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2. Dynamic optical coherence tomography evaluation in locally advanced basal cell carcinoma during sonidegib treatment.

Author

Cantisani, C., Musolff, N., Longo, C., Di Guardo, A., Rovaldi, E., Rossi, G., Sasso, F., Farnetani, F., Rega, F., Bánvölgyiv, A., Azzella, G., Paolino, G., and Pellacani, G.

Subjects
OPTICAL coherence tomography, BASAL cell carcinoma, HEDGEHOG signaling proteins, CREATINE kinase, SKIN cancer, ISLANDS of Langerhans
Abstract

Background: Basal cell carcinoma (BCC) is the most common cancer in the Caucasian population. It has a multifactorial pathogenesis, in which constitutive activation of the Sonic Hedgehog signalling (SHH) pathway (via mutations in PTCH1 or SMO genes) represents by far the most common genetic aberration. The introduction of vismodegib and sonidegib, two SHH pathway inhibitors, changed the therapeutic approach of locally advanced and metastatic BCCs. EADO's (European Association of Dermato-Oncology) new staging system refers to these as 'difficult-to- treat' BCCs. Objective: The aim was to evaluate sonidegib's effectiveness in patients affected by difficult-to-treat BCCs by using non-invasive diagnostic techniques. Methods: We retrospectively evaluated 14 patients (4 females, 10 males; mean age 77 ± 11 years) affected by difficult-to-treat BCCs treated with oral sonidegib 200 mg/ day that were followed with total body videodermoscopy (V-Track, Vidix 4.0) and dynamic optical coherence tomography (D-OCT, VivoSight Dx) since May 2022. Considering the risk of rhabdomyolysis routine blood tests, especially for creatine kinase concentrations, were performed. All treated patients were inserted in the BasoCare database, which aims to offer support to patients taking sonidegib. Complete and partial responses were evaluated by the overall reduction of the number of lesions and their individual sizes. Safety was evaluated by assessing the occurrence and severity of adverse reactions. Results: Eighty per cent achieved complete clearance and 75% reduction of diameter. D-OCT scans performed at every follow-up showed concordance with clinical appearance and demonstrated reduction of hyporeflective structures, that is, islets of tumour cells and overall improvement of morphology. Conclusion: Sonidegib can be considered an effective treatment option in cases where surgery or radiotherapy would be unfeasible or has previously failed, although pigmented lesions did not show complete clearance, suggesting that there are factors other than the SHH pathway involved in tumour growth. Videodermoscopy and DOCT were useful in the quick and seamless follow-up of lesions and added valuable information in assessing efficacy. [ABSTRACT FROM AUTHOR]

Published
2024
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5. The combination of oral and topical photoprotection with a standardized Polypodium leucotomos extract is beneficial against actinic keratosis

Author

Pellacani, G., Peris, Ketty, Ciardo, S., Pezzini, C., Tambone, S., Farnetani, F., Longo, Carmela, Chello, C., Gonzalez, S., Peris K. (ORCID:0000-0002-5237-0463), Longo C., Pellacani, G., Peris, Ketty, Ciardo, S., Pezzini, C., Tambone, S., Farnetani, F., Longo, Carmela, Chello, C., Gonzalez, S., Peris K. (ORCID:0000-0002-5237-0463), and Longo C.

Abstract

Introduction: This study describes a prospective, multicentre, randomized controlled, open-label study with three arms aimed at studying the differences between: [Cnt], self-administered sun protection; [T], topical treatment; and [TO], topical + oral treatment; for the management of Actinic Keratosis (AK) in a cohort of subjects of advanced age displaying severe actinic damage (SAD). Methods: Treatments administered to groups [T] and [TO] had a common component, which is a botanical extract, Fernblock, with demonstrated photoprotective activity. Results: In total, 131 subjects were distributed randomly in the three groups, and followed up clinically at three separate time points, beginning of the study (t = 0) and after 6 and 12 months. Analysis of clinical data and examination using reflectance confocal microscopy (RCM) revealed that group [T] and [TO] displayed decreased clinical AK and field cancerization parameters, including the number of new lesions, and reduced the need for additional interventions in these patients. RCM revealed normalization of the keratinocyte layer. Improvements in AK and field cancerization parameters were greatest in the group [TO], suggesting that topical and oral photoprotection improves the clinical and anatomical outcome compared to control conditions. Conclusions: The combination of topical and oral immune photoprotection provides an advantage compared to topical photoprotection alone.

