Barbara Alfaioli

Dermoscopy for early detection of facial lentigo maligna

Up until now, only lesions selected on the basis of their clinical atypia or which appear equivocal on naked eye examination have been shown to benefit from the use of dermoscopy. In our experience, dermoscopic evaluation of lesions located on the face may require a different approach, as a histopathological diagnosis of malignancy is not uncommon in clinically trivial lesions (i.e. lesions lacking the ABCD criteria for clinical suspicion). Moreover, at this site dermoscopy reveals specific criteria according to the particular histological architecture shown by sun‐damaged skin. We report four cases of lentigo maligna (LM) of the face whose identification depended on dermoscopic examination which was performed routinely on all facial lesions, as the lesions did not show ABCD clinical criteria for malignancy. In our experience, the identification of early signs of malignancy by dermoscopy may indicate the excision of LM at an early phase, before the lesion is associated with the ABCD signs of melanoma. Dermatologists should avoid the mistake of immediately excluding a diagnosis of malignancy when examining an ABCD‐negative pigmented skin lesion of the face.

Cutaneous manifestations of breast carcinoma.

The incidence of breast carcinoma cutaneous manifestation in patients with breast carcinoma is 23.9%. The most common sites of breast carcinoma cutaneous manifestation are the chest wall and abdomen, but they can occur at the extremities and in the head/neck region. Due the high incidence of breast carcinoma, these cutaneous manifestations are the most common metastases seen by dermatologists.

Cutaneous collision tumour (melanocytic naevus, basal cell carcinoma, seborrhoeic keratosis): a clinical, dermoscopic and pathological case report

The association of contiguous or ‘collision’ tumours in the same biopsy specimen is not uncommon and is often reported in the literature. The most common association, basal cell carcinoma (BCC) and naevus, is very difficult to diagnose clinically. We describe a 38‐year‐old woman with a previous history of melanoma, who presented with a modified pigmented lesion of the hip that had begun to change 6 months earlier. Histologically, the lesion was a melanocytic compound naevus and a BCC with a seborrhoeic keratosis. The case was investigated clinically and by focusing on the dermoscopic features and their pathological correlates. Cutaneous collision tumours are extremely difficult to diagnose preoperatively, even with the help of dermoscopy, in particular when one of the lesions is melanocytic.

The use of silicone gel in the treatment of fresh surgical scars: a randomized study

Aim.  To evaluate the effectiveness of a silicone gel in treating surgical wounds compared with a control group of the same phenotype and same scar site for which a placebo was advised.

Multiple pigmented trichoblastomas and syringocystadenoma papilliferum in naevus sebaceous mimicking a malignant melanoma: a clinical dermoscopic–pathological case study

We report a case of three distinct adnexal neoplasms associated with a naevus sebaceous of the scalp: a nodular pigmented trichoblastoma, a smaller flat pigmented trichoblastoma and a syringocystadenoma papilliferum, and discuss the clinical and histological features of these neoplasms. The clinical manifestation was suggestive of malignant melanoma, a feature that has never been reported before. For the first time in the literature we describe the case also by means of a noninvasive analysis, i.e. epiluminescence microscopy. In our experience, epiluminescence microscopy does not appear to be more diagnostically accurate than simple clinical examination when diagnosing lesions of the scalp, contrary to other regions.

Multiple primary melanoma: the impact of atypical naevi and follow up

Background  Patients with melanoma are especially encouraged to have regular follow‐up visits with their dermatologist and to perform total‐body skin examination on a routine basis to identify new pigmented lesions or detect significant changes in existing naevi.

Solitary cutaneous metastasis as the first sign of relapse of thyroid carcinoma: a clinical, dermoscopic-pathologic case study.

Cutaneous metastases are a rare event, representing 0.7% to 2.0% of all cutaneous malignant neoplasms. They may be the first sign of a previously undiagnosed visceral malignancy or the initial presentation of a recurrent neoplasm. The frequency of cutaneous metastases according to the type of underlying malignancies varies with sex. In men, the most common internal malignancies leading to cutaneous metastases are lung cancer, colon cancer, melanoma, squamous cell carcinoma of the oral cavity, and renal cell carcinoma. In women, breast cancer, colon cancer, melanoma, lung cancer, and ovarian cancer are the most common malignancies leading to cutaneous metastases.

Lipoma of the finger: a case report and differential diagnosis

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Superficial Cutaneous Leiomyosarcoma A Rare, Misleading Tumor

Leiomyosarcomas are rare malignant tumors of smooth muscles. Superficial leiomyosarcoma is generally a disease of middle age, most frequently encountered between 40 and 60 years of age. It is usually diagnosed late or misdiagnosed, since it is a very rare tumor of the head and neck. Awareness of the particularly misleading features of this tumor, especially in elderly patients, is important, as delayed diagnosis is correlated with larger size and invasiveness into contiguous structures, which influence the practicability of radical resection. We present the case of an 81-year-old man with cutaneous leiomyosarcoma on the forehead.

Dermoscopy in pigmented squamous cell carcinoma.

Background: The diagnosis of squamous cell carcinoma (SCC) is, generally, a clinical diagnosis, but in some cases, when the lesion is pigmented, as in our case, the differential diagnosis between pigmented SCC and other pigmented skin lesions, in particular melanocytic lesions, is difficult. Dermoscopy may improve the early diagnosis of SCC and thus play a role in its preoperative classification. However, its potential role has been hampered so far by the fact that little is known about the dermoscopic features of pigmented SCC. Objective: We report the case of a rare pigmented SCC dermoscopically mimicking a melanocytic lesion whose dermoscopic features have been investigated. Conclusion: On the basis of the literature and our experience, pigmented SCC can present dermoscopic features typical of melanocytic lesions, such as radial streaks, globules, and homogeneous blue pigmentation, and can lead dermatologists to diagnostic errors.