One hundred and one patients participating in a phase I study with the synthetic retinoid 4-HPR (... more One hundred and one patients participating in a phase I study with the synthetic retinoid 4-HPR (4-hydroxyphenyl retinamide) were evaluated. The study was set up by Veronesi et al. during 1986 at the National Cancer Institute of Milan. The patients were randomized into 4 groups. of therapy: 25 in the placebo group, 25 in the group receiving a daily dose of 100 mg of HPR, 26 in the group receiving 200 nig/day of HPR, and 25 in the group receiving 300 mg/day of HPR. All patients were previously treated at our Institute for breast cancer. None had received adjuvant therapy, chemotherapy or hormone therapy. After 4–5 months from the beginning of treatment, all patients received a series of tests to evaluate anxiety, depression and sexual life. Moreover, during one the follow-up checkups after 4–5 months, the patients filled-out a self-scoring mood questionnaire. The results did not show any particular differences between the groups, although we found that the administered drug and exper...
European Journal of Cancer and Clinical Oncology, 1991
A group of 53 patients initially participating in a phase I trial with the synthetic retinoid fen... more A group of 53 patients initially participating in a phase I trial with the synthetic retinoid fenretinide was assessed for the long-term tolerability of this compound. The patients were evaluated after 42 months of drug intake at a dose of 200 mg/day, including a 3-day drug interruption at the end of each month, by the following examinations: a dermatological visit; an ophthalmological evaluation including an ophthalmological questionnaire and an electroretinogram (ERG); a study on blood chemistry and plasma retinol levels; a study on bone densities and on skeletal X-rays; and finally a psychological evaluation including various tests for anxiety, depression and overall mood. The results show that prolonged administration of fenretinide is well tolerated. No acute nor severe toxicity was observed and thus this compound can be considered a good candidate for chemoprevention trials in a variety of patient populations.
European Journal of Cancer and Clinical Oncology, 1989
Fenretinide, N-(4-hydroxyphenyl)retinamide (HPR), is a synthetic retinoid which has been proven e... more Fenretinide, N-(4-hydroxyphenyl)retinamide (HPR), is a synthetic retinoid which has been proven effective in inducing cell differentiation and in inhibiting carcinogen induced mammary tumors in rodents. Because of its efficacy and low toxicity in animals, HPR has been proposed for chemopreventive evaluation in humans. Thus, a randomized trial has been conducted to select a dose which can be administered over a lengthy period of time and with acceptable toxicity. The retinoid was administered orally to patients already operated on for breast cancer in daily doses of 100, 200 and 300 mg for 6 months and subsequently at 200 mg for another 6 months. No acute toxicity was found. Dermatological toxicity was minimal and no liver function abnormalities were observed. Nausea and headaches were infrequent and always mild. Menstrual irregularities were recorded with similar frequency in the treatment and placebo groups and appeared to be more age related than drug dependent. After 6 months of treatment one of 25 patients taking 300 mg HPR daily experienced impaired night vision, confirmed by the electroretinogram, and resolved by interruption of treatment. Because the 300 mg daily dose is possibly associated with impaired dark adaptation, the recommended dose for chemoprevention trials of HPR is 200 mg per day.
Cutaneous melanoma (CM) is a very aggressive tumor whose incidence has been increasing in the las... more Cutaneous melanoma (CM) is a very aggressive tumor whose incidence has been increasing in the last decades. CM is visible in its early stages and early surgical treatment can lead to a high cure rate. Therefore, education and early detection should curtail melanoma morbidity and mortality.The aim of this regional program was to evaluate the role of a skin examination performed by General Practitioners (GPs) in people older than 18 without previously known skin lesions, spontaneously presenting to them for any reason; suspect cases were referred to pre-identified regional Institutions. MethodsIn late 1995 and in 1996 all GPs of the Friuli-Venezia Giulia were asked to take part in the program. During the same period support from all regional Dermatology, Pathology and Plastic Surgery Institutions was obtained. Educational meetings directed to cooperating GPs were held and operational procedures for the management of referred people were defined in the preliminary phase. The program started at the end of 1996 and continued during 1997 and 1998. Information about the number of whole skin examinations performed and patients referred and about the number and thickness of diagnosed CMs, as well as the number of skin carcinomas and dysplasic nevi was obtained. At the same time the Pathology Institutions were asked to send data about the thickness distribution of all cutaneous melanomas diagnosed in Friuli-Venezia Giulia before and during the program. Results153 GPs participated in the program, but only 74 were evaluable; they performed 11.040 skin examinations (average, 75 per GP) and referred 820 people for dermatologic evaluation (average, 8 per GP). Among these patients, 38 CMs (4.6%) were detected. 18 were ≤1.5 mm in thickness and 11 were >1.5 mm; thickness was unknown in 9 cases. The dermatologic examination/diagnosed CMs ratio was 21. Further, 94 skin carcinomas and 50 dysplastic nevi were detected and, at a regional level, the percentage of thin CMs increased from 65.3% in 1995–1996 to 72.2% in 1997–1998, while the number of thick CMs decreased. ConclusionsAlthough in our study only a minority of GPs chose to participate in the program, the diagnosed CM rate was notably high and most detected CMs were thin. Besides, workload was acceptable as compared to reported experiences where only Dermatologists and self-referred people were involved, without a filter work by GPs. This study shows that the involvement of GPs in the early diagnosis of CM can lead to a valuable selection of patients to be referred to specialists with a good yield of CMs, mostly with a favourable staging.
