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Background: Spitz nevus is a melanocytic tumor considered a variant of the composed melanocytic nevus. It is usually benign, but the clinical presentation and histopathology sometimes mimic melanoma. Objective: To determine the clinical and epidemiological characteristics of Spitz nevus at Instituto Dermatológico de Jalisco Dr. José Barba Rubio. Methods: We performed a retrospective study from January 1st 1996 to December 31st 2007. All histopathological samples diagnosed with Spitz nevus were included and demographic and clinical variables were analyzed. With regard to statistical analysis we used descriptive statistics. Results: Spitz nevus affected 114 patients with 117 lesions over a period of 12 years, with a frequency of 9.75 cases per year. Women were more commonly affected (53%), age ranged from 3 months to 32 years (84% of patients were younger than 20 years). Average time of evolution to diagnosis was 4.5 years. Most frequent localizations were head and neck (35%), and lower extremities (27%). The mean nevi size was 7.9 mm, being < 6 mm in 53% of cases. Pigmented lesions predominated in 70% of cases. Conclusions: Clinical features in this study are similar to those previously reported in world literature. Nevertheless, frequency of pigmented lesions was higher and the localization in head and neck was common. [ABSTRACT FROM AUTHOR]

Background: Dermoscopy is a non invasive technique useful for the diagnosis of different kinds of skin lesions, specially pigmented lesions. Its use increases sensitivity and specificity in the diagnosis of malignant melanoma. Objective: To confirm the increase in diagnostic accuracy of pigmented lesions, assessed dermoscopically by a group of dermatologists who attended to a short basic dermoscopy course. Participants and methods: Before and immediately after the basic dermoscopy course, an exam was applied to the attendants, a total of 37 dermatologists participated in the study. Results: Average score in test after the course was almost 20 points higher than the test previous to the course (p < 0.0001). Conclusion: The results of this study show an improvement in diagnostic accuracy when dermatologists attend to a short basic dermoscopy course, increasing scores almost 20 points when assessing dermoscopic images of pigmented lesions. This knowledge, if applied to daily clinical practice, will allow an opportune diagnosis of pigmented lesions. [ABSTRACT FROM AUTHOR]

The incidence of melanoma is on the rise, and early detection of disease is imperative to reduce mortality. Dermatologists are key players in the early detection of melanoma; however, some clinicians rely on their clinical examination without any additional diagnostic tools to make this important diagnosis. Certain patients, such as atypical nevus patients, have more complicated mole examinations, making the diagnosis of melanoma difficult, whereas some melanomas, such as amelanotic melanomas, can be diagnostically challenging. The goal of the clinician is to detect melanoma with the highest accuracy, while avoiding unnecessary biopsies. Using diagnostic melanoma tools as an adjunct to the clinical examination, dermatologists have the opportunity to increase both their sensitivity and specificity for melanoma detection. This article will review current imaging technologies and those in development for pigmented lesions, updating the clinician on basic principals of such modalities and clinical use of such technologies in practice. [Copyright &y& Elsevier]

Oral malignant melanomas are extremely rare lesions and occur commonly in the maxillary gingiva more frequently on the palate with fewer incidences in the mandibular gingiva. Though these lesions are biologically aggressive, they often go unnoticed since they are clinically asymptomatic in the early stages and usually present merely as a hyperpigmented patch on the gingival surface. These lesions if diagnosed at an early in situ stage are potentially curable and definitely have a better prognosis, but unfortunately as they are clinically asymptomatic, it results in delayed diagnosis thus making the prognosis extremely poor. This paper presents the case of a patient who visited our department with the complaint of darkened patches on the gums and his concern was purely aesthetic. There were no symptoms associated with the hyperpigmented lesions and hence the patient did not approach us earlier. When the lesions grew larger and were unsightly, the patient has seeked dental advice. Histopathologic investigation confirmed the diagnosis as 'Oral Malignant Melanoma'. Though aggressive therapy was instilled immediately, unfortunately, the patient succumbed to death within a few months after diagnosis as the lesion was highly invasive. Due to the biologically aggressive but clinically silent nature of progression of the lesion, the importance of maintaining a high index of suspicion and early detection and diagnosis for any pigmented gingival lesions cannot be overemphasised. Diagnosis must be based on thorough detailed history and valid histologic evidence. [ABSTRACT FROM AUTHOR]

