Changes in the presentation of nodular and superficial spreading melanomas over 35 years.

Background: Nodular melanoma (NM) may be biologically aggressive compared with the more common superficial spreading melanoma (SSM), with recent data suggesting underlying genetic differences between these 2 subtypes. To better define the clinical behavior of NMs, the authors compared their clinical and histopathologic features to those of SSMs at their institution, a tertiary referral center, over 3 decades.

Methods: A total of 1,684 patients diagnosed with 1,734 melanomas were prospectively enrolled.

Differences in dermoscopic images from nonpolarized dermoscope and polarized dermoscope influence the diagnostic accuracy and confidence level: a pilot study.

Background: Studies have demonstrated differences in colors and dermoscopic structures observed with polarized dermoscopes (PDs) and nonpolarized dermoscopes (NPDs).

Objective: The objective was to evaluate whether diagnosis and diagnostic confidence changes when viewing dermoscopic images from NPDs and PDs.

Methods: A total of 100 dermatologists participated in the study.

The diagnostic performance of expert dermoscopists vs a computer-vision system on small-diameter melanomas.

Objective: To evaluate the performance of dermoscopists in diagnosing small pigmented skin lesions (diameter
Design: Blinded comparison study.

Setting: Dermatologic hospital-based clinics and private practice offices.

Utility of lesion diameter in the clinical diagnosis of cutaneous melanoma.

Objective: To determine the utility of the current diameter criterion of larger than 6 mm of the ABCDE acronym for the early diagnosis of cutaneous melanoma.

Design: Cohort study.

Setting: Dermatology hospital-based clinics and community practice offices.

The CASH (color, architecture, symmetry, and homogeneity) algorithm for dermoscopy.

Background: The color, architecture, symmetry, and homogeneity (CASH) algorithm for dermoscopy includes a feature not used in prior algorithms, namely, architecture. Architectural order/disorder is derived from current concepts regarding the biology of benign versus malignant melanocytic neoplasms.

Objective: We sought to evaluate the accuracy of the CASH algorithm.

"Fat fingers:" a clue in the dermoscopic diagnosis of seborrheic keratoses.

"Fat fingers" are thick digitate linear, curvilinear, branched, or oval/circular dermoscopic structures typically seen in seborrheic keratoses where they represent the gyri of their cerebriform surfaces. Their recognition is very useful in the diagnosis of these lesions, especially when the classic features (eg, milia, comedo-like openings) are absent. Histologically and by confocal microscopy the "fat finger" gyri are accentuated by pigmented keratin filling the sulci.

Level of confidence in diagnosis: clinical examination versus dermoscopy examination.

Background: Confidence is an important factor in decision making and may influence patient care.

Objectives: To evaluate whether short-training-based dermoscopy increases confidence in the diagnosis of skin lesions.

Methods And Materials: After a 1-hour course on dermoscopy, 20 pairs of clinical and dermoscopic images of lesions were presented to 19 dermatology residents with little or no dermoscopy experience.

Dermoscopy of pigmented skin lesions.

Dermoscopy is an in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented lesions of the skin. It has been shown to increase diagnostic accuracy over clinical visual inspection in the hands of experienced physicians. This article is a review of the principles of dermoscopy as well as recent technological developments.

Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria.

Context: The incidence of cutaneous melanoma has increased over the past several decades, making its early diagnosis a continuing public health priority. The ABCD (Asymmetry, Border irregularity, Color variegation, Diameter >6 mm) acronym for the appraisal of cutaneous pigmented lesions was devised in 1985 and has been widely adopted but requires reexamination in light of recent data regarding the existence of small-diameter (< or =6 mm) melanomas.

Evidence Acquisition: Cochrane Library and PubMed searches for the period 1980-2004 were conducted using search terms ABCD and melanoma and small-diameter melanoma.

Current technologies for the in vivo diagnosis of cutaneous melanomas.

The rising incidence of cutaneous malignant melanoma has been observed in the past decades. Currently, there is no cure for metastatic melanoma; only early diagnosis followed by prompt excision of cutaneous lesions ensures a good prognosis. The clinical ABCD rule is created as a framework for differentiating melanomas from benign pigmented skin lesions, and it serves as the basis for current clinical diagnosis.

Detection of melanomas in patients followed up with total cutaneous examinations, total cutaneous photography, and dermoscopy.

Background: Many factors have been identified as important determinants that increase the risk of malignant melanoma (MM) developing. Patients with classic atypical mole syndrome (CAMS) have multiple such factors and are known to be at high risk for MMs developing.

Objective: We sought to evaluate the risk for newly diagnosed MMs developing in patients with CAMS and in a heterogeneous group of patients at high risk (ie, those with high-risk non-CAMS [HRNCAMS]) who had 1 or more risk factors: personal history of nonmelanoma skin cancers; family history of melanoma; biopsy specimen-confirmed dysplastic nevi; and meeting 1 or 2 of the 3 CAMS criteria.

Instruments and new technologies for the in vivo diagnosis of melanoma.

The principal objective of screening individuals at risk for melanoma is detection of cutaneous melanoma during the curable stages of its early evolution. Unaided visual inspection of the skin is often suboptimal at diagnosing melanoma. Improving the diagnostic accuracy for melanoma remains an area of active research.

Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet.

Background: There is a need for better standardization of the dermoscopic terminology in assessing pigmented skin lesions.

Objective: The virtual Consensus Net Meeting on Dermoscopy was organized to investigate reproducibility and validity of the various features and diagnostic algorithms.

Methods: Dermoscopic images of 108 lesions were evaluated via the Internet by 40 experienced dermoscopists using a 2-step diagnostic procedure.

Dermoscopy of pigmented seborrheic keratosis: a morphological study.

Objectives: To describe morphological features of seborrheic keratosis as seen by dermoscopy and to investigate their prevalence.

Design: Prospective cohort study using macrophotography and dermoscopy for the documentation of seborrheic keratosis.

Settings: Seborrheic keratoses were prospectively collected in 2 sites: a private practice in Plantation, Fla (site 1), and the Department of Dermatology at the University Hospital Geneva in Switzerland (site 2).

HDM2 protein overexpression and prognosis in primary malignant melanoma.

Overexpression of the oncogene HDM2 is observed in a substantial proportion of melanomas, including noninvasive and thin lesions, suggesting that HDM2 overexpression may be an early event in melanocyte transformation. To determine the role of HDM2 in the clinical progression of melanoma, we examined whether its expression was associated with patient survival. From November 1972 through November 1982, 134 patients with melanoma who participated in the New York University Melanoma Cooperative Group were studied, if representative tissues and follow-up were available.