, due to its late detection, lack of an early reaction from... (Review)
Review
UNLABELLED
Subungual melanoma is a rare, but one of the diagnostically most difficult variants of melanoma. Unfortunately, due to its late detection, lack of an early reaction from the patient and diagnosis in advanced stages, subungual melanoma is deemed as a prognostically unfavorable variant of this malignancy. Diagnosis of subungual melanoma is very difficult to establish merely on the basis of clinical examination due to the resemblance of subungual hematoma to melanocytic nevus, fungal or bacterial infections. Dermoscopy seems to be the ideal diagnostic tool in the differential diagnosis of this life-threatening disease.
AIMS
To describe the basic aspects of dermoscopy of subungual melanoma and other conditions involving the nails.
METHODS
Review of medical database PubMed for the literature of the last 10 years on the dermoscopic patterns of subungual melanoma and other subungual diseases.
RESULTS
We collate the fundamental rules of performing dermoscopy in subungual melanoma, as well as basic dermoscopic features and diagnostic algorithms of selected subungual lesions requiring differentiation from melanoma.
CONCLUSIONS
Dermoscopy is a safe, easily repeatable diagnostic method, and the knowledge of basic dermoscopic patterns of developing melanoma in subungual localization, along with the differential diagnosis of other diseases within the nail plate, will help not only dermatologists, but also the professionals of other specialties, such as surgeons, oncologists, orthopedists, and also general practitioners.
Topics: Dermatitis; Dermoscopy; Diagnosis, Differential; Hematoma; Humans; Melanoma; Mycoses; Nail Diseases; Nevus, Pigmented; Skin Neoplasms
PubMed: 23667097
DOI: 10.5604/17322693.1048815 -
PeerJ 2022Reflectance confocal microscopy (RCM), VISIA, and dermoscopy have emerged as promising tools for objective diagnosis and assessment of rosacea. However, little is known...
BACKGROUND
Reflectance confocal microscopy (RCM), VISIA, and dermoscopy have emerged as promising tools for objective diagnosis and assessment of rosacea. However, little is known about the diagnostic value of these imaging systems for rosacea.
OBJECTIVES
To assess the diagnostic value of RCM, VISIA, and dermoscopy for rosacea by establishing a novel multilayer perceptron (MLP) model.
METHODS
A total of 520 patients with rosacea and other facial diseases were included in this study. A total of 474 samples of dermoscopy data, 374 samples of RCM data, 434 samples of VISIA data, and 291 samples containing three data sources were collected. An MLP model was built with the total data to explore the association between the imageological features of each instrument and the probability of rosacea.
RESULTS
Our MLP model revealed that the area under the receiver operating characteristic curve (AUROC) values of RCM, VISIA and dermoscopy for diagnosing rosacea were 0.5233, 0.5646 and 0.7971, respectively. The integration of these three tools with clinical data could further improve the accuracy of the predictive diagnosis to 0.8385. For the imageological features of each tool, abnormalities (hyperkeratosis or parakeratosis) in the stratum corneum were effective variables for excluding rosacea (odds ratio [OR], 0.4333) under RCM. The indicators of rosacea under VISIA included overall severity of erythema, erythema involving the cheek or superciliary arch, visible red blood vessels, and papules (OR = 2.2745, 3.1592, 1.8365, 2.8647, and 1.4260, respectively). The candidate variables of dermoscopy included yellow background, white background, uniform distribution of vessels, branched vessels, and reticular blood vessels (OR = 0.4259, 0.4949, 2.2858, 3.7444, and 2.4576, respectively).
CONCLUSIONS
RCM, dermoscopy, and VISIA each can present several imageological features and were of certain value for assisting rosacea diagnosis. The combined analysis of these three tools using our MLP model may be useful for improving the accuracy of diagnosing rosacea.
Topics: Humans; Skin Neoplasms; Dermoscopy; Rosacea; Erythema; Microscopy, Confocal
PubMed: 35996670
DOI: 10.7717/peerj.13917 -
Canadian Family Physician Medecin de... Jul 2012To assess the diagnostic accuracy and clinical utility of dermoscopy for melanoma detection in family practice. (Review)
Review
OBJECTIVE
To assess the diagnostic accuracy and clinical utility of dermoscopy for melanoma detection in family practice.