Malignant melanoma of the oral cavity is extremely rare, accounting for 0.2% to 8% of all melanomas. Primary gingival malignant melanoma is associated with poor prognosis. We present the clinopathological findings of a case. A 64-year-old woman presented with a hyperplastic-pigmented lesion which was located on the right vestibular maxillary gingiva adjacent to the first molar-canine area. Under local anesthesia an incisional biopsy was taken from the lesion. The pathologic diagnosis of primary malignant melanoma of the gingiva was established after microscopic and immunohistochemical examination, which revealed the neoplastic cells to be positive for HMB-45. A computerized tomography scan on the neck, liver, and lungs revealed no further evidence of disease. A partial right maxillectomy with radical neck dissection was planned. The patient refused the treatment and died after 4 months. In malignant melanoma of the gingiva, survival rates may be increased by early diagnosis and treatment. The dentist must carefully examine periodontal tissues, and pigmented lesions should be biopsied. [ABSTRACT FROM AUTHOR]

A retrospective study was conducted to investigate the incidence of adverse effects following Q-switched ruby laser treatment of pigmented lesions at the Wessex Specialist Laser Centre. Sixty-one patients received a total of 151 treatments between January 2006 and January 2008. This is the largest series to date of patients on whom adverse effects have been reported following Q-switched ruby laser treatment of an assortment of pigmented lesions. Patients with traumatic or decorative tattoos were excluded from this study. Two of the treatments (1.3%) resulted in adverse effects. One patient developed hyperpigmentation and the other experienced scabbing and subsequent textural change following abrasion of the scab. No predisposing medical or other factors were observed in either patient. This low incidence of adverse effects is consistent with the highly selective absorption of ruby laser light by melanin. The presence of these adverse effects highlights the importance of test patch treatments, the necessity for patients to follow good post-treatment advice and the case for vigilance in monitoring the quality of the laser output. [ABSTRACT FROM AUTHOR]

Abstract: Light is electromagnetic radiation and human beings encounter it on a number of levels. The versatility of the cutaneous biological effects allows the medical utilization of light to be used as a potential diagnostic and therapeutic tool. In almost all cases the light used is restricted to certain wavelengths and defined photophysical parameters. In terms of diagnostic purposes photo testing, Wood''s light diagnostics and fluorescence diagnostics are frequently used tools. The therapeutic use of incoherent light can be divided in four main groups: (1) UV phototherapy, (2) photodynamic therapy (PDT), (3) treatment with light-emitting diodes (LEDs), and (4) treatment with intense pulsed light (IPL). Intense pulsed light (IPL) devices use flashlamps and bandpass filters to emit polychromatic, incoherent, high-intensity pulsed light of a determined wavelength spectrum, fluence, and pulse duration. Similar to lasers, the basic principle of IPL devices is the selective thermal damage of the target structure. This review summarizes the practical use of IPL devices and the current literature on IPL with regard to the treatment of unwanted hair growth, vascular lesions, pigmented lesions, acne vulgaris, and as a light source for PDT. [Copyright &y& Elsevier]