Our case of pigmented mammary Paget&a... more Our case of pigmented mammary Paget's disease simulated melanoma clinically and dermoscopically. Histologically, the lesion was characterized by microscopic features similar to those seen in malignant melanoma and, to a lesser extent, in Bowen's disease (intra-epidermal squamous cell carcinoma). Immunohistochemical studies demonstrated that the tumor cells were positive for keratins (Cam 5.2+MNF 116) and AE1-AE3 and negative for HMB-45 and S-100 proteins. In conclusion clinical and dermoscopic examination cannot reliably distinguish melanoma from epithelial pre-neoplastic or neoplastic disease, therefore the differentiation of pigmented Paget's disease from superficial spreading of melanoma and Bowen's disease is based on histopathologic integrated with immunohistochemical criteria.
Background A regional program for the early diagnosis of cutaneous melanoma involving general pra... more Background A regional program for the early diagnosis of cutaneous melanoma involving general practitioners was effective in 1997–1998 in the Friuli Venezia Giulia region in Northern Italy. The aim of the 2-year program was to evaluate the role of a skin examination performed by general practitioners in people older than 18 years without known skin lesions and spontaneously presenting to their offices for any reason, with referral of suspect cases to a pre-identified regional dermatology or plastic surgery institution. Methods In the preparatory phase (late 1995 and 1996), all general practitioners operating in the Friuli Venezia Giulia region (n = 1,038) were asked to participate in the program. Support from all regional dermatology, pathology and plastic surgery institutions was obtained. Operational procedures for the management of referred people were defined, and educational meetings directed to general practitioners interested in the program were held. Skin examinations by gen...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2002
A healthy 37-year-old woman with a familial history of cutaneous melanoma and a recent history (6... more A healthy 37-year-old woman with a familial history of cutaneous melanoma and a recent history (6 months) of atypical nevus was seen in consultation by a dermatologist. Complete skin mapping revealed only an oval, 6 ... Journal of Clinical Oncology, Vol 20, No 5 (March 1), 2002: pp ...
A Fenretinide (HPR) é um retinóide sintético análogo á Vit. A que provou ser efetivo na prevenção... more A Fenretinide (HPR) é um retinóide sintético análogo á Vit. A que provou ser efetivo na prevenção de tumores mamários em animais modelos. Este estudo, nesta fase 1, foi proposto no Instituto Nacional dos Tumores de Milão com o objetivo de avaliar a tolerância desta droga em humanos. Neste estudo, 101 pacientes com câncer de mama foram randomizadas em 4 grupos de acordo com a dose diária da droga: 100 mg, 200 mg, 300 mg e placebo. Todas as pacientes foram operadas no mesmo Instituto e não receberam nenhum tratamento adjuvante (endócrino ou quimioterápico). Exame clinico, testes sanguineos de laboratório, avaliação dermatológica e oftamológica foram realizadas periodicamente. Uma paciente interrompeu o tratamento na 12 semana, por terem sido demonstradas metástases ósseas e pulmonares. Cem pacientes completaram as 20 semanas de tratamento e não apresentaram efeitos colaterais significa ti vos. Em um caso foi necessário diminuir a dose por três dias com o objetivo de verificar a possív...
