Applications of Dermatoscopy in Skin Diseases

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 11768

Special Issue Editors


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Guest Editor
Centrum Medyczne Zwierzyniecka, Poznań, Poland
Interests: skin cancer; melanoma; inflammoscopy; autoimmunity; artificial intelligence; total body photography and ultraviolet reflectance dermatoscopy; polarization
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Guest Editor
Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, 33100 Udine, Italy
Interests: dermoscopy; immune-mediated skin diseases; inflammoscopy; pediatric dermatology; psoriasis; rare diseases; skin of color; skin tumors

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Guest Editor
Affiliation: Department of Dermatology, Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
Interests: skin cancer; dermoscopy; reflectance confocal microscopy; optical coherence tomography; artificial intelligence; melanoma; Mohs micrographic surgery

Special Issue Information

Dear Colleagues,

Dermatoscopy is an auxiliary non-invasive in vivo diagnostic method complementary to clinical examination and pathology. It enables the visualization of submacroscopic structures in the skin, mucosa and adnexa, and has been proved to have a tremendous impact on diagnostic accuracy, decision making and disease monitoring. In recent decades, we witnessed the rapid development of devices, including the implementation of polarized light source, multispectral illumination, optical super-high magnification dermatoscopy, and finally, the use of ultraviolet diodes. Once used as a handheld device, dematoscopes are becoming videodermatoscopes, easily attached to smartphones and cameras allowing for clinical and microscopic data storage, digital follow-up and data transfer/processing (telehealth and artificial intelligence). Even though the method was initially intended to be used in skin cancer diagnosis, its scope became very vast including non-neoplastic dermatoses, infestations and infectious diseases, abnormalities of the adnexa (hair, nails, teeth), extending to mucosal disorders, genital dermatoses and esthetic medicine.

We would like to invite you to contribute papers addressing all the aforementioned aspects related to this Special Issue on ‘Applications of Dermoscopy in Skin Diseases.

Dr. Paweł Pietkiewicz
Dr. Enzo Errichetti
Dr. Cristian Navarrete
Guest Editors

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Keywords

  • melanoma
  • skin cancer
  • inflammoscopy
  • trichoscopy
  • ultraviolet reflectance dermatoscopy
  • skin of colour
  • basal cell carcinoma
  • squamous cell carcinoma
  • nevus
  • digital dermoscopy

Published Papers (4 papers)

