Camilla Salvini

In vivo characterization of the inflammatory infiltrate and apoptotic status in imiquimod‐treated basal cell carcinoma

Background  Imiquimod use in the treatment of basal cell carcinoma (BCC) has proven to be successful in a large percentage of cases, inducing tumor regression; however, the exact cellular mechanism has not been fully clarified.

Pigmented seborrheic keratoses of the vulva clinically mimicking a malignant melanoma: a clinical, dermoscopic‐pathologic case study

The diagnosis of seborrheic keratosis is, in general, a clinical one, but in some cases, the differential diagnosis between pigmented seborrheic keratosis and malignant melanoma is difficult. Dermoscopy may improve the early diagnosis of vulvar melanoma and thus play a role in the preoperative classification of pigmented lesions at this particular site. We report the first case of a pigmented seborrheic keratosis of the vulva clinically mimicking a malignant melanoma, whose dermoscopic features have been investigated together with their pathologic correlates. Dermoscopically our case shows the absence of comedo‐like openings and the presence of the pseudo‐network. Dermoscopy is therefore a useful method for the differential diagnosis of pigmented lesions even in the vulva.

Application of optical coherence tomography in non‐invasive characterization of skin vascular lesions

Background: Optical coherence tomography (OCT) is a new non‐invasive approach for real‐time in vivo tissue characterization. A promising use of OCT can be the assessment of the architecture of lesions with some degree of inhomogeneities, such as vascular lesions. Knowledge of the size and depth of the vascular structures can be useful for the diagnosis and for choosing the best treatment.

Dermoscopic features of combined melanocytic nevi

Abstract:  In order to investigate the possible role of dermoscopy in the non‐invasive classification of combined nevi, we analyzed dermoscopic features of a series of combined nevi consecutively excised. Two dermatologists expert in dermoscopy retrospectively evaluated all images based on the presence of dermoscopic findings to analyze which epiluminescence microscopy features were more frequently associated with each type of combined nevus. Dermoscopy may provide useful information in the non‐invasive diagnosis of combined nevi, allowing a conservative management, but this may be limited to combined nevi including a blue nevus component. Conversely, combined nevi including a Spitz nevus component may be difficult to classify even by dermoscopy, thus requiring careful monitoring or surgical excision.

Eruptive multiple blue nevi of the penis: a clinical dermoscopic pathologic case study.

Multiple blue nevi have rarely been reported, and the majority of the lesions are located on the trunk and lower extremities. The blue nevus is a rare lesion on genital mucosa and may cause confusion in differential diagnosis with other pigmented lesions such as genital melanocytic macules, lentigo simplex, and malignant melanoma. Here, we describe an unusual patient who presented with a sudden onset in adulthood of multiple blue nevi on the glans penis. The epiluminescence examination revealed a substantially homogenous bluish pigmentation, which led us to favor a diagnosis of blue nevus, whereas not entirely excluding the possibility of a regressing melanoma or a metastatic melanoma. Because of the well‐known diagnostic value of the blue hue in the diagnosis of malignancy by dermoscopy, a careful examination of these lesions should be made in order to minimize any risk of misclassification with melanoma.

The p.G23S CDKN2A founder mutation in high-risk melanoma families from Central Italy.

We have investigated the frequency and spectrum of CDKN2A/CDK4 mutations in 23 cutaneous melanoma families from Central Italy (Tuscany). Three distinct mutations were identified in five families. One mutation, p.G23S, was present in three families. Several lines of evidence indicate that p.G23S is a pathogenic mutation: it is located in the functionally important first ankyrinic domain of p16, it was not detected in a sample of 100 control individuals, and it was present in all tested affected individuals from the three families. Haplotype analysis showed a common ancestral origin of the p.G23S mutation. Our data show that the p.G23S mutation is an important cause of hereditary melanoma in Tuscany.

Lipoma of the finger: a case report and differential diagnosis

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Efalizumab for severe palmo‐plantar psoriasis: an open‐label pilot trial in five patients

Background  Palmo‐plantar psoriasis (PPP) is a disabling condition that significantly impairs quality of life. PPP tends to be resistant to conventional therapies and may last for several years. Topical treatments are usually ineffective. Systemic therapy with oral retinoids and psoralen plus ultraviolet A is frequently required, although it rarely leads to remission.

The Use of Commercially Available Personal UV-meters Does Cause Less Safe Tanning Habits: A Randomized-controlled Trial

UV Index information is currently recommended as a vehicle to raise public awareness about the risk of sun‐exposure. It remains unknown to what extent this information can change personal sun‐protective behavior. The aim of the study was to analyze the effects of UV‐Index (UV‐I) information provided by low cost, commercially available UV‐I sensors on major indicators of sun‐tanning behavior. A randomized‐controlled trial was carried out on 94 healthy volunteers aged 21–23 years. After the exclusion of subjects with photosensitive disorders (n = 3), 91 subjects were randomized in two arms after stratification based on phototype and sex. Both arms received a diary to be filled every day with a log of intentional sun‐exposure during summer. Subjects in the intervention group also received a commercially available UV‐I sensor. The UV‐I sensors were switched on and the UV‐value was recorded in 77% of days with sun‐exposure. During days of sun‐exposure, subjects randomized to the intervention group had longer average time of sun‐exposure (227.7 vs 208.7 min per day, P = 0.003), also between noon and 4 pm (P < 0.001), and less frequently adopted sun protective measures than controls (hat [6.4%vs 10.2%, P = 0.007], sunglasses [23.9%vs 30.8%, P = 0.003], sunscreen [41.4%vs 47.2%, P = 0.02]) and they experienced more frequent sunburns (27.8%vs 21.5%, P = 0.004). The odd ratio of sunburns was 1.60 for subjects in the intervention group compared with controls (after adjustment for sex, sunscreen use and skin type). The mean UV‐I value recorded by volunteers was lower (5.6 [SD ± 0.9]) than that (7.3 [SD ± 0.46]) recorded by a professional instrument in the same period at the same latitude. Poststudy laboratory tests showed that the sensor was able to detect only about 60% of the solar diffuse radiation. The use of UV‐I sensors changed the sun protective behavior of sunbathers in the direction of less use of sun protective measures. One possible explanation is that the low cost UV‐meters may have functioned incorrectly and under‐reported UV exposure. This may have led to an underestimation of UV‐I values, erroneously reassuring subjects and causing a less protective sunbathing behavior. Another hypothesis relies on a cognitive pitfall in the subjects’ dealing with intermediate UV‐I values, as they may have been discouraged in the use of sunscreen as they did not feel that they had yet been exposed to very harmful UV radiation.

Multiple synchronous pigmented basal cell carcinomas following radiotherapy for Hodgkin’s disease

Background  Multiple basal cell carcinomas (BCCs) are infrequently seen in patients under 30 years of age. Their occurrence at a young age is often linked to some genodermatosis, including Nevoid Basal Cell Carcinoma Syndrome (NBCCS). The exposure to ionizing radiation is also considered to be a predisposing factor in the development of BCCs.