Usefulness of photodynamic therapy as a possible therapeutic alternative in the treatment of basal cell carcinoma

Basal cell carcinoma (BCC) is the most common cancer in individuals with fair skin type (I–II) and steadily increasing in incidence (70% of skin malignancy). It is locally invasive but metastasis is usually very rare, with an estimated incidence of 0.0028%–0.55%. Conventional therapy is surgery, especially for the H region of the face and infiltrative lesions; in case of inoperable tumors, radiotherapy is a valid option. Recently, topical photodynamic therapy (PDT) has become an effective treatment in the management of superficial and small nodular BCC. PDT is a minimally invasive procedure that involves the administration of a photo-sensibilizing agent followed by irradiation at a pre-defined wavelength; this determines the creation of reactive oxygen species that specifically destroy target cells. The only major side effect is pain, reported by some patients during the irradiation. The high cure rate and excellent cosmetic outcome requires considering this possibility for the management of patients with both sporadic and hereditary BCC. In this article, an extensive review of the recent literature was made, in order to clarify the role of PDT as a possible alternative therapeutic option in the treatment of BCC

Targetoid hemosiderotic nevus: A trauma-induced simulator of malignant melanoma

BACKGROUND: Simulators of malignant melanoma comprise a heterogenous group of melanocytic and nonmelanocytic lesions of the skin. Among frequent clinical mimickers of melanoma are injured melanocytic nevi. Any change in the clinical appearance of a pre-existing nevus should alert the clinician to exclude the possibility of malignant transformation in order to early identify a lesion at a stage when complete cure can still be achieved. OBJECTIVE: The purpose of this study was to present the clinical, dermoscopic and histopathologic findings of a series of acquired melanocytic nevi which abruptly developed a pigmented peripheral halo, presumably following minor trauma. METHODS: A series of 6 cases of acquired melanocytic nevi which suddenly developed a targetoid halo were included in the study. All lesions were evaluated by dermoscopy. Three cases were surgically removed at different stages of evolution and submitted to histopathologic examination. In all cases, follow-up was obtained. RESULTS: All the lesions arose on trauma-prone skin sites of young women. The sudden development of an asymptomatic, targetoid halo on a long-lasting, acquired exophytic nevus was the main presentation. Whereas the central nevus persisted, the ecchymotic halo ultimately disappeared. Histopathologic examination disclosed changes of the traumatized nevus in the central part, whereas the ring showed hemorrhage and hemosiderin deposits. Increased numbers of small vessels with hobnail characteristics were associated features. CONCLUSIONS: Targetoid hemosiderotic nevus is a distinctive clinicopathologic variant of traumatized acquired melanocytic nevus which should be included in the list of clinical simulators of melanoma

Psoriasis-like dermoscopic pattern of clear cell acanthoma

Dermoscopy provides additional criteria for the diagnosis of skin lesions

Indocyanine Green and Fluorescein Filters Reveal Dye Staining before Clinical Development of Hives

Purpose During retinal angiography a fluorescein-induced allergic reaction is rare but possible. Methods We report a single retrospective clinical case. Results During retinal angiography on a 75-year-old man, an unexpected allergic reaction to fluorescein (FL) dye occurred. At the beginning of the exam, we erroneously took some filtered shots of the patient's face. We noticed that the pictures of the patient's skin using the FL and indocyanine green filters revealed dye accumulation before the clinical appearance of hives. Conclusions Taking filtered shots of a patient's face could be an original method to promptly detect and easily document allergic hives, by simply using an angiographic device

Dermoscopy patterns of fibroepithelioma of pinkus

Background: Fibroepithelioma of Pinkus ( FeP) is a rare variant of basal cell carcinoma that may clinically mimic a number of benign skin tumors. While the dermoscopic features of basal cell carcinoma have been studied extensively, little is known about the dermoscopic features of FeP. Observations: Retrospective evaluation of clinical records and digital clinical dermoscopic images of 10 histopathologically proved FePs ( 6 nonpigmented and 4 pigmented) was performed. Clinically, no FeP was correctly identified and, in half of all patients, a clinical differential diagnosis of purely benign skin lesions was made. Dermoscopy enabled the correct diagnosis in 9 of 10 FePs, based on the presence of fine arborizing vessels, either alone or associated with dotted vessels, and white streaks ( in 100%, 70%, and 90% of lesions, respectively). In the 4 pigmented FePs, a structureless gray- brown area of pigmentation and variable numbers of gray- blue dots were observed, in addition. Conclusions: Dermoscopy is helpful in diagnosing FeP and in differentiating this variant of basal cell carcinoma from other benign skin tumors commonly included in the clinical differential diagnosis. This presumes, however, that dermoscopy is used as a first- line examination for all skin lesions, not only for those that are clinically suspect