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Background: Preoperative diagnosis of malignant collision tumors (MCT) is extremely difficult. The value of dermoscopy to improve the correct detection of these tumors has not been previously studied. This study aims to evaluate the diagnostic accuracy of MCT with and without dermoscopy and to describe the dermoscopic features of a large series of MCT. Methods: Dermoscopic images of 161 MCT were evaluated. Clinical and dermoscopic images of histopathologically proven MCT intermingled with other tumors were randomly presented to clinicians with different levels of experience, blinded to the diagnosis and objective of the study. The clinical and dermoscopic diagnostic accuracies were measured separately. Results: A total of 161 histopathologically proven cases of MCT were collected. The most frequent MCT was basal cell carcinoma-seborrheic keratosis collision tumor (CT; 37.9%), followed by basal cell carcinoma-melanocytic nevus CT (19.9%), and melanoma-seborrheic keratosis CT (6.8%). Diagnostic accuracy among experts on dermoscopy was 71.4%. The study included 119 participants. The percentage of correct diagnoses was 8% by naked eye examination and 36.4% by dermoscopy (p < 0.001). The presence of the malignant component in the cases of MCT was not recognizable in 19.1% of cases by naked eye examination and in 11.8% of cases by dermoscopy (p < 0.001). Conclusions: The diagnosis of MCT can be assisted and clarified by dermoscopy. However, many of these lesions manifest complex morphologies and continue to be challenging, even for experts on dermoscopy. Atypical, uncertain, or non-classifiable lesions still need a complete excision for the final diagnosis. [ABSTRACT FROM AUTHOR]

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Background: Giant basal cell carcinoma (GBCC) is a basal cell carcinoma (BCC) enlarged in a diameter more than 5 cm. Since GBCCs are a highly infrequent entity and the occurrence rate is approximately 0.5–1% out of all BCC types, only anecdotal cases are reported, and causes and characteristics inducing development of this tumor are not defined. Objectives: Evaluate causative factors and clinico‐histological characteristics of GBCCs. Methods: The study is a 6‐month, hospital‐based case series study performed in 12 Italian dermatologic centers. Results: A total of 59 cases and 458 control BCCs were collected. No significant differences existed between the two groups if we take into account social or cultural factors. The average duration of GBCCs is considerably longer than controls. GBCCs are located on unexposed areas while BCCs are on areas not usually covered by clothes. Superficial histological subtype was more frequent in the BCCs group, while infiltrative in GBCCs. GBCCs showed significantly higher local invasiveness, and greater metastatic capacity. More than half of GBCCs had been previously treated with one or more treatments. Conclusions: Patients with GBCCs appear to belong to two categories: (i) those who present with GBCC due to delay in accessing medical attention, and (ii) those who have BCCs previously treated with inappropriate strategies. Only very few cases can be carried out with intrinsic biological features of tumor aggressiveness. Social and cultural conditions do not appear to be involved in the development of GBCCS. These observations may help clinicians in selecting correct therapeutic strategies in the treatment of BCCs, which give rise to GBCC. [ABSTRACT FROM AUTHOR]

Abstract: Background/Objectives: The dermoscopy of lymphangioma circumscriptum, also known as superficial lymphatic malformation, remains to be clarified. Methods: Digital dermoscopic images of 45 histopathologically confirmed cases of lymphangioma circumscriptum collected from nine hospitals in Spain, Italy and Turkey were evaluated for the presence of dermoscopic structures and patterns. Results: Our study shows that the most common structure found in lymphangioma circumscriptum was the presence of lacunae (89% of cases). The latter were red or dark‐coloured in 18 cases (45%), yellowish or whitish in 14 cases (35%) and multicoloured in eight cases (20%). The second most common dermoscopic structure was the presence of vascular structures, which were found in 82% of cases, followed by white lines (47%), the hypopyon sign or two‐tone lacunae (42%) and scales (7%). Conclusions: Dermoscopy is useful in improving the diagnosis of lymphangioma circumscriptum with characteristic structures and patterns and could assist in elucidating the presence of blood in lymphatic channels. [ABSTRACT FROM AUTHOR]

Background: Nodular hidradenoma is an uncommon, benign, adnexal neoplasm of apocrine origin which is a clinical simulator of other tumours. Objective: The aim of this study was to evaluate the morphological findings of a large series of nodular hidradenomas under dermoscopic observation. Methods: Dermoscopic examination of 28 cases of nodular hidradenomas was performed to evaluate specific dermoscopic criteria and patterns. Results: The most frequently occurring dermoscopic features were: (1) in 96.4% of cases, a homogeneous area that covered the lesion partially or totally, the colour of which was pinkish in 46.4% of cases, bluish in 28.6%, red-blue in 14.3%, and brownish in 10.7%; (2) white structures were found in 89.3% of cases; (3) in 82.1% of cases, vascular structures were also observed, especially arborising telangiectasias (39.3%) and polymorphous atypical vessels (28.6%). Conclusion: Nodular hidradenomas represent a dermoscopic pitfall, being difficult to differentiate clinically and dermoscopically from basal cell carcinomas and melanomas. [ABSTRACT FROM AUTHOR]