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Research

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12 pages, 1322 KiB  
Article
Dermoscopy of Chronic Radiation-Induced Dermatitis in Patients with Head and Neck Cancers Treated with Radiotherapy
by Aleksandra Pilśniak, Anastazja Szlauer-Stefańska, Andrzej Tukiendorf, Tomasz Rutkowski, Krzysztof Składowski and Grażyna Kamińska-Winciorek
Life 2024, 14(3), 399; https://doi.org/10.3390/life14030399 - 18 Mar 2024
Viewed by 857
Abstract
Radiotherapy (RT) is an integral part of many cancer treatment protocols. Chronic radiation-induced dermatitis (CRD) is a cutaneous toxicity that occurs in one-third of all patients treated with this method. CRD is usually observed several months after completion of treatment. Typical symptoms of [...] Read more.
Radiotherapy (RT) is an integral part of many cancer treatment protocols. Chronic radiation-induced dermatitis (CRD) is a cutaneous toxicity that occurs in one-third of all patients treated with this method. CRD is usually observed several months after completion of treatment. Typical symptoms of CRD are telangiectasia, skin discoloration, atrophy, thickening, and cutaneous fibrosis. There are currently no data in the literature on the evaluation of the dermoscopic features of CRD. The aim of this prospective study was the identification of clinical and dermoscopic features in a group of 32 patients with head and neck cancer (HNC) in whom CRD developed after RT. CRD was assessed at 3, 6, and 12 months after RT in 16, 10, and 10 patients, respectively. CRD was assessed at one time point and two time points in 28 and 4 patients, respectively. The control included skin areas of the same patient not exposed to RT. The dataset consisted of 36 clinical and 216 dermoscopic photos. Clinical evaluation was performed according to the RTOG/EORTC radiation-induced dermatitis scale. The highest score was grade 2 observed in 21 patients. Clinical observations revealed the presence of slight and patchy atrophy, pigmentation change, moderate telangiectasias, and some and total hair loss. Dotted vessels, clustered vessel distribution, white patchy scale, perifollicular white color, white structureless areas, brown dots and globules, and white lines were the most frequently noted features in dermoscopy. Three independent risk factors for chronic toxicity, such as age, gender, and surgery before RT, were identified. The dermoscopic features that had been shown in our study reflect the biological reaction of the skin towards radiation and may be used for the parametrization of CRD regarding its intensity and any other clinical consequences in the future. Full article
(This article belongs to the Special Issue Applications of Dermatoscopy in Skin Diseases)
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31 pages, 3751 KiB  
Article
Multiple Primary Melanoma: A Five-Year Prospective Single-Center Follow-Up Study of Two MC1R R/R Genotype Carriers
by Ana Maria Fagundes Sortino, Bianca Costa Soares de Sá, Marcos Alberto Martins, Eduardo Bertolli, Rafaela Brito de Paula, Clovis Antônio Lopes Pinto, Waldec Jorge David Filho, Juliana Casagrande Tavoloni Braga, João Pedreira Duprat Neto, Dirce Maria Carraro and Maria Paula Curado
Life 2023, 13(10), 2102; https://doi.org/10.3390/life13102102 - 23 Oct 2023
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Abstract
Background: Multiple primary melanoma (MPM) is a diagnostic challenge even with ancillary imaging technologies available to dermatologists. In selected patients’ phenotypes, the use of imaging approaches can help better understand lesion characteristics, and aid in early diagnosis and management. Methods: Under a 5-year [...] Read more.
Background: Multiple primary melanoma (MPM) is a diagnostic challenge even with ancillary imaging technologies available to dermatologists. In selected patients’ phenotypes, the use of imaging approaches can help better understand lesion characteristics, and aid in early diagnosis and management. Methods: Under a 5-year prospective single-center follow-up, 58 s primary melanomas (SPMs) were diagnosed in two first-degree relatives, with fair skin color, red hair, green eyes, and personal history of one previous melanoma each. Patients’ behavior and descriptive demographic data were collected from medical records. The information on the first two primary melanomas (PMs) were retrieved from pathology reports. The characteristics of 60 melanomas were collected from medical records, video dermoscopy software, and pathology reports. Reflectance confocal microscopy (RCM) was performed prior to excision of 22 randomly selected melanomas. Results: From February 2018 to May 2023, two patients underwent a pooled total of 214 excisional biopsies of suspect lesions, resulting in a combined benign versus malignant treatment ratio (NNT) of 2.0:1.0. The number of moles excised for each melanoma diagnosed (NNE) was 1.7:1.0 and 6.9:1.0 for the female and male patient respectively. The in-situ melanoma/invasive melanoma ratio (IIR) demonstrated a higher proportion of in-situ melanomas for both patients. From June 2018 to May 2023, a total of 58 SPMs were detected by the combination of total body skin exam (TBSE), total body skin photography (TBSP), digital dermoscopy (DD), and sequential digital dermoscopy imaging (SDDI) via