Published
2023

10. Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma

Author

Pampena R., Parisi G., Benati M., Borsari S., Lai M., Paolino G., Cesinaro A. M., Ciardo S., Farnetani F., Bassoli S., Argenziano G., Pellacani G., Longo C., Pampena, R., Parisi, G., Benati, M., Borsari, S., Lai, M., Paolino, G., Cesinaro, A. M., Ciardo, S., Farnetani, F., Bassoli, S., Argenziano, G., Pellacani, G., and Longo, C.

Subjects
subtype, integumentary system, Oncology, basal cell carcinoma, superficial, nodular, dermoscopy, infiltrative, fungi, skin and connective tissue diseases, Original Research
Abstract

Background: Infiltrative basal cell carcinoma (BCC) has a higher risk for post-surgical recurrence as compared to the most common low-aggressive superficial and nodular BCC. Independent diagnostic criteria for infiltrative BCC diagnosis have not been still defined. Improving the pre-surgical recognition of infiltrative BCC might significantly reduce the risk of incomplete excision and recurrence. Objective: The aim of this study is to define clinical and dermoscopic criteria that can differentiate infiltrative BCC from the most common low-aggressive superficial and nodular BCC. Methods: Clinical and dermoscopic images of infiltrative, superficial, and nodular BCC were retrospectively retrieved from our database and jointly evaluated by two experienced dermoscopists, blinded for the histologic subtype. Pairwise comparisons between the three histologic subtypes were performed and multivariable logistic regression models were constructed in order to define clinical and dermoscopic factors independently associated with each subtype. To validate our findings, two experienced dermoscopists not previously involved in the study were asked to evaluate clinical and dermoscopic images from an external dataset, guessing the proper BCC subtype between infiltrative, nodular and superficial, before and after being provided with the study results. Result: A total of 481 histopathologically proven BCCs (51.4% nodular, 33.9% superficial, and 14.8% infiltrative) were included. We found that infiltrative BCC mostly appeared on the head and neck as an amelanotic hypopigmented plaque or papule, displaying ulceration on dermoscopic examination, along with arborizing and fine superficial telangiectasia. Shiny white structures were also frequently observed. Multivariate regression analysis allowed us to define a clinical-dermoscopic profile of infiltrative BCC. Conclusions: We defined the clinical-dermoscopic profile of infiltrative BCC, allowing to differentiate this variant from superficial and nodular BCC. This will improve pre-surgical recognition of infiltrative forms, reducing the risk for post-surgical recurrence.

Published
2020

23. Facial seborrheic keratosis with unusual dermoscopic patterns can be differentiated from other skin malignancies by in vivo reflectance confocal microscopy

Author

Farnetani, F., primary, Pedroni, G., additional, Lippolis, N., additional, Giovani, M., additional, Ciardo, S., additional, Chester, J., additional, Kaleci, S., additional, Pezzini, C., additional, Cantisani, C., additional, Dattola, A., additional, Manfredini, M., additional, Dika, E., additional, Patrizi, A., additional, and Pellacani, G., additional

Published
2021
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24. Flat scalp melanoma dermoscopic and reflectance confocal microscopy features correspond to histopathologic type and lesion location

Author

Garbarino, F., primary, Pampena, R., additional, Lai, M., additional, Pereira, A.R., additional, Piana, S., additional, Cesinaro, A.M., additional, Cinotti, E., additional, Fiorani, D., additional, Ciardo, S., additional, Farnetani, F., additional, Chester, J., additional, Pellacani, G., additional, Guitera, P., additional, and Longo, C., additional