Introduction: Primary malignant melanoma of the oral cavity is an aggressive and distinctly rare neoplasm mostly seen in middle aged person. It is more frequently seen on the hard palate and gingiva. The tumour has a tendency to metastasize or locally invade tissue more readily than other malignant tumours in the oral region. It has a poor prognosis and the survival rate is much lower than its cutaneous counterpart. There is no specific guideline for the treatment of oral malignant melanoma to date. Surgical resection is the main stay of treatment with combination of post-operative radiation in selected cases. Objective: To illustrate a unique presentation of oral malignant melanoma and to discuss the management. Design: This report highlights a case report of a 65-year-old male patient diagnosed and treated surgically for an oral malignant melanoma of the alveolar process of the maxilla with regional nodal and ipsilateral submandibular gland metastases with review of literature. Conclusion: The data on management and treatment of OMM is scarce due to the rarity of this condition. OMM is different from cutaneous melanomas in its pathogenesis and presentation, therefore it is paramount to establish new criteria for the diagnosis and treatment of this malignancy. [ABSTRACT FROM AUTHOR]

Pigmented lesions are commonly found in the oral cavity. They represent a variety of clinical entities, ranging from physiological changes (e.g. racial pigmentation) to manifestations of systemic illnesses (e.g. Addison's disease) and malignant neoplasms (e.g. melanoma). The clinical appearance of oral pigmentation ranges from brown to black, depending on the level of melanin production and depth of the pigment location. Peutz-Jeghers syndrome is a rare genetic disorder associated with mutation of the LKB1 (STK11) gene on chromosome 19. It is characterized by pigmented mucocutaneous macules, intestinal hamartomatous polyposis, a positive family history, and an increased risk of cancer in many organs, including the small intestine, colon, stomach, pancreas, breast, and genital tract. The melanotic spots of Peutz-Jeghers syndrome are characteristically small and multiple. Round, oval, or irregular patches of brown or almost black pigmentation from 1 mm to 1.2 cm of diameter, irregularly distributed over the oral mucosa, gingiva, hard palate, and lips (especially the lower one) are observed; the cutaneous macules are most commonly found around the mouth, nose, hands, and feet. The melanotic spots do not require treatment and are not associated with increased risk of melanoma. The purpose of this review is to characterize the clinical and pathological features and symptoms of mucosa pigmentation, especially Peutz-Jeghers syndrome, in the oral mucosa. Close examination of a patient presenting with a pigmented lesion should include a full medical and dental history and extraoral and intraoral examinations. In some cases, biopsy and laboratory investigations should be done. Due to an increased risk of cancer in many organs such the small intestine, stomach, and genital tract, patients with Peutz-Jeghers syndrome should be carefully observed. [ABSTRACT FROM AUTHOR]

Summary: Background: Digital epiluminescence dermoscopy is a relatively recent tool, based on the acquisition of high-definition digital images, for the diagnosis of pigmented cutaneous lesions. Purpose: To verify the usefulness of digital dermoscopy in detecting pigmented lesions with features which may lead to suspicion of malignancy, when the examination is carried out by primary care physicians (PCP), not expert in that kind of diagnosis. Another target was an appraisal of the effectiveness and safety of telediagnosis based on epiluminescence digital dermoscopy on pigmented lesions. Methods: Digital images from some peripheral centres (235 lesions) have been forwarded in real time to the reference centre (Unit of Plastic Surgery, University of Siena, Italy), with a double judgement by each primary care physician (‘benign'' or ‘suspicious of malignancy’) on the basis of anamnesis and clinical examination at first step, and dermoscopy as second step. The image analysis carried out from the reference centre identified every lesion examined as ‘to be controlled’ (219 lesions) or ‘to be removed’ (16 lesions). Results: Regarding the patients with dermoscopic examination (197 subjects, 235 lesions), the investigation reduced the number of lesions suspected of malignancy from 68 to 29 after the first dermoscopy, and from 29 to 16 after the re-examination of the image by the central unit researchers. Fourteen lesions suspected of malignancy when examined in the peripheral centres were then evaluated as benign by the central unit researchers, while one lesion, judged as benign at first (always labelled as ‘benign’ by the PCP), was then revealed as a dysplastic naevus. Conclusion: Digital dermoscopy can be enhanced by telediagnosis, which provides a better control of cutaneous pigmented lesions in the peripheral areas, thus reducing the number of consultations in specialised centres. [Copyright &y& Elsevier]

