Search

Though the diagnosis of actinic keratoses is most often clinical, it is sometimes necessary to use non-invasive imaging methods to confirm this diagnosis. Reflectance confocal microscopic examination of actinic keratosis may reveal hyperkeratosis (i.e., detached, isolated or scaly corneocytes), parakeratosis (i.e., nucleated cells in the stratum corneum), dilated vessels and signs of solar elastosis, including clusters of moderately reflecting material and/or undulating shiny elastic fibres that are clearly visible in the superficial dermis. Hopefully, new in vivo microscopic imaging techniques such as line-field confocal optical coherence tomography will make it possible to obtain a three-dimensional examination of the skin and, thus, to further improve diagnostic accuracy of these lesions. © 2019 Elsevier Masson SAS. All rights reserved. Cet article fait partie du numéro supplément Kératoses actiniques : comprendre et traiter réalisé avec le soutien institutionnel de Galderma International., (© 2019 Elsevier Masson SAS. Tous droits réservés.)

Background: Vulvar melanosis can occasionally be clinically challenging by mimicking an early melanoma., Objective: To report our experience of initial evaluation and follow-up in this peculiar subset of vulvar melanosis using reflectance confocal microscopy (RCM)., Methods: We retrospectively evaluated 18 consecutive cases referred for atypical vulvar pigmentation or for which melanoma was considered and that underwent both RCM examination and histopathological assessment. In 13 cases with available dermoscopic pictures, RCM classification was compared to dermoscopic diagnosis, and in all cases, the density of melanocytes was evaluated on biopsies using MelanA immunostaining., Results: Among the 18 atypical pigmented lesions, 17 vulvar melanosis and one melanoma were histologically determined. RCM concluded a benign vulvar melanosis in 10 of 17 cases, whereas dermoscopy did so in three of 12 cases. RCM identified the only early malignant lentiginous melanoma. In several cases of vulvar melanosis, RCM could identify foci of melanocytic hyperplasia in an otherwise benign pattern., Conclusions: In this clinically and dermoscopically challenging subset of vulvar pigmentations, RCM appears relevant for initial extensive evaluation, especially to target initial biopsy sampling, and to perform non-invasive monitoring of foci of melanocytic hyperplasia., (© 2018 European Academy of Dermatology and Venereology.)

Splenosis corresponds to an autotransplantation of splenic tissue, consecutive to a traumatic or surgical wound of the spleen. The peritoneal cavity is usually affected but intrathoracic nodules are also described, when simultaneous rupture of the spleen and diaphragmatic laceration exist. Diaphragmatic laceration may be subclinical. Lesions are generally asymptomatic and are a fortuitous finding in radiographs or by the surgeons in the majority of the cases. We report a case of pleural and pulmonary splenosis, mimicking pleural and pulmonary metastasis of a dorsal melanoma., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)