Published
2021
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29. The impact of anatomical location and sun exposure on the dermoscopic recognition of atypical nevi and early melanomas: usefulness of an integrated clinical‐dermoscopic method ( iDScore )

Author

Tognetti, L., primary, Cartocci, A., additional, Cinotti, E., additional, Moscarella, E., additional, Farnetani, F., additional, Lallas, A., additional, Tiodorovic, D., additional, Carrera, C., additional, Longo, C., additional, Puig, S., additional, Perrot, J.L., additional, Argenziano, G., additional, Pellacani, G., additional, Cataldo, G., additional, Balistreri, A., additional, Cevenini, G., additional, and Rubegni, P., additional

Published
2020
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31. COVID‐19 and dermatology: a comprehensive guide for dermatologists

Author

Fahmy, D.H., primary, El‐Amawy, H.S., additional, El‐Samongy, M.A., additional, Fouda, A.A., additional, Soliman, S.H., additional, El‐Kady, A., additional, Farnetani, F., additional, Conti, A., additional, Zoeir, A., additional, Eissa, A., additional, Eissa, R., additional, Puliatti, S., additional, Sighinolfi, M.C., additional, Rocco, B., additional, and Pellacani, G., additional

Published
2020
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34. Flat‐pigmented facial lesions without highly specific melanocytic dermoscopy features: the role of dermoscopic globules and dots in differential diagnosis with corresponding reflectance confocal microscopy substrates

Author

Guida, S., primary, Farnetani, F., additional, De Pace, B., additional, Kaleci, S., additional, Chester, J., additional, Stanganelli, I., additional, Ciardo, S., additional, De Carvalho, N., additional, Longo, C., additional, and Pellacani, G., additional

Published
2019
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35. Validation of an integrated dermoscopic scoring method in an European teledermoscopy web platform: theiDScoreproject for early detection of melanoma

Author

Tognetti, L., primary, Cevenini, G., additional, Moscarella, E., additional, Cinotti, E., additional, Farnetani, F., additional, Lallas, A., additional, Tiodorovic, D., additional, Carrera, C., additional, Puig, S., additional, Perrot, J.L., additional, Longo, C., additional, Argenziano, G., additional, Pellacani, G., additional, Smargiassi, E., additional, Cataldo, G., additional, Cartocci, A., additional, Balistreri, A., additional, and Rubegni, P., additional

Published
2019
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36. Melanoma types by in vivo reflectance confocal microscopy correlated with protein and molecular genetic alterations: A pilot study

Author

Beretti, F., Bertoni, L., Farnetani, F., Pellegrini, C., Gorelli, G., Cesinaro, A. M., Reggiani Bonetti, L., Di Nardo, Lucia, Kaleci, S., Chester, J., Longo, C., Massi, D., Fargnoli, M. C., Pellacani, G., Di Nardo L., Beretti, F., Bertoni, L., Farnetani, F., Pellegrini, C., Gorelli, G., Cesinaro, A. M., Reggiani Bonetti, L., Di Nardo, Lucia, Kaleci, S., Chester, J., Longo, C., Massi, D., Fargnoli, M. C., Pellacani, G., and Di Nardo L.

Abstract

Cutaneous melanoma (CM) is one of the most prevalent skin cancers, which lacks both a prognostic marker and a specific and lasting treatment, due to the complexity of the disease and heterogeneity of patients. Reflectance confocal microscopy (RCM) in vivo analysis is a versatile approach offering immediate morphological information, enabling the identification of four primary cutaneous RCM CM types. Whether RCM CM types are associated with a specific protein and molecular genetic profiles at the tissue level remains unclear. The current pilot study was designed to identify potential correlations between RCM CM types and specific biological characteristics, combining immunohistochemistry (IHC) and molecular analyses. Eighty primary CMs evaluated at patient bedside with RCM (type 1 [19, 24%], type 2 [12, 15%], type 3 [7, 9%] and type 4 [42, 52%]) were retrospectively evaluated by IHC stains (CD271, CD20, CD31, cyclin D1), fluorescence in situ hybridization FISH for MYC gain and CDKN2A loss and molecular analysis for somatic mutations (BRAF, NRAS and KIT). RCM CM types correlated with markers of stemness property, density of intra-tumoral lymphocytic B infiltrate and cyclin D1 expression, while no significant association was found with blood vessel density nor molecular findings. RCM CM types show a different marker profile expression, suggestive of a progression and an increase in aggressiveness, according to RCM morphologies.

