Histopathologic correlation of high-risk MelaFind lesions: a 3-year experience from a high-risk pigmented lesion clinic.

Background: A significant number of pigmented lesions are biopsied to rule out melanoma, but most will be benign. MelaFind is a highly sensitive, noninvasive computer-assisted system to aid in clinical diagnosis of melanoma.

Methods: A total of 140 high-risk patients were followed by one expert dermatologist.

Mixed Versus Pure Variants of Desmoplastic Melanoma: The Cleveland Clinic Experience.

Background: Desmoplastic melanoma (DM) is a subvariant of spindle cell melanoma, accounting for less than 4% of all cutaneous melanomas. It occurs later in life and is associated with chronic sun exposure. Desmoplastic melanoma prognosis is considered more favorable than other variants, with lower rates of metastasis and higher survival.

Comparison between melanoma gene expression score and fluorescence in situ hybridization for the classification of melanocytic lesions.

Melanoma accounts for most skin cancer-related deaths and has an increasing incidence. Accurate diagnosis and distinction from atypical nevi can be at times difficult using light microscopy alone. Fluorescence in situ hybridization (FISH) and melanoma gene expression score (myPath, Myriad Genetics) have emerged as ancillary tools to further aid in this differential diagnosis.

The Genetic Evolution of Melanoma from Precursor Lesions.

Background: The pathogenic mutations in melanoma have been largely catalogued; however, the order of their occurrence is not known.

Methods: We sequenced 293 cancer-relevant genes in 150 areas of 37 primary melanomas and their adjacent precursor lesions. The histopathological spectrum of these areas included unequivocally benign lesions, intermediate lesions, and intraepidermal or invasive melanomas.

Accuracy in melanoma detection: a 10-year multicenter survey.

Background: Early excision is the only strategy to reduce melanoma mortality, but unnecessary excision of benign lesions increases morbidity and healthcare costs.

Objective: To assess accuracy in melanoma detection based on number-needed-to-excise (NNE) values over a 10-year period.

Methods: Information was retrieved on all histopathologically confirmed cutaneous melanomas or melanocytic nevi that were excised between 1998 and 2007 at participating clinics.

Langerhans cells and melanocytes share similar morphologic features under in vivo reflectance confocal microscopy: a challenge for melanoma diagnosis.

Background: Intraepidermal Langerhans cells (ILC) are difficult to differentiate from melanocytes under reflectance confocal microscopy (RCM) and their presence may simulate pagetoid spread of melanocytes on RCM images.

Objective: We sought to correlate bright round and dendritic cells in a pagetoid pattern identified on RCM with findings of conventional histopathology and immunohistochemistry for lesions that were falsely diagnosed as melanoma by RCM.

Methods: This retrospective study included histopathologically proven nevi, imaged by RCM, which displayed bright cells in a pagetoid pattern (BCPP) under RCM, resulting in the incorrect RCM diagnosis of melanoma.

The impact of physician screening on melanoma detection.

Objective: To compare melanoma characteristics and detection patterns in new vs established patients in a pigmented lesion clinic at Memorial Sloan-Kettering Cancer Center (MSKCC) during a 10-year period.

Design: Single-center historical cohort study.

Setting: Academic practice of 2 dermatologists with expertise in the management of pigmented skin lesions.

Skin cancer prevention educational resources: just a click away?

Background: The general public and health professionals are increasingly choosing the Internet to access skin cancer prevention information.

Objectives: To identify the optimal mechanism for finding skin cancer educational resources through the Internet and to characterize the resources currently available on-line.

Methods: A survey of experts involved in skin cancer prevention, followed by standardized searches through popular general Internet search engines using a list of 10 terms relevant to skin cancer prevention resources.

Sigma 1 receptor modulation of G-protein-coupled receptor signaling: potentiation of opioid transduction independent from receptor binding.

sigma Ligands modulate opioid actions in vivo, with agonists diminishing morphine analgesia and antagonists enhancing the response. Using human BE(2)-C neuroblastoma cells that natively express opioid receptors and human embryonic kidney (HEK) cells transfected with a cloned mu opioid receptor, we now demonstrate a similar modulation of opioid function, as assessed by guanosine 5'-O-(3-[(35)S]thio)triphosphate ([(35)S]GTP gamma S) binding, by sigma(1) receptors. sigma Ligands do not compete opioid receptor binding.

Congenital melanocytic naevi.

Congenital melanocytic naevi, consisting of clusters of naevo-melanocytes, develop in utero. Although many congenital naevi are visible at birth, some may not become evident until later in life. The timing of naevo-melanocyte proliferation, senescence and melanogenesis may all contribute towards determining when a naevus will become clinically manifest on the skin.

Selective potentiation of opioid analgesia by nonsteroidal anti-inflammatory drugs.

Opioids are often used in conjunction with nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of moderate to severe pain. In this study we have examined interactions between these two classes of drugs. NSAIDs are inactive in the radiant heat tail-flick test, an assay of moderate to severe pain in which opioids are effective.