Background. To perform a multicentric study in evaluating the diagnostic accordance between '... more Background. To perform a multicentric study in evaluating the diagnostic accordance between 'face-to-face' diagnosis and telediagnosis, clinical and dermatoscopic digital images of pigmented skin tumors were sent by e-mail to 5 remote European centers for teleconsultation. Methods. Fourty patients (21 males and 19 females; age range 3 to 91 years) with pigmented skin neoplasms (11 malignant melanomas, 23 melanocytic nevi, 3 basal cell carcinomas, 3 lentigines, 2 seborrheic keratoses and 1 angiokeratoma) were evaluated on a 'face-to-face' basis at the Department of Dermatology of Graz, Austria. All clinical and dermatoscopic images were compressed in JPEG format file and then sent by E-mail to 6 physicians (dermatologists, oncologists) in 5 centers for telediagnosis. All lesions were surgically excised and histopathologically examined in Graz. Results. Eight out of 11 melanomas were correctly diagnosed on a 'face-to-face' basis in Graz while one nevus was over...
Background Reproducible, high-quality surgery is a key point in the management of cancer patients... more Background Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an Italian registry. Methods Data were extracted from the Central National Melanoma Registry (CNMR) promoted by the Italian Melanoma Intergroup (IMI). All surgical procedures (WE, SNLB or LFND) for non-metastatic skin melanoma between January 2011 and February 2017 were evaluated for inclusion in the study. Only centers with adequate completeness of information (> 80%) were included in the study. Short-term complications (wound infection, dehiscence, skin graft failure and seroma) were investigated. Results Wound infection rate was 1.1% (0.4 to 2.7%) in WE, 1.3% (0.7 to 2.5%) in SLNB and 4.1% (2.1 to 8.0%) in LFND. Wound dehiscence rate was...
The International Journal of Biological Markers, 1993
Mucin-like Carcinoma-associated Antigen (MCA) is a glycoprotein belonging to the mucin family; it... more Mucin-like Carcinoma-associated Antigen (MCA) is a glycoprotein belonging to the mucin family; it is defined by the monoclonal antibody b-12. Mucins represent an interesting group of tumor markers and are widely utilized in the clinical monitoring of neoplastic patients. These molecules show a certain degree of tissue specificity and MCA is preferentially associated with breast tissue. Several studies have demonstrated that patients with breast cancer usually have high MCA serum levels. In this paper the experience of the National Cancer Institute of Milan with the clinical use of MCA in breast cancer patients is reported. The observed sensitivity of the MCA test was poor in patients with early-stage disease, while it was acceptable in patients with advanced breast cancer. MCA concentrations appeared to be directly related to disease spread. A clear relationship was seen between MCA levels and lymph-nodal status. The highest MCA plasma levels were observed in patients with metastati...
Aim and background Dermoscopic diagnosis of pigmented skin lesions is based on the evaluation of ... more Aim and background Dermoscopic diagnosis of pigmented skin lesions is based on the evaluation of dermoscopic criteria (classical pattern analysis) and on alternative diagnostic methods, such as the ABCD (A, asymmetry; B, border; C, color; D, differential structures) rule based on the total dermatoscopic score. The aim of the study was to investigate the interobserver agreement of standard dermoscopic criteria between two observers and the diagnostic validity of dermoscopic diagnosis by pattern analysis and by the ABCD rule. Study design The study included a total of 129 small (≤5 mm) melanocytic skin lesions selected from all lesions observed in consecutive patients between April 1996 and September 1998. Before surgery, each lesion was photographed with a Dermaphot. Dermoscopic images were examined independently by two observers to evaluate the presence or absence of standard dermoscopic criteria and to establish the dermoscopic diagnosis by pattern analysis and by the ABCD rule. Re...
We performed a multicentre study to evaluate the agreement between the direct clinical diagnosis ... more We performed a multicentre study to evaluate the agreement between the direct clinical diagnosis and the telediagnosis of 43 cutaneous pigmented lesions. Digital clinical and dermoscopic images of the 43 pigmented skin lesions (11 melanomas, 23 melanocytic naevi, three basal cell carcinomas, three lentigines, two seborrhoeic keratoses and one angiokeratoma) were sent by email to 11 colleagues (six dermatologists, two residents in dermatology, one oncologist, one specialist in internal medicine and one general practitioner) in 10 centres. These 11 colleagues had different degrees of experience in dermoscopy. With histopathology as the gold standard, an average of 85% of the telediagnoses were correct, with results varying from 77% to 95%, whereas face-to-face diagnosis by an expert dermatologist was correct in 91% of cases. The kappa value for all participants ranged from 0.35 to 0.87. The results confirm that teledermoscopy can be a reliable technique for the diagnosis of pigmented ...