Primary oral melanoma (POM) is an uncommon malignant tumor that originates from the proliferation of melanocytes. Such tumors can be present at any location in the oral cavity; however, it affects more frequently the hard palate and the maxillary alveolar mucosa. POM is usually asymptomatic in the early stages and it presents normally as a pigmented patch or as a mass with a rapid growth rate. In the advanced stages, it can show ulceration, swelling, bleeding, rapid enlargement and loosening of teeth. Melanoma of the mouth is rare, most commonly occurring in the upper jaw of patients more than 65 years. Because of a frequent delay in diagnosis, the tumors are often diagnosed when they are deeper than the average cutaneous melanoma. The prognosis is extremely poor, especially in advanced stages. Therefore, pigmented lesions of undetermined origin should be routinely subjected to a biopsy examination. In this study, we aimed to present a review on primary malignancy. [ABSTRACT FROM AUTHOR]

Background Instruments designed to provide computer program-driven diagnosis of dermoscopic images of lesions are now commercially available. Multiple publications tout the improved diagnostic accuracy of these instruments compared with that of clinicians. Objectives Our aim was to evaluate the actual usefulness of these instruments for dermatologists practising in a pigmented lesion clinic. Methods Over a 4-month period we subjected lesions, which were being evaluated in one of our clinics, to automated computer diagnosis performed by three commercially available instruments. We intentionally included three groups of lesions: group 1 lesions were suspicious melanocytic lesions that were scheduled to be excised; group 2 lesions were nonmelanocytic lesions; group 3 lesions were clinically obvious melanomas. The automated diagnoses provided by the instruments were compared with the dermoscopy diagnosis of experienced physicians and with histopathology. Results We included a total of 107 lesions. One imaging system’s computer algorithm was unable to analyse one third of the lesions. All three instruments’ computer algorithms were able to identify the clinically obvious melanomas (group 3) correctly. However, all three systems tended to overdiagnose by incorrectly classifying most seborrhoeic keratoses (group 2) as potential malignant lesions. Concerning the suspect melanocytic lesions (group 1), which are precisely the lesions for which a dermatologist would welcome a second opinion, we found significant variability in the diagnostic accuracy of the instruments tested. However, all three systems providing computer-assisted diagnosis had a tendency to overdiagnose benign melanocytic lesions as potential melanomas. Conclusions Although the image analysis systems tested by us correctly identified the clinically obvious melanomas, they were not able to discriminate between most dysplastic naevi and early malignant melanoma. Thus, for the moment these computer-assisted diagnostic imaging machines provide little to no added benefit for the experienced dermatologist/dermoscopist. [ABSTRACT FROM AUTHOR]

Abstract: Lasers may be used to treat a variety of dermatological disorders in children. This review article outlines the issues surrounding parental counselling and the use of lasers in paediatric patients. It summarises which lasers are currently being used to treat common paediatric skin diseases. Port wine stains and haemangiomas are common vascular lesions that are usually treated with the pulsed dye laser (PDL). Ruby and Q-switched long-pulsed neodymium-doped yttrium–aluminium–garnet (Nd:YAG) lasers may be used to treat pigmented lesions such as melanocytic naevi and naevus of Ota. Erbium-YAG and carbon dioxide lasers are employed to treat verrucous epidermal naevi. Long-pulsed ruby, alexandrite, diode, Nd:YAG lasers and intense pulsed light (IPL) are all currently used for hair removal. [Copyright &y& Elsevier]

