Accuracy and confidence in the clinical diagnosis of basal cell cancer using dermoscopy and reflex confocal microscopy.

Background: Diagnosis of suspected basal cell carcinoma (BCC) is typically confirmed with incisional biopsy before referral to final surgery.

Objective: To investigate the clinical confidence and accuracy of physicians making a diagnosis of BCC based on dermoscopic and reflectance confocal microscopy (RCM) features.

Methods: This study was designed as a simulation to determine the certainty and willingness to refer to surgery without previous biopsy confirmation of BCC.

Skin cancer prevention in annual performance of total skin examination, photoprotection counseling, and patient instruction of self-skin examination.

Background: Prevention of skin cancer includes early diagnosis and photoprotection, such as by physician-performed total skin examination (TSE) and patient-performed self-skin examination (SSE). Hypothesizing that 90% of our patients receive an annual TSE, photoprotection counseling, and SSE instruction, we assessed the extent to which this was documented in patients' records. We also sought to identify differences in documentation of TSE, photoprotection counseling, and instruction on SSE with or without use of a dictation template prompting documentation.

The impact of biopsy technique on upstaging, residual disease, and outcome in cutaneous melanoma.

Background: After skin biopsy of malignant melanoma, the findings in the subsequent wide local excision (WLE) sometimes result in upgrading of the T-category. Herein, we examine the influence of biopsy technique on residual disease in melanoma WLE specimens and on upstaging.

Methods: We performed a retrospective review of data from malignant melanoma patients who underwent sentinel lymph node biopsy between 1997 and 2010.

Risk factors associated with local and in-transit recurrence of cutaneous melanoma.

Background: Understanding the risk factors for local and in-transit recurrences (LR/ITR) may help facilitate methods of prevention, early detection, and treatment.

Methods: A retrospective review of a prospectively collected database was performed on patients diagnosed with single-lesion cutaneous melanoma. Clinical and pathologic characteristics of the tumors were evaluated.

Optical transfer diagnosis of pigmented lesions.

Background: Optical transfer diagnosis is a novel melanoma detection system that uses morphologic-physiologic mapping.

Objective: To further evaluate the potential of optical transfer diagnosis for distinguishing benign from malignant pigmented melanocytic neoplasms.

Methods And Materials: Ninety-four patients with pigmented lesions suggestive of melanoma were referred for optical transfer diagnosis.

Factors leading to the biopsy of 1547 pigmented lesions at Mayo Clinic, Scottsdale, Arizona, in 2005.

Background: Both physician-driven and patient-driven factors influence biopsy decisions. We sought to determine the ratio of benign to malignant melanocytic biopsy findings in our general dermatology practice and to characterize the reasons for biopsy.

Methods: A retrospective review of institutional records (1 January to 31 December 2005) was undertaken.

Optical transfer diagnosis of pigmented lesions: a pilot study.

Objective: To evaluate the potential of a novel imaging technology, optical transfer diagnosis (OTD), for differentiation of benign from malignant pigmented melanocytic lesions.

Design: Patients with pigmented lesions suspicious for melanoma were referred for OTD. After scanning, lesions were biopsied for histopathologic examination, each by two separate dermatopathologists.

Malignant melanoma in the 21st century: the emerging molecular landscape.

Malignant melanoma presents a substantial clinical challenge. Current diagnostic methods are limited in their ability to diagnose early disease and accurately predict individual risk of disease progression and outcome. The lack of adequate approaches to properly define disease subgroups precludes rational treatment design and selection.

Malignant melanoma in the 21st century, part 2: staging, prognosis, and treatment.

Critical to the clinical management of a patient with malignant melanoma is an understanding of its natural history. As with most malignant disorders, prognosis is highly dependent on the clinical stage (extent of tumor burden) at the time of diagnosis. The patient's clinical stage at diagnosis dictates selection of therapy.

Malignant melanoma in the 21st century, part 1: epidemiology, risk factors, screening, prevention, and diagnosis.

Malignant melanoma is an aggressive, therapy-resistant malignancy of melanocytes. The incidence of melanoma has been steadily increasing worldwide, resulting in an increasing public health problem. Exposure to solar UV radiation, fair skin, dysplastic nevi syndrome, and a family history of melanoma are major risk factors for melanoma development.

The exanthem of acute pulmonary coccidioidomycosis: Clinical and histopathologic features of 3 cases and review of the literature.

Background: Coccidioidomycosis may be associated with a reactive generalized cutaneous eruption early in the course of the illness. Detailed descriptions in the literature are scarce.

Observations: We describe 3 patients with a florid eruption associated with pulmonary coccidioidomycosis.

An unusual case of calciphylaxis.

Background: Cutaneous calciphylaxis is a rare disorder that occurs most frequently in patients with end-stage renal disease (ESRD), those on hemodialysis, and renal transplant recipients. It is frequently associated with hyperparathyroidism and a markedly elevated calcium-phosphate product, and it carries a high mortality rate. The usual clinical presentation is of painful, stellate necrosis of the thighs or buttocks, often in the setting of livedo reticularis.