One hundred and one patients participating in a phase I study with the synthetic retinoid 4-HPR (... more One hundred and one patients participating in a phase I study with the synthetic retinoid 4-HPR (4-hydroxyphenyl retinamide) were evaluated. The study was set up by Veronesi et al. during 1986 at the National Cancer Institute of Milan. The patients were randomized into 4 groups. of therapy: 25 in the placebo group, 25 in the group receiving a daily dose of 100 mg of HPR, 26 in the group receiving 200 nig/day of HPR, and 25 in the group receiving 300 mg/day of HPR. All patients were previously treated at our Institute for breast cancer. None had received adjuvant therapy, chemotherapy or hormone therapy. After 4–5 months from the beginning of treatment, all patients received a series of tests to evaluate anxiety, depression and sexual life. Moreover, during one the follow-up checkups after 4–5 months, the patients filled-out a self-scoring mood questionnaire. The results did not show any particular differences between the groups, although we found that the administered drug and exper...
European Journal of Cancer and Clinical Oncology, 1991
A group of 53 patients initially participating in a phase I trial with the synthetic retinoid fen... more A group of 53 patients initially participating in a phase I trial with the synthetic retinoid fenretinide was assessed for the long-term tolerability of this compound. The patients were evaluated after 42 months of drug intake at a dose of 200 mg/day, including a 3-day drug interruption at the end of each month, by the following examinations: a dermatological visit; an ophthalmological evaluation including an ophthalmological questionnaire and an electroretinogram (ERG); a study on blood chemistry and plasma retinol levels; a study on bone densities and on skeletal X-rays; and finally a psychological evaluation including various tests for anxiety, depression and overall mood. The results show that prolonged administration of fenretinide is well tolerated. No acute nor severe toxicity was observed and thus this compound can be considered a good candidate for chemoprevention trials in a variety of patient populations.
European Journal of Cancer and Clinical Oncology, 1989
Fenretinide, N-(4-hydroxyphenyl)retinamide (HPR), is a synthetic retinoid which has been proven e... more Fenretinide, N-(4-hydroxyphenyl)retinamide (HPR), is a synthetic retinoid which has been proven effective in inducing cell differentiation and in inhibiting carcinogen induced mammary tumors in rodents. Because of its efficacy and low toxicity in animals, HPR has been proposed for chemopreventive evaluation in humans. Thus, a randomized trial has been conducted to select a dose which can be administered over a lengthy period of time and with acceptable toxicity. The retinoid was administered orally to patients already operated on for breast cancer in daily doses of 100, 200 and 300 mg for 6 months and subsequently at 200 mg for another 6 months. No acute toxicity was found. Dermatological toxicity was minimal and no liver function abnormalities were observed. Nausea and headaches were infrequent and always mild. Menstrual irregularities were recorded with similar frequency in the treatment and placebo groups and appeared to be more age related than drug dependent. After 6 months of treatment one of 25 patients taking 300 mg HPR daily experienced impaired night vision, confirmed by the electroretinogram, and resolved by interruption of treatment. Because the 300 mg daily dose is possibly associated with impaired dark adaptation, the recommended dose for chemoprevention trials of HPR is 200 mg per day.
Cutaneous melanoma (CM) is a very aggressive tumor whose incidence has been increasing in the las... more Cutaneous melanoma (CM) is a very aggressive tumor whose incidence has been increasing in the last decades. CM is visible in its early stages and early surgical treatment can lead to a high cure rate. Therefore, education and early detection should curtail melanoma morbidity and mortality.The aim of this regional program was to evaluate the role of a skin examination performed by General Practitioners (GPs) in people older than 18 without previously known skin lesions, spontaneously presenting to them for any reason; suspect cases were referred to pre-identified regional Institutions. MethodsIn late 1995 and in 1996 all GPs of the Friuli-Venezia Giulia were asked to take part in the program. During the same period support from all regional Dermatology, Pathology and Plastic Surgery Institutions was obtained. Educational meetings directed to cooperating GPs were held and operational procedures for the management of referred people were defined in the preliminary phase. The program started at the end of 1996 and continued during 1997 and 1998. Information about the number of whole skin examinations performed and patients referred and about the number and thickness of diagnosed CMs, as well as the number of skin carcinomas and dysplasic nevi was obtained. At the same time the Pathology Institutions were asked to send data about the thickness distribution of all cutaneous melanomas diagnosed in Friuli-Venezia Giulia before and during the program. Results153 GPs participated in the program, but only 74 were evaluable; they performed 11.040 skin examinations (average, 75 per GP) and referred 820 people for dermatologic evaluation (average, 8 per GP). Among these patients, 38 CMs (4.6%) were detected. 18 were ≤1.5 mm in thickness and 11 were >1.5 mm; thickness was unknown in 9 cases. The dermatologic examination/diagnosed CMs ratio was 21. Further, 94 skin carcinomas and 50 dysplastic nevi were detected and, at a regional level, the percentage of thin CMs increased from 65.3% in 1995–1996 to 72.2% in 1997–1998, while the number of thick CMs decreased. ConclusionsAlthough in our study only a minority of GPs chose to participate in the program, the diagnosed CM rate was notably high and most detected CMs were thin. Besides, workload was acceptable as compared to reported experiences where only Dermatologists and self-referred people were involved, without a filter work by GPs. This study shows that the involvement of GPs in the early diagnosis of CM can lead to a valuable selection of patients to be referred to specialists with a good yield of CMs, mostly with a favourable staging.