Twenty years of laser dermatology has resulted in current technology which allows variable spot sizes, different wavelengths, and a variety of effective cooling devices. These developments have made the treatment of cutaneous pigmented and vascular lesions safe and efficacious by targeting selected chromophores while minimizing damage to the surrounding tissue. Vascular lesions are targeted by a variety of wavelength lasers including the KTP (532 nm), pulsed dye (585–595 nm), and the Nd:YAG (1064 nm) laser systems. Pigmented lesions may be treated with a wide variety of lasers due to the broad absorption spectrum of melanin. Intense pulsed light (IPL), with its widely adjustable parameters, has established itself as a useful adjunctive for the treatment of a variety of pigmented and vascular lesions. The purpose of this review article is to present the current treatment options for the common aesthetic complaints of pigmented and vascular lesions. [ABSTRACT FROM AUTHOR]

Background Just a few decades ago, before lasers were introduced into dermatologic practice, many cutaneous lesions were untreatable. Since the introduction of lasers in dermatology in the 1960s and its revolution by Anderson and Parrish in the 1980s based on the selective photothermolysis theory, lasers have become a main component of many dermatology practices. With the advent of these selective lasers and their constant technological advancements, many lesions can now be easily removed with a low incidence of complications, creating a high demand for laser surgery. Aims This paper will review current laser systems used for pigmented lesions. Methods An English-language literature search and review through Medline from January 1994 to October 2004. Review of the latest techniques and lasers used in treating pigmentary disorders and possible future applications and treatment options. Conclusions Laser technique and technology has greatly advanced producing more effacious treatment with minimal complications. [ABSTRACT FROM AUTHOR]

A 64-year-old woman with a clinically diagnosed ‘lentigo simplex’ on her right cheek was dermatologically treated several times with a CO2 laser. Three years later she showed a metastasis of a malignant melanoma in her right parotid gland. Considering this case, as well as other published cases reporting malignant melanomas occurring after laser treatment, we again underscore that naevomelanocytic lesions are not a routine indication for laser treatment. [ABSTRACT FROM AUTHOR]

Pigmented nevi are a heterogeneous group of lesions that range from uniquely curable with laser treatment, to partially responsive, to unresponsive or dangerous. This article presents laser and IPL treatment strategies from a clinical perspective for nevi organized by their typical responsiveness. A rationale for surgical excision, laser, and/or medical therapy in individual patients is also presented. Despite significant recent progress, it is clear that much understanding are still lacking about optimal laser treatment for pigmented lesions. [ABSTRACT FROM AUTHOR]

We demonstrate the utility of the Wood's light in a practice that specializes in the evaluation of pigmented lesions. The Wood's light assisted the physician in locating the site of a completely regressed primary cutaneous melanoma, determining the clinical borders of a lentigo maligna melanoma, differentiating between agminated naevi and a naevus spilus and detecting the recurrence of pigmentation after the excision of a dysplastic naevus, and also proved useful in monitoring a large segmental speckled atypical lentiginous naevus for change. Despite the availability of many‘high-tech’ imaging and diagnostic devices designed to evaluate skin lesions, the relatively simple Wood's lamp continues to be of great value. We encourage physicians not to abandon the use of the Wood's light in their clinical practice. [ABSTRACT FROM AUTHOR]

