Mostrando entradas con la etiqueta microscopy. Mostrar todas las entradas
Mostrando entradas con la etiqueta microscopy. Mostrar todas las entradas

lunes, 4 de marzo de 2019

Patrones de distribución de los nevos melanocíticos congénitos gigantes (GCMN): La regla 6B.

Martins da Silva VP  Marghoob A Pigem R Carrera C Aguilera P Puig-Butillé JA Puig S Malvehy J .

Resumen



FONDO:

Se han usado términos relacionados con prendas de ropa para describir el patrón de distribución de los nevos melanocíticos congénitos gigantes (GCGN).

OBJETIVO:

Buscamos describir los patrones de distribución de GCMN y proponer un esquema de clasificación.

MÉTODOS:

Se analizaron los registros fotográficos de pacientes con GCMN del Hospital Clínico de Barcelona y se creó una clasificación basada en los patrones de distribución observados de GCMN. La clasificación fue aplicada de forma independiente por 8 observadores a los casos encontrados en la literatura. El acuerdo interobservador fue evaluado.

RESULTADOS:

Entre los 22 pacientes observamos 6 patrones repetibles de distribución de GCMN, que denominamos "6B": bolero (que involucra el aspecto superior de la espalda, incluido el cuello), la espalda (en la espalda, sin la participación de las nalgas ni los hombros) , tronco de baño (que involucra la región genital y los glúteos), pecho / vientre (aislado en el tórax o abdomen sin participación del bolero o distribuciones del tronco de baño), extremidad del cuerpo (aislado a la extremidad) y cuerpo (compromiso tanto del bolero como del tronco de baño) . Nuestra búsqueda en la literatura encontró 113 casos de GCMN, que pudimos clasificar en 1 de los patrones 6B con un kappa general de 0,89.

LIMITACIONES:

Algunos patrones ocurren con poca frecuencia con una escasez de imágenes disponibles para el análisis.

CONCLUSIONES:

La distribución anatómica de GCMN se produce en 6 patrones reconocibles y repetibles.

Fuente: PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28325390

Patterns of distribution of giant congenital melanocytic nevi (GCMN): The 6B rule.


Abstract

BACKGROUND:

Garment-related terms have been used to describe the pattern of distribution of giant congenital melanocytic nevi (GCMN).

OBJECTIVE:

We sought to describe patterns of distribution of GCMN and propose a classification scheme.

METHODS:

Photographic records of patients with GCMN from the Hospital Clinic of Barcelona were analyzed and a classification based on observed GCMN distribution patterns was created. The classification was independently applied by 8 observers to cases found in the literature. The interobserver agreement was assessed.

RESULTS:

Among 22 patients we observed 6 repeatable patterns of distribution of GCMN, which we termed the "6B": bolero (involving the upper aspect of the back, including the neck), back (on the back, without involvement of the buttocks or shoulders), bathing trunk (involving the genital region and buttocks), breast/belly (isolated to the chest or abdomen without involvement of bolero or bathing trunk distributions), body extremity (isolated to extremity), and body (both bolero and bathing trunk involvement). Our literature search found 113 cases of GCMN, which we were able to classify into 1 of the 6B patterns with an overall kappa of 0.89.

LIMITATIONS:

Some patterns occur infrequently with a dearth of images available for analysis.

CONCLUSIONS:

The anatomic distribution of GCMN occurs in 6 recognizable and repeatable patterns.

jueves, 1 de febrero de 2018

Dermoscopy versus reflectance confocal microscopy for the diagnosis of lentigo maligna

PubMed

Dermoscopy versus reflectance confocal microscopy for the diagnosis of lentigo maligna

BACKGROUND:
Several dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques.

OBJECTIVE:

We evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images.

METHODS:

223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination were compared. Inter-investigator variability and confidence level in the diagnosis were also evaluated.

RESULTS:

Overall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80%, versus 61%) and less specific (81% versus 92%) than dermoscopy for LM/LMM. In particular RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher inter-investigator agreement and a higher confidence level in the diagnosis than dermoscopy.

CONCLUSION:

RCM and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM. This article is protected by copyright. All rights reserved.

https://www.ncbi.nlm.nih.gov/pubmed/29341263

 
#confocal #cristinacarrera #josepmalvehy #susanapuig #skincancer #invivo #confocalinvivo #cutaneousmelanoma #lentigo #reflactanceconfocal #cedilp #pubmed #microscopy

 

jueves, 25 de enero de 2018

Improving diagnostic sensitivity of combined dermoscopy and reflectance confocal microscopy imaging through double reader concordance evaluation in telemedicine settings: A retrospective study of 1000 equivocal cases

PubMed

Improving diagnostic sensitivity of combined dermoscopy and reflectance confocal microscopy imaging through double reader concordance evaluation in telemedicine settings: A retrospective study of 1000 equivocal cases

Abstract

BACKGROUND:

Reflectance confocal microscopy (RCM) is an imaging device that permits non-invasive visualization of cellular morphology and has been shown to improve diagnostic accuracy of dermoscopically equivocal cutaneous lesions. The application of double reader concordance evaluation of dermoscopy-RCM image sets in retrospective settings and its potential application to telemedicine evaluation has not been tested in a large study population.

OBJECTIVE:

To improve diagnostic sensitivity of RCM image diagnosis using a double reader concordance evaluation approach; to reduce mismanagement of equivocal cutaneous lesions in retrospective consultation and telemedicine settings.

METHODS:

1000 combined dermoscopy-RCM image sets were evaluated in blind by 10 readers with advanced training and internship in dermoscopy and RCM evaluation. We compared sensitivity and specificity of single reader evaluation versus double reader concordance evaluation as well as the effect of diagnostic confidence on lesion management in a retrospective setting.

RESULTS:

Single reader evaluation resulted in an overall sensitivity of 95.2% and specificity of 76.3%, with misdiagnosis of 8 melanomas, 4 basal cell carcinomas and 2 squamous cell carcinomas. Combined double reader evaluation resulted in an overall sensitivity of 98.3% and specificity of 65.5%, with misdiagnosis of 1 in-situ melanoma and 2 basal cell carcinomas.

CONCLUSION:

Evaluation of dermoscopy-RCM image sets of cutaneous lesions by single reader evaluation in retrospective settings is limited by sensitivity levels that may result in potential mismanagement of malignant lesions. Double reader blind concordance evaluation may improve the sensitivity of diagnosis and management safety. The use of a second check can be implemented in telemedicine settings where expert consultation and second opinions may be required.

https://www.ncbi.nlm.nih.gov/pubmed/29121636

#josepmalvehy  #carcinomabasocelular  #dermatoscopy #confocal #cancerdepiel #confocalinvivo, #microscopy #cutaneousmelanoma #squamouscellcarcinomas #carcinomas  #melanomas #reflectanceconfocal #telemedicine