Mariano Suppa

Knowledge, perceptions and behaviours about skin cancer and sun protection among secondary school students from Central Italy

Background  Although sun exposure is a strong risk factor for skin cancer, tanning is very popular among adolescents. Awareness of skin cancer and sun exposure might influence sun protective behaviours in this population.

High-definition optical coherence tomography algorithm for discrimination of basal cell carcinoma from clinical BCC imitators and differentiation between common subtypes

Preliminary studies have described morphological features of basal cell carcinoma (BCC) imaged by high‐definition optical coherence tomography (HD‐OCT) and suggested that this technique may aid in its diagnosis and management. However, systematic studies evaluating the accuracy of HD‐OCT for the diagnosis of BCC are lacking.

High-definition optical coherence tomography algorithm for the discrimination of actinic keratosis from normal skin and from squamous cell carcinoma

Preliminary studies described morphological features of actinic keratosis (AK) and squamous cell carcinoma (SCC) imaged by High‐Definition Optical Coherence Tomography (HD‐OCT) and suggested that this technique may aid in their diagnosis. However, systematic studies evaluating the accuracy of HD‐OCT for the diagnosis of AK and SCC are lacking so far.

Efficacy and tolerability of 5-aminolevulinic acid 0.5% liposomal spray and intense pulsed light in wrinkle reduction of photodamaged skin

Abstract Background: Photodynamic therapy (PDT) with 5-aminolevulinic acid (5-ALA) is effective for the treatment of photoaging. Objective: To evaluate the efficacy and safety of PDT using a novel 0.5% liposome-encapsulated 5-ALA spray and an intense pulsed light (IPL) system (Ellipse Flex PPT) in reduction of periorbital and nasolabial wrinkles. Patients and Methods: Thirty healthy volunteers, aged 35–65 years, skin type I–III, with type 2 photoaging underwent a baseline visit, three ALA-IPL treatments once every 3 weeks, an end-of-treatment visit and a final visit 3 months after the end-of-treatment visit. Wrinkle depth was evaluated according to the modified Fitzpatrick wrinkle scale (MFWS). At the final visit, patients rated their degree of overall improvement. Results: For periorbital and nasolabial wrinkles, the differences of the average MFWS evaluation between baseline versus end-of-treatment visit, baseline versus final visit and end-of-treatment visit versus final visit were statistically significant (p < 0.001). The average overall improvement was greater for periorbital than for nasolabial wrinkles (p < 0.001). No side effects were observed during and after treatment. The degree of overall improvement was scored as excellent by 47% of the volunteers. Conclusions: ALA-IPL treatment using 0.5% liposome-encapsulated 5-ALA spray and Ellipse Flex PPT system is effective and safe for the treatment of type 2 photoaging reducing the PDT-associated side effects.

High-definition optical coherence tomography intrinsic skin ageing assessment in women: a pilot study

AbstractSeveral non-invasive two-dimensional techniques with different lateral resolution and measurable depth range have proved to be useful in assessing and quantifying morphological changes in skin ageing. Among these, only in vivo microscopy techniques permit histometric measurements in vivo. Qualitative and quantitative assessment of chronological (intrinsic) age-related (IAR) morphological changes of epidermis, dermo-epidermal junction (DEJ), papillary dermis (PD), papillary-reticular dermis junction and reticular dermis (RD) have been performed by high-definition optical coherence tomography in real time 3-D. HD-OCT images were taken at the internal site of the right upper arm. Qualitative HD-OCT IAR descriptors were reported at skin surface, at epidermal layer, DEJ, PD and upper RD. Quantitative evaluation of age-related compaction and backscattered intensity or brightness of different skin layers was performed by using the plugin plot z-axis profile of ImageJ® software permitting intensity assessment of HD-OCT (DICOM) images (3-D images). Analysis was in blind from all clinical information. Sixty, fair-skinned (Fitzpatrick types I–III) healthy females were analysed retrospectively in this study. The subjects belonged to three age groups: twenty in group I aged 20–39, twenty in group II aged 40–59 and twenty in group III aged 60–79. Only intrinsic ageing in women has been studied. Significant age-related qualitative and quantitative differences could be noticed. IAR changes in dermal matrix fibers morphology/organisation and in microvasculature were observed. The brightness and compaction of the different skin layers increased significantly with intrinsic skin ageing. The depth of visibility of fibers in RD increased significantly in the older age group. In conclusion, HD-OCT allows 3-D in vivo and real time qualitative and quantitative assessment of chronological (intrinsic) age-related morphological skin changes at high resolution from skin surface to a depth of the superficial reticular dermis.

Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location

Correctly diagnosing basal cell carcinoma (BCC) clinical type is crucial for the therapeutic management. A systematic description of the variability of all reported BCC dermoscopic features according to clinical type and anatomic location is lacking.

Validation of a diagnostic algorithm for the discrimination of actinic keratosis from normal skin and squamous cell carcinoma by means of high‐definition optical coherence tomography

Actinic keratoses (AKs) commonly arise on sun‐damaged skin. Visible lesions are often associated with subclinical lesions on surrounding skin, giving rise to field cancerization. To avoid multiple biopsies to diagnose subclinical/early invasive lesions, there is an increasing interest in non‐invasive diagnostic tools, such as high‐definition optical coherence tomography (HD‐OCT). We previously developed a HD‐OCT‐based diagnostic algorithm for the discrimination of AK from squamous cell carcinoma (SCC) and normal skin. The aim of this study was to test the applicability of HD‐OCT for non‐invasive discrimination of AK from SCC and normal skin using this algorithm. Three‐dimensional (3D) HD‐OCT images of histopathologically proven AKs and SCCs and images of normal skin were collected. All images were shown in a random sequence to three independent observers with different experience in HD‐OCT, blinded to the clinical and histopathological data and with different experience with HD‐OCT. Observers classified each image as AK, SCC or normal skin based on the diagnostic algorithm. A total of 106 (38 AKs, 16 SCCs and 52 normal skin sites) HD‐OCT images from 71 patients were included. Sensitivity and specificity for the most experienced observer were 81.6% and 92.6% for AK diagnosis and 93.8% and 98.9% for SCC diagnosis. A moderate interobserver agreement was demonstrated. HD‐OCT represents a promising technology for the non‐invasive diagnosis of AKs. Thanks to its high potential in discriminating SCC from AK, HD‐OCT could be used as a relevant tool for second‐level examination, increasing diagnostic confidence and sparing patients unnecessary excisions.

A new algorithm for the discrimination of actinic keratosis from normal skin and squamous cell carcinoma based on in vivo analysis of optical properties by high-definition optical coherence tomography

High‐definition optical coherence tomography (HD‐OCT) features of actinic keratosis (AK) may aid in its diagnosis and therapeutic strategy. A diagnostic algorithm permitting discrimination of AK from squamous cell carcinoma (SCC) and normal skin has been proposed. However, diagnostic accuracy strongly depends on the experience of physicians. In two recent studies, it was demonstrated that HD‐OCT permits to quantify in vivo optical properties such as light attenuation in intrinsic ageing skin, in melanocytic lesions and in basal cell carcinoma. This approach seems to permit a semiautomated classification of lesions easier to handle by non‐experts.

In vivo assessment of optical properties of basal cell carcinoma and differentiation of BCC subtypes by high-definition optical coherence tomography

High-definition optical coherence tomography (HD-OCT) features of basal cell carcinoma (BCC) have recently been defined. We assessed in vivo optical properties (IV-OP) of BCC, by HD-OCT. Moreover their critical values for BCC subtype differentiation were determined. The technique of semi-log plot whereby an exponential function becomes linear has been implemented on HD-OCT signals. The relative attenuation factor (µraf ) at different skin layers could be assessed.. IV-OP of superficial BCC with high diagnostic accuracy (DA) and high negative predictive values (NPV) were (i) decreased µraf in lower part of epidermis and (ii) increased epidermal thickness (E-T). IV-OP of nodular BCC with good to high DA and NPV were (i) less negative µraf in papillary dermis compared to normal adjacent skin and (ii) significantly decreased E-T and papillary dermal thickness (PD-T). In infiltrative BCC (i) high µraf in reticular dermis compared to normal adjacent skin and (ii) presence of peaks and falls in reticular dermis had good DA and high NPV. HD-OCT seems to enable the combination of in vivo morphological analysis of cellular and 3-D micro-architectural structures with IV-OP analysis of BCC. This permits BCC sub-differentiation with higher accuracy than in vivo HD-OCT analysis of morphology alone.

The Italian Euromelanoma Day: evaluation of results and implications for future prevention campaigns

Melanoma incidence/mortality is increasing worldwide. “Euromelanoma Day” is a pan‐European campaign for skin cancer prevention. Results of the 2010 Euromelanoma Day in Italy are reported herein.