This is an overview of dermatoses which are predominantly seen in the genital area. Five large groups of dermatoses can be distinguished: inflammatory dermatoses without any causative organism, infections and dermatoses originating from cutaneous appendages, precancerous lesions, pigmented lesions and genital pruritus. The etiology, causative factors, clinical features and newer treatment options are considered. Because of local environmental factors, genital dermatoses often present in a different way than in other localizations. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background Early detection of melanoma results in excision of thinner melanomas, which are associated with better prognosis. Total cutaneous photography provides a temporal comparison o lesions, which allows clinicians and patients to recognize new and subtly changing lesions. Objectives We examined the utility of total cutaneous photography in detecting melanoma identified the reason for biopsy of suspicious lesions and determined who detected new melanomas the physician on follow-up examination or the patient on self-examination. Patients/methods The charts of the 576 patients in the total cutaneous photography database were reviewed. Twelve patients were identified who had melanoma diagnosed with photographic assistance. Baseline and prebiopsy photographs, dermatology clinic notes (115 patient visits) and pathology reports for each biopsied lesion were reviewed. Histological diagnosis, cause for biopsy and whether the lesion was detected by the patient or physician, was recorded for each of the biopsied lesions. Also noted were all the lesions that concerned patients, the cause for concern, and whether these lesions were biopsied. Results A total of 93 lesions were biopsied in these patients. Twenty-seven (35%) of 77 melano- cytic lesions were histologically diagnosed as melanoma. The thickest melanoma found measured 1·1 mm, indicating a favourable prognosis in our patients. Seventy-four per cent of the melanomas were biopsied due to changes from baseline and 19% were biopsied because they were new lesions The changes noted were subtle and the lesions that proved to be melanoma did not satisfy the classical clinical criteria for melanoma. Eight (30%) of the melanomas were identified by patients on skin self-examination. Twenty-six per cent of the lesions that concerned patients were not biopsied after evaluation by a physician. Conclusions We found that photographically assisted follow-up helped detect new and subtly changing melanomas, which did not satisfy the classical clinical features of melanoma. In addition photographically assisted follow-up helped detect nonmelanoma skin cancers. Patient skin selfexamination proved to be valuable, in that it complemented physician follow-up examination in detecting melanomas. Photographic follow-up was also valuable in avoiding unnecessary biopsy in suspicious, but stable lesions. Total cutaneous photography therefore may be an effective way to increase the sensitivity and specificity for detecting melanoma. [ABSTRACT FROM AUTHOR]

We report a case of three distinct adnexal neoplasms associated with a naevus sebaceous of the scalp: a nodular pigmented trichoblastoma, a smaller flat pigmented trichoblastoma and a syringocystadenoma papilliferum, and discuss the clinical and histological features of these neoplasms. The clinical manifestation was suggestive of malignant melanoma, a feature that has never been reported before. For the first time in the literature we describe the case also by means of a noninvasive analysis, i.e. epiluminescence microscopy. In our experience, epiluminescence microscopy does not appear to be more diagnostically accurate than simple clinical examination when diagnosing lesions of the scalp, contrary to other regions. [ABSTRACT FROM AUTHOR]

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Summary Background There is continuing interest in pre-operative evaluation of cutaneous pigmented lesions with the aim of differentiating early melanoma, which requires excision from non-melanomatous pigmented lesions that may safely be left untreated. Objectives To establish, in the setting of a specialist pigmented lesion clinic, if use of the hand-held dermatoscope can prevent unnecessary excision of benign melanocytic pigmented lesions. Methods The study was carried out by three dermatologists experienced in the use of the dermatoscope. Patients had been referred by primary care physicians to the pigmented lesion clinic and had melanocytic lesions considered by dermatologists to merit excision on clinical grounds. A set of 74 sequentially observed lesions referred for excision, 37 melanomas and 37 melanocytic naevi, was used as the initial set and, thereafter, a second set of 52 lesions comprising 32 melanomas and 20 melanocytic naevi was used to validate conclusions drawn from the original set. Clinical features such as appearance and history, and also dermatoscope features were included in the assessment. Results In both sets of lesions, the most powerful identifying feature of lesions subsequently shown on pathological examination to be melanoma was the presence of three or more colours seen in the lesion on dermatoscopy. In the initial set of lesions, the age of the patient, an irregular edge and largest diameter of the lesion also contributed to diagnosis; however, in the second set of lesions these variables contributed little additional discriminatory value. The sensitivity and specificity of the three-colour dermatoscopy test for melanoma vs. naevus were 92% and 51%, respectively. Conclusions The use of the dermatoscope three-colour test could reduce excision of benign melanocytic naevi by 50%, and thus prevent both unnecessary minor surgical workload and patient morbidity. [ABSTRACT FROM AUTHOR]

