Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · May 2007
Sensitivity, specificity, and diagnostic accuracy of three dermoscopic algorithmic methods in the diagnosis of doubtful melanocytic lesions: the importance of light brown structureless areas in differentiating atypical melanocytic nevi from thin melanomas.
Over the past decade numerous epiluminescence microscopy (ELM) criteria and algorithmic methods have been developed to improve the diagnosis of cutaneous melanocytic lesions. ⋯ The pattern analysis method showed the highest sensitivity, specificity, and diagnostic accuracy for TM. Light brown structureless areas were both a statistically significant discriminator and the most reliable predictor of TM (PPV = 93.8%, positive likelihood ratio = 16). Therefore the use of this previously underestimated ELM criterion may not only improve diagnostic performance of equivocal macular melanocytic lesions but also significantly decrease the rate of false-negative results obtained with the 7-point checklist method.
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Longitudinal pigmentation of the nail is very common. The differential diagnosis varies from subungual hematoma, to a fungal infection, to a melanocytic lesion (lentigo, nevus melanoma, etc.) to others. Often, dermatologists do not feel at ease with these pathologies and management is often not clear. ⋯ The use of noninvasive techniques such as dermoscopy has been described to be useful for the preoperative evaluation and the management decision. Using these technique, one will be able to reduce the number of unnecessary surgeries and to choose the most adequate biopsy technique. In this article, we will review the management, including diagnosis as well as differential diagnosis of nail pigmentations and propose a new algorithm for the non invasive diagnosis of nail pigmentation.
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J. Am. Acad. Dermatol. · May 2007
Case ReportsTreatment of extensive cutaneous metastatic melanoma with topical diphencyprone.
Diphencyprone is a potent contact sensitizer sometimes used to treat alopecia areata and cutaneous warts. A patient with previous primary nodular melanoma on the scalp developed extensive, confluent cutaneous metastases near the primary site, unsuitable for treatment with surgery or radiotherapy. Topical treatment with diphencyprone as a single agent resulted in regression of all lesions, and the patient remains well 18 months later. Topical immunotherapy with diphencyprone was an inexpensive and well-tolerated treatment for extensive cutaneous melanoma metastases in our patient unsuitable for other therapies.