comparative approach. The younger patient had her PM one month prior to the second and third cutaneous melanomas (CMs), characterizing a case of synchronous primary CM. The male older relative had a total of 7 nonsynchronous melanomas. Conclusions: This CM cohort is composed of 83.3% in-situ melanoma and 16.7% invasive melanoma. Both patients had a higher percentage of SPM with clinical nevus-like morphology (84.5%), global dermoscopic pattern of asymmetric multiple component (60.3%) and located on the lower limbs (46.6%). When RCM was performed prior to excision, 81% of SPM had features suggestive of malignancy. As well, invasive melanomas were more frequent in the lower limbs (40%). In the multivariate model, for the two high-risk patients studied, the chance of a not associated with nevus (“de novo”) invasive SPM diagnosis is 25 times greater than the chance of a diagnosis of a nevus-associated invasive SPM. Full article
(This article belongs to the Special Issue Applications of Dermatoscopy in Skin Diseases)
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14 pages, 2681 KiB  
Article
Exploring Small-Diameter Melanomas: A Retrospective Study on Clinical and Dermoscopic Features
by Maria Fernanda Vianna Hunziker, Beatrice Martinez Zugaib Abdalla, Flavia Vieira Brandão, Luana Pizarro Meneghello, Jaciara Moreira Sodré Hunnicutt, Thais Helena Bello Di Giacomo, Cristina Martinez Zugaib Abdalla and Ana Maria Fagundes Sortino
Life 2023, 13(9), 1907; https://doi.org/10.3390/life13091907 - 13 Sep 2023
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Abstract
Background: Early melanoma detection allows for timely intervention and treatment, significantly improving the chances of favorable outcomes for patients. Small-diameter melanoma (SDM) typically represents an initial growth phase of cutaneous melanoma. One of the challenges in detecting melanoma in their early stage lies [...] Read more.
Background: Early melanoma detection allows for timely intervention and treatment, significantly improving the chances of favorable outcomes for patients. Small-diameter melanoma (SDM) typically represents an initial growth phase of cutaneous melanoma. One of the challenges in detecting melanoma in their early stage lies in the fact that dermoscopy criteria have been primarily designed for fully developed lesions. Early-stage melanomas may be difficult to detect and possibly even be overlooked or misinterpreted during examinations. Methods: The primary aim of this study was to identify valuable clinical and dermoscopic clues to enhance the detection of SDMs. To achieve this objective, we conducted a comprehensive retrospective analysis, including forty SDMs with a diameter of 5 mm or less. These cases were diagnosed over an 8-year period and were collected from five referral centers across Brazil. Seven experienced dermatologists independently assessed the dermoscopic features of each lesion. Additionally, this study includes demographic and histological information. Results: The study encompassed a total of 28 patients, of which 16 were females, accounting for 58% of the participants, with an average age of 43.6 years. Among the small-diameter melanomas (SDMs) under investigation, the majority, constituting 27 cases (69.2%), were identified as “de novo” lesions, i.e., not associated with a nevus. Additionally, eight SDMs (20%) exhibited invasive characteristics, with Breslow index measurements ranging between 0.2 to 0.4 mm, suggesting an early stage of malignancy. During dermoscopic examinations, the most prevalent features observed were irregular dots and globules, present in 95% and 87.5% of cases, respectively. Moreover, brown structureless areas were identified in 70% of lesions, followed by atypical network (67.5%), pseudopods (55%), dotted vessels (47.5%), flat structureless blue-gray areas (42.5%), and irregular blotches (40%). Notably, all SDM were diagnosed in patients under surveillance through total body skin photography (TBSP) and Digital Dermoscopy (DD). Conclusions: Dermoscopy significantly enhances the diagnostic accuracy of melanoma, even in its early stages. Particularly for high-risk patients with numerous nevi, the identification of a new lesion or subtle changes on dermoscopy during follow-up may serve as the sole clue for an early diagnosis. This emphasizes the critical role of dermoscopy in SDM detection and reinforces the importance of surveillance in high-risk patients for timely and effective management. Full article
(This article belongs to the Special Issue Applications of Dermatoscopy in Skin Diseases)
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Review

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19 pages, 22552 KiB  
Review
Pityriasis Versicolor—A Narrative Review on the Diagnosis and Management
by Nina Łabędź, Cristian Navarrete-Dechent, Honorata Kubisiak-Rzepczyk, Monika Bowszyc-Dmochowska, Anna Pogorzelska-Antkowiak and Paweł Pietkiewicz
Life 2023, 13(10), 2097; https://doi.org/10.3390/life13102097 - 22 Oct 2023
Cited by 2 | Viewed by 4337
Abstract
This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper [...] Read more.
This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered. Full article
(This article belongs to the Special Issue Applications of Dermatoscopy in Skin Diseases)
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