Various types of lasers, such as the Q-switched ruby laser and the Alexandrite laser, cause selective damage to cutaneous pigmented cells and are currently used in the therapy of pigmented lesions. The aim of this study was to evaluate the effects of a diode laser at a wavelength of 810 nm on pigmented guinea-pig skin. The diode laser was supplied by OcuLight Iris Medical Instruments, Inc. and was used to deliver 0.15, 0.2, 0.3, 0.4, 0.5, 1 and 1.5 J/cm2 laser beams in micropulses of 100 micros. The study was carried out on albino and black-spotted guinea pigs (GP). After irradiation, punch biopsies were taken and analysed by light and electron microscopy. Albino animals developed just a few signs of cutaneous injury. This mostly consisted of spongiotic disarray, after the highest doses were administered (>1 J/cm2). In the black skin of spotted GPs alterations appeared at 0.15 J/cm2 and included melanosome damage and, at doses higher than 0.3 J/cm2, also melanocyte damage. These observations demonstrate that the diode laser at 810 nm selectively affects pigmented structures and that the cellular targets of diode laser radiation are the melanosomes. The diode laser specificity for melanin may provide a biological basis for the treatment of pigmented superficial cutaneous lesions. [ABSTRACT FROM AUTHOR]

Melanonychia including melanonychia striata in children poses a diagnostic dilemma. Atypical clinical features often raise the possibility of malignancy, and a nail unit biopsy may be recommended. Commensurate with atypical clinical features, the histopathology may also appear alarming. However, accumulating data illustrate that most cases of melanonychia striata are benign and suggest that an alternate approach is often warranted for pediatric patients. Herein, we review the existing data regarding pediatric melanonychia striata and offer an evidence-based approach to its evaluation and management., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Abstract Background Melanoacanthoma (MA) has been described in the oral mucosa as a solitary lesion or, occasionally, as multiple lesions. MA mainly affects dark skinned patients and grows rapidly, showing a plane or slightly raised appearance and a brown to black color. The differential diagnosis includes oral nevi, amalgam tattoos, and melanomas. We report here the case of a 58-year-old black woman who presented multiple pigmented lesions on the hard palate. Case presentation Based on the differential diagnosis of melanoma, a punch biopsy (4 mm in diameter) was performed. The material was fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin-eosin or submitted to immunohistochemical analysis. Immunohistochemistry using antibodies against protein S-100, melan-A, HMB-45, MCM-2, MCM-5, Ki-67 and geminin was performed. Immunohistochemical analysis revealed strong cytoplasmic immunoreactivity of dendritic melanocytes for proteinS-100, HMB-45 and melan-A.Positive staining for proliferative markers (MCM-2, MCM-5, Ki-67) was only observed in basal and suprabasal epithelial cells, confirming the reactive etiology of the lesion. The diagnosis was oral Melanoacanthoma (MA). Conclusion The patient has been followed up for 30 months and shows no clinical alterations. MA should be included in the differential diagnosis of pigmented lesions of the oral cavity.

A Q-switched ruby laser was used for treatment of 10 patients with solar lentigo and 12 patients with café-au-lait macules. In this study, the lesions were treated with the laser at a rate of 6 J/cm2. The patients were observed for 10–21 months with an average of 13.8 months after the final session. Solar lentigos were treated once or twice, and the response rate was 70%. Café-au-lait macules were treated one to six times, and the response rate was 33%. Side effects, such as hyperpigmentation and scar formation, were rarely seen. Therefore, Q-switched ruby laser treatment is an effective treatment for epidermal pigmented lesions; however, in patients with café-au-lait macules, the responses to the treatment varied, and a repigmentation was seen in 50% of these patients. Thus, long-term follow-up is required for patients with café-au-lait macules. [ABSTRACT FROM AUTHOR]