Our case of pigmented mammary Paget&a... more Our case of pigmented mammary Paget's disease simulated melanoma clinically and dermoscopically. Histologically, the lesion was characterized by microscopic features similar to those seen in malignant melanoma and, to a lesser extent, in Bowen's disease (intra-epidermal squamous cell carcinoma). Immunohistochemical studies demonstrated that the tumor cells were positive for keratins (Cam 5.2+MNF 116) and AE1-AE3 and negative for HMB-45 and S-100 proteins. In conclusion clinical and dermoscopic examination cannot reliably distinguish melanoma from epithelial pre-neoplastic or neoplastic disease, therefore the differentiation of pigmented Paget's disease from superficial spreading of melanoma and Bowen's disease is based on histopathologic integrated with immunohistochemical criteria.
Background A regional program for the early diagnosis of cutaneous melanoma involving general pra... more Background A regional program for the early diagnosis of cutaneous melanoma involving general practitioners was effective in 1997–1998 in the Friuli Venezia Giulia region in Northern Italy. The aim of the 2-year program was to evaluate the role of a skin examination performed by general practitioners in people older than 18 years without known skin lesions and spontaneously presenting to their offices for any reason, with referral of suspect cases to a pre-identified regional dermatology or plastic surgery institution. Methods In the preparatory phase (late 1995 and 1996), all general practitioners operating in the Friuli Venezia Giulia region (n = 1,038) were asked to participate in the program. Support from all regional dermatology, pathology and plastic surgery institutions was obtained. Operational procedures for the management of referred people were defined, and educational meetings directed to general practitioners interested in the program were held. Skin examinations by gen...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2002
A healthy 37-year-old woman with a familial history of cutaneous melanoma and a recent history (6... more A healthy 37-year-old woman with a familial history of cutaneous melanoma and a recent history (6 months) of atypical nevus was seen in consultation by a dermatologist. Complete skin mapping revealed only an oval, 6 ... Journal of Clinical Oncology, Vol 20, No 5 (March 1), 2002: pp ...
A Fenretinide (HPR) é um retinóide sintético análogo á Vit. A que provou ser efetivo na prevenção... more A Fenretinide (HPR) é um retinóide sintético análogo á Vit. A que provou ser efetivo na prevenção de tumores mamários em animais modelos. Este estudo, nesta fase 1, foi proposto no Instituto Nacional dos Tumores de Milão com o objetivo de avaliar a tolerância desta droga em humanos. Neste estudo, 101 pacientes com câncer de mama foram randomizadas em 4 grupos de acordo com a dose diária da droga: 100 mg, 200 mg, 300 mg e placebo. Todas as pacientes foram operadas no mesmo Instituto e não receberam nenhum tratamento adjuvante (endócrino ou quimioterápico). Exame clinico, testes sanguineos de laboratório, avaliação dermatológica e oftamológica foram realizadas periodicamente. Uma paciente interrompeu o tratamento na 12 semana, por terem sido demonstradas metástases ósseas e pulmonares. Cem pacientes completaram as 20 semanas de tratamento e não apresentaram efeitos colaterais significa ti vos. Em um caso foi necessário diminuir a dose por três dias com o objetivo de verificar a possív...
