Measuring the horizontal and vertical growth rates of superficial spreading melanoma: a pilot study with sequential digital dermoscopy.

BACKGROUND Some authors have hypothesized that the initial kinetics of the primary melanoma (MM) growth could reflect its biologic aggressiveness. The aim of this study was to pilot a measure of the horizontal vs vertical growth of superficial spreading melanomas (SSM). METHODS The dermoscopic images of twenty-three consecutive MMs (17 SSMs and 6 MMs in situ), excised after digital sequential dermoscopy, were reviewed. We built up two indexes: 1) dROG (digital Rate of Growth) defined as Breslow thickness/(t1-tR), where t1 was the reported time of the first dermoscopic image acquisition and tR was the reported time of the acquisition before the lesion excision; 2) lHGR (linear Horizontal Growth Rate) took into account the greater axis of the lesion at two time points, at the time (t1) of the first image acquisition (D1) and before (tR) lesion excision (DR). The index was computed as (DR- D1)/(t1-tR). We built up the Composite Rate of Growth index (cROG) calculated as dROG/lHRG. If the value of cROG is 1 the vertical growth is prevalent on the superficial growth. RESULTS In 82.6% of lesions the horizontal growth was prevalent on the vertical growth, and in 17.4% of cases the vertical growth was equal or prevalent on the superficial growth. CONCLUSIONS A small proportion of SSMs with a slow horizontal growth could have a precocious vertical growth. Other larger studies are needed to confirm this observation

Laugier-Hunziker syndrome: a case and dermoscopic features

Laugier-Hunziker syndrome (LHS) is a sporadic, acquired, and infrequent condition characterized by the onset of brown macules on the lips, the oral mucosa, and the acral glabrous skin (mainly fingers and toes) in middle-aged patients. In several cases melanonychia of fingernails and toenails coexists. No other systemic involvement is observed. A case of LHS in a 50-year-old woman is described, with particular attention to dermoscopic features. No dermoscopic specific findings of mucosal/cutaneous maculae have been to date described in the literature. Accumulation of dermoscopic observations of pigmented lesions in LHS is needed and if found to be distinct, it may contribute to a more accurate diagnosis in the futur

Atopic dermatitis in young adult italian males: persistent and adult-onset varieties did not differ clinically and as for allergological variables.

BACKGROUND The prevalence of adult atopic dermatitis (AD) in general population range from 2.6% to 8% according to objective diagnosis in selected groups of people. The adult-onset AD is the clinical form arising de novo in adulthood. The aim of this study was to detect retrospectively the prevalence of AD in Italian general population, examining a sample of young Italian males affected by AD, which was representative of people of same sex and age, and to point out the clinical and allergological differences between the persistent and adult-onset form. METHODS 198,730 potential male conscripts were visited in Italian Navy and Air Force Recruitment's Centres in Taranto to evaluate their fitness to recruitment. All the young men who showed eczema were referred to Italian Navy Hospital. The diagnosis of AD was stated according to Hanifin and Rajka's criteria. All the patients were patch and prick tested. RESULTS One hundred twenty four cases of AD were diagnosed, with a prevalence of 6.2 cases for 10,000 subjects (95% CI: 5.2-7.4). The subjects with the persistent form were 68 (75.6%; 95% CI: 66.7-84.4) vs 26 patients with the adult-onset form (21.0%; 95% CI: 13.8-28.1). No statistical difference in clinical and allergological variables was showed between the persistent and adult-onset AD. CONCLUSIONS The prevalence of adult AD in a large sample of young males representative of the general population of same age and sex is appreciably lower than the rates previously reported. No clinical feature or allergological variable discriminate between persistent vs adult- onset varieties

Clinicopathologic and Dermoscopic Features of 20 Cases of Spark's Nevus, a Dermoscopic Simulator of Melanoma

Spark's nevus is a particular type of melanocytic nevus, with histology that shows features of both Spitz and Clark nevus. Detailed dermoscopic features in a series of Spark nevi have not been described yet. We performed a monocentric retrospective observational study on 20 lesions of Spark nevus excised from 19 patients (M:F = 10:9; mean age: 37,6 years), reviewed by 5 experts in dermoscopy and 2 dermatopathologists. A histologic review confirmed that Spark nevi were mostly symmetric (80%), well circumscribed (100%), mainly compound (65%) melanocytic lesions with either epithelioid (55%) or spitzoid (45%) cell morphology and bridging of the nests (100%). Spark nevi were more frequently found on the trunk (85%) in patients with a history of sunburns in childhood (84%), with skin phototype III (79%), and with high nevus count (>100 nevi, 7 patients (36%)). On dermoscopy, we observed different general patterns: multicomponent (40%), reticular-globular-homogeneous (15%), globular homogeneous (15%), reticular (15%), reticular-globular (5%), homogeneous (5%), and globular (5%). Spark nevi showed frequently dermoscopic asymmetry (63%), brown color (90%) with areas of central hyperpigmentation (41%) and peripheral hypopigmentation (28%), atypical pigment network (48%), irregular globules (42%), irregular dots (31%), irregular blotches (16%), blue-whitish veil (13%), peripheral island (25%), irregular hyperpigmented areas (12%), and regression (33%). BRAF mutation was present in 7 of the 10 analyzed cases (70%); all these cases presented a history of evolution. In conclusion, Spark nevi occur on the trunk of young adults with high nevus count and history of sunburns; dermoscopic features are protean, often atypical and suspicious of melanoma