Background and Objectives: In this study, the threshold fluences for disrupting the melanosomes for pigmented skin lesion treatment were determined using a 755-nm picosecond laser for clinical use. Based on the melanosome disruption thresholds, incident fluences corresponding to the target lesion depths were evaluated in silico for different laser spot sizes., Study Design/materials and Methods: Melanosome samples were isolated from porcine eyes as alternative samples for human cutaneous melanosomes. The isolated melanosomes were exposed to 755-nm picosecond laser pulses to measure the mean particle sizes by dynamic light scattering and confirm their disruption by scanning electron microscopy. The threshold fluences were statistically determined from the relationships between the irradiated fluences and the mean particle sizes. Incident fluences of picosecond laser pulses for the disruption of melanosomes located at different depths in skin tissue were calculated through a light transport simulation using the obtained thresholds., Results: The threshold fluences of 550- and 750-picosecond laser pulses were determined to be 2.19 and 2.49 J/cm 2 , respectively. The numerical simulation indicated that appropriate incident fluences of picosecond laser pulses differ depending on the depth distribution of the melanosomes in the skin tissue, and large spot sizes are desirable for disrupting the melanosomes more deeply located within the skin tissue., Conclusion: The threshold fluences of picosecond laser pulses for melanosome disruption were determined. The incident fluence analysis based on the thresholds for melanosome disruption provides valuable information for the selection of irradiation endpoints for picosecond laser treatment of pigmented skin lesions. Lasers Surg. Med. © 2021 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC., (© 2021 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.)

Pigmented vulvar lesions represent a wide range of diagnostic units with the essential role of precise histopathologic identification. The article reviews pigmented vulvar lesions. Furthermore, it deals with basal cell carcinoma in more detail and presents a case of an 85-year-old female with vulvar pigmented basal cell carcinoma.

Background: Melanoma can mimic other cutaneous lesions, but the full spectrum and prevalence of these morphologic variants remain largely unknown.Objective: To classify nonacral cutaneous melanomas into distinct morphologic clusters and characterize clusters' clinicopathologic features.Methods: All pathologic melanoma diagnoses (occurring during 2011-2016) were reviewed for routine prebiopsy digital photographs (n = 400). Six dermatologists independently assigned lesions into 1 of 14 diagnostic classes on the basis of morphology. Image consensus clusters were generated by K-means; clinicopathologic features were compared with analysis of variance and χ2.Results: Five morphologic clusters were identified: typical (n = 136), nevus-like (n = 81), amelanotic/nonmelanoma skin cancer (NMSC)-like (n = 70), seborrheic keratosis (SK)-like (n = 68), and lentigo/lentigo maligna (LM)-like (n = 45) melanomas. Nevus-like melanomas were found in younger patients. Nevus-like and lentigo/LM-like melanomas tended to be thinner and more likely identified on routine dermatologic examinations. NMSC-like melanomas were tender, thicker, more mitotically active, and associated with prior NMSC. Typical and SK-like melanomas had similar clinicopathologic features.Limitations: Cluster subdivision yielded diminished sample sizes. Visual assignment was performed without clinical context.Conclusion: When primary cutaneous melanomas were assigned into diagnostic groups and subjected to novel consensus clustering, recurrent morphologic patterns emerged. The spectrum of these morphologies was unexpectedly diverse, which might have implications for visual training and possibly clinical diagnosis. [ABSTRACT FROM AUTHOR]

The article presents case study of a 24‑year‑old asymptomatic female with congenital hypertrophy of retinal pigment epithelium lesion. It mentions examinations showing presence of a solitary, hyperpigmented flat lesion with scalloped margins in the inferotemporal quadrant suggestive of congenital hypertrophy of retinal pigment epithelium (CHRPE) and scattered retinal hemorrhages over the lesions. It also mentions common vascular abnormality noted in CHRPE such as capillary nonperfusion.