QUALITY OF EVIDENCE
Ovid MEDLINE (1946 to June 2011), EMBASE, PubMed, and Cochrane databases were searched using the following terms: dermoscopy, dermatoscopy, epiluminescence microscopy, family practice, general practice, primary health care, melanoma, skin neoplasms, and pigmented nevus. To be included, studies had to be primary research articles with family physicians as the subjects and dermoscopy training and use as the intervention. Four papers met all inclusion criteria and provided level I evidence according to the Canadian Task Force on Preventive Health Care definition.
MAIN MESSAGE
Among family physicians, dermoscopy has higher sensitivity for melanoma detection than naked-eye examination with generally no decrease in specificity. Dermoscopy also helps to increase family physicians' confidence in their preliminary diagnosis of lesions. When using dermoscopy, compared with naked-eye examination, there is a higher likelihood that a lesion assessed as being malignant is in fact malignant and that a lesion assessed as being benign is in fact benign.
CONCLUSION
Dermoscopy has been shown to be a useful and fairly inexpensive tool for melanoma detection in family practice. This technique can increase family physicians' confidence in their referral accuracy to dermatologists and can assist in decreasing unnecessary biopsies. Dermoscopy might be especially useful in examining patients at high risk of melanoma, as the current Canadian clinical practice guideline recommends yearly screening in these individuals.
Topics: Dermoscopy; Family Practice; Humans; Melanoma; Predictive Value of Tests; Sensitivity and Specificity; Skin Neoplasms
PubMed: 22859635
DOI: No ID Found -
Italian Journal of Dermatology and... Apr 2024Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being... (Review)
Review
INTRODUCTION
Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being employed for both tumors and inflammatory diseases. Whereas distinction between neoplastic and inflammatory lesions is often straightforward based on clinical data, there are some scenarios that may be troublesome, e.g., solitary inflammatory lesions or tumors superimposed to a widespread inflammatory condition that may share macroscopic morphological findings.
EVIDENCE ACQUISITION
We reviewed the literature to identify dermoscopic clues to support the differential diagnosis of clinically similar inflammatory and neoplastic skin lesions, also providing the histological background of such dermoscopic points of differentiation.
EVIDENCE SYNTHESIS
Dermoscopic differentiating features were identified for 12 relatively common challenging scenarios, including Bowen's disease and basal cell carcinoma vs. psoriasis and dermatitis, erythroplasia of Queyrat vs. inflammatory balanitis, mammary and extramammary Paget's disease vs. inflammatory mimickers, actinic keratoses vs. discoid lupus erythematosus, squamous cell carcinoma vs. hypertrophic lichen planus and lichen simplex chronicus, actinic cheilitis vs. inflammatory cheilitis, keratoacanthomas vs. prurigo nodularis, nodular lymphomas vs. pseudolymphomas and inflammatory mimickers, mycosis fungoides vs. parapsoriasis and inflammatory mimickers, angiosarcoma vs granuloma faciale, and Kaposi sarcoma vs pseudo-Kaposi.
CONCLUSIONS
Dermoscopy may be of aid in differentiating clinically similar inflammatory and neoplastic skin lesions.
Topics: Dermoscopy; Humans; Diagnosis, Differential; Skin Neoplasms; Dermatitis; Skin Diseases; Psoriasis
PubMed: 38650495
DOI: 10.23736/S2784-8671.24.07825-3 -
Sensors (Basel, Switzerland) Jun 2023Melanoma is a malignant cancer type which develops when DNA damage occurs (mainly due to environmental factors such as ultraviolet rays). Often, melanoma results in...
Melanoma is a malignant cancer type which develops when DNA damage occurs (mainly due to environmental factors such as ultraviolet rays). Often, melanoma results in intense and aggressive cell growth that, if not caught in time, can bring one toward death. Thus, early identification at the initial stage is fundamental to stopping the spread of cancer. In this paper, a ViT-based architecture able to classify melanoma versus non-cancerous lesions is presented. The proposed predictive model is trained and tested on public skin cancer data from the ISIC challenge, and the obtained results are highly promising. Different classifier configurations are considered and analyzed in order to find the most discriminating one. The best one reached an accuracy of 0.948, sensitivity of 0.928, specificity of 0.967, and AUROC of 0.948.
Topics: Humans; Dermoscopy; Melanoma; Skin Neoplasms; DNA Damage
PubMed: 37420843
DOI: 10.3390/s23125677 -
Journal of the American Academy of... Jan 2021
Topics: Administration, Cutaneous; Dermatology; Dermoscopy; Ethanol; Hand Sanitizers; Hemangioma; Humans; Nevus, Pigmented; Photography; Skin; Skin Neoplasms; Smartphone; Telemedicine
PubMed: 32771542
DOI: 10.1016/j.jaad.2020.07.119