Background. To perform a multicentric study in evaluating the diagnostic accordance between '... more Background. To perform a multicentric study in evaluating the diagnostic accordance between 'face-to-face' diagnosis and telediagnosis, clinical and dermatoscopic digital images of pigmented skin tumors were sent by e-mail to 5 remote European centers for teleconsultation. Methods. Fourty patients (21 males and 19 females; age range 3 to 91 years) with pigmented skin neoplasms (11 malignant melanomas, 23 melanocytic nevi, 3 basal cell carcinomas, 3 lentigines, 2 seborrheic keratoses and 1 angiokeratoma) were evaluated on a 'face-to-face' basis at the Department of Dermatology of Graz, Austria. All clinical and dermatoscopic images were compressed in JPEG format file and then sent by E-mail to 6 physicians (dermatologists, oncologists) in 5 centers for telediagnosis. All lesions were surgically excised and histopathologically examined in Graz. Results. Eight out of 11 melanomas were correctly diagnosed on a 'face-to-face' basis in Graz while one nevus was over...
Background Reproducible, high-quality surgery is a key point in the management of cancer patients... more Background Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an Italian registry. Methods Data were extracted from the Central National Melanoma Registry (CNMR) promoted by the Italian Melanoma Intergroup (IMI). All surgical procedures (WE, SNLB or LFND) for non-metastatic skin melanoma between January 2011 and February 2017 were evaluated for inclusion in the study. Only centers with adequate completeness of information (> 80%) were included in the study. Short-term complications (wound infection, dehiscence, skin graft failure and seroma) were investigated. Results Wound infection rate was 1.1% (0.4 to 2.7%) in WE, 1.3% (0.7 to 2.5%) in SLNB and 4.1% (2.1 to 8.0%) in LFND. Wound dehiscence rate was...
The International Journal of Biological Markers, 1993
Mucin-like Carcinoma-associated Antigen (MCA) is a glycoprotein belonging to the mucin family; it... more Mucin-like Carcinoma-associated Antigen (MCA) is a glycoprotein belonging to the mucin family; it is defined by the monoclonal antibody b-12. Mucins represent an interesting group of tumor markers and are widely utilized in the clinical monitoring of neoplastic patients. These molecules show a certain degree of tissue specificity and MCA is preferentially associated with breast tissue. Several studies have demonstrated that patients with breast cancer usually have high MCA serum levels. In this paper the experience of the National Cancer Institute of Milan with the clinical use of MCA in breast cancer patients is reported. The observed sensitivity of the MCA test was poor in patients with early-stage disease, while it was acceptable in patients with advanced breast cancer. MCA concentrations appeared to be directly related to disease spread. A clear relationship was seen between MCA levels and lymph-nodal status. The highest MCA plasma levels were observed in patients with metastati...
Aim and background Dermoscopic diagnosis of pigmented skin lesions is based on the evaluation of ... more Aim and background Dermoscopic diagnosis of pigmented skin lesions is based on the evaluation of dermoscopic criteria (classical pattern analysis) and on alternative diagnostic methods, such as the ABCD (A, asymmetry; B, border; C, color; D, differential structures) rule based on the total dermatoscopic score. The aim of the study was to investigate the interobserver agreement of standard dermoscopic criteria between two observers and the diagnostic validity of dermoscopic diagnosis by pattern analysis and by the ABCD rule. Study design The study included a total of 129 small (≤5 mm) melanocytic skin lesions selected from all lesions observed in consecutive patients between April 1996 and September 1998. Before surgery, each lesion was photographed with a Dermaphot. Dermoscopic images were examined independently by two observers to evaluate the presence or absence of standard dermoscopic criteria and to establish the dermoscopic diagnosis by pattern analysis and by the ABCD rule. Re...
We performed a multicentre study to evaluate the agreement between the direct clinical diagnosis ... more We performed a multicentre study to evaluate the agreement between the direct clinical diagnosis and the telediagnosis of 43 cutaneous pigmented lesions. Digital clinical and dermoscopic images of the 43 pigmented skin lesions (11 melanomas, 23 melanocytic naevi, three basal cell carcinomas, three lentigines, two seborrhoeic keratoses and one angiokeratoma) were sent by email to 11 colleagues (six dermatologists, two residents in dermatology, one oncologist, one specialist in internal medicine and one general practitioner) in 10 centres. These 11 colleagues had different degrees of experience in dermoscopy. With histopathology as the gold standard, an average of 85% of the telediagnoses were correct, with results varying from 77% to 95%, whereas face-to-face diagnosis by an expert dermatologist was correct in 91% of cases. The kappa value for all participants ranged from 0.35 to 0.87. The results confirm that teledermoscopy can be a reliable technique for the diagnosis of pigmented ...
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Papers by M. Pizzichetta