Background: Targetoid hemosiderotic hemangioma is an uncommon, vascular, benign solitary lesion of lymphatic origin that can be misdiagnosed as other tumors including melanomas.Objectives: To evaluate the dermoscopic features of a large series of targetoid hemosiderotic hemangiomas.Methods: Digital dermoscopic images of 35 histopathologically confirmed cases of targetoid hemosiderotic hemangiomas collected from 7 hospitals in Spain and Italy were evaluated for the presence of dermoscopic structures and patterns.Results: The results of our study reveal that the presence of central red and dark lacunae and a peripheral circular reddish-violaceous homogeneous area is the most common dermoscopic pattern in targetoid hemosiderotic hemangioma (71.4%). The targetoid hemosiderotic hemangiomas of our study were correctly diagnosed in 77% of cases.Conclusion: Dermoscopy is helpful in improving the diagnosis of targetoid hemosiderotic hemangioma. However, attention must be paid to those cases that dermoscopically may show nontargetoid patterns, which often mimic other lesions, including melanoma. [ABSTRACT FROM AUTHOR]

The article presents a study which discusses face and scalp angiosarcoma (AS) including its dermoscopic, histopathological, and clinical features. It says that biopsy specimens from infected patients were evaluated through dermoscopic devices, digital camera, and haematoxylin-eosin staining. Results show that AS exhibits a red, purple-blue color of vascular tumors due to the presence of epidermis which was thinned.

Discusses sentinel node (SN) biopsy in patients with malignant melanoma (MM). Sign of regional metastasis of MM; How excised SN is studied; Risk of not treating metastatic non-SN; Success rate of identifying and harvesting SN using lymphoscintigraphy and lymphatic mapping with patent blue dye and γ probe guidance; Importance of SN biopsy.

Cutaneous lesions of disseminated cryptococcosis as the first clinical evidence of acquired immunodeficiency syndrome (AIDS) is described in three cases. The clinical diagnosis was difficult because of the polymorphism of lesions, absence of general symptoms and the patients' unawareness of their HIV infection. Patient 1 had central nervous system involvement and a poor prognosis. Patients 2 and 3 had cutaneous lesions only and have remained in relatively good health at 18- and 14-month follow-ups, respectively, after treatment. The patients were treated with amphotericin B 0.5 mg/kg per day for 6 weeks and oral fluconazole at 300 mg/day. The cutaneous lesions healed in 30 days. Because the high risk of relapse, long-term suppressive therapy was instituted with oral fluconazole 300 mg/day, supplemented with three weekly amphotericin infusions. To the best of our knowledge, cutaneous cryptococcosis as the presenting sign of HIV infection has not been previously reported in medical literature. [ABSTRACT FROM AUTHOR]

A 70-year-old woman had noticed, at the age of 30, a single blue nodule of about 1 cm in size on her scalp. The lesion remained stable until 1991, when it became larger and ulcerated and, because of the sudden onset of additional macules and nodules around it, the patient presented at our Dermatological Division in August 1992. Physical examination showed a blue–black plaque, 2 × 2 cm in size, on the left parietal area of the scalp, surrounded by several blue–grey pigmented nodules and macules (Fig. 1). Chest X-ray, abdomen scan, and a total body computed tomography (CT) scan were negative for metastatic disease. A wide resection of the scalp lesion was performed. The histologic evaluation revealed a dense collection of spindled melanocytes in the dermis and in the subcutaneous fat. Nuclear and cytoplasmic pleomorphism, some mitotic figures, and necrosis foci were present (Figs 2 and 3). Pictures of cellular blue nevus were found in the surrounding lesions. Ten months later, new blue macular and papular lesions appeared in proximity to the surgical scar. The patient refused any additional surgery, and so was treated with dacarbazine (DTIC) 800 mg intravenously (every 20 days) and 2α interferon (3 million units subcutaneously, three times weekly). The growth of the lesions slowed down for a few weeks, and then increased again to become a wide, blue–black vegetating mass (Fig. 4). In June 1995, a total body CT scan revealed multiple focal nodules on the lungs and two metastatic masses on the eighth segment of the liver. A palliative polychemotherapy, with vindesin 3 mg/m2 and DTIC 400 mg/m2, was started, but did not stop the progression of the disease, and the patient died in December 1996. [ABSTRACT FROM AUTHOR]