Published
2019

41. The integration of dermoscopy and reflectance confocal microscopy improves the diagnosis of lentigo maligna

Author

Cinotti, E., primary, Fiorani, D., additional, Labeille, B., additional, Gonzalez, S., additional, Debarbieux, S., additional, Agozzino, M., additional, Ardigò, M., additional, Lacarrubba, F., additional, Farnetani, F., additional, Carrera, C., additional, Cevenini, G., additional, Le Duff, F., additional, Tognetti, L., additional, Pellacani, G., additional, Rubegni, P., additional, and Perrot, J.L., additional

Published
2019
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43. Morphological classification of melanoma metastasis with reflectance confocal microscopy

Author

Farnetani, F., primary, Manfredini, M., additional, Longhitano, S., additional, Chester, J., additional, Shaniko, K., additional, Cinotti, E., additional, Mazzoni, L., additional, Venturini, M., additional, Manganoni, A., additional, Longo, C., additional, Reggiani‐Bonetti, L., additional, Giannetti, L., additional, Rubegni, P., additional, Calzavara‐Pinton, P., additional, Stanganelli, I., additional, Perrot, J.L., additional, and Pellacani, G., additional

Published
2018
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45. The impact of anatomical location and sun exposure on the dermoscopic recognition of atypical nevi and early melanomas: usefulness of an integrated clinical‐dermoscopic method (iDScore).

Author

Tognetti, L., Cartocci, A., Cinotti, E., Moscarella, E., Farnetani, F., Lallas, A., Tiodorovic, D., Carrera, C., Longo, C., Puig, S., Perrot, J.L., Argenziano, G., Pellacani, G., Cataldo, G., Balistreri, A., Cevenini, G., and Rubegni, P.

Subjects
MELANOMA, DYSPLASTIC nevus syndrome, DIAGNOSIS, DIAGNOSIS methods, NEVUS
Abstract

Background: The anatomical location of atypical melanocytic skin lesion (aMSL) was never combined into an algorithm for discriminating early melanomas (EM) from atypical nevi (AN). Aims: To investigate the impact of body location on the intuitive diagnosis performed in teledermoscopy by dermatologists of different skill levels. A further aim was to evaluate how the integration of the body location could improve an algorithm‐aided diagnosis. Methods: We retrospectively collected 980 standardized dermoscopic images of aMSL cases (663 AN, 317 EM): data on the anatomical location were collected according to 15 body sites classified into 4 macro‐areas of chronically/frequently/seldom/rarely exposure. Through a teledermatology web platform, 111 variously skilled dermoscopists performed either the intuitive diagnosis and 3 algorithm‐assisted diagnostic tests (i.e. iDScore, 7‐point checklist, ABCD rule) on each case, for a total of 3330 examinations. Results: In the rarely photoexposed area (side, bottom, abdomen), AN were the most tricky (i.e. highest quote of false positives), due to a frequent recognition of dermoscopic features usually considered as suggestive for melanoma in these lesions; the EM at these sites received the highest quote of false negatives, being generally interpreted as 'featureless' according to these traditional parameters, that were more frequently displayed on the chronically photoexposed area. In rarely and seldom photoexposed area, intuitive diagnosis fails to achieve adequate accuracy for all aMSLs, as the ABCD rule and the 7‐point checklist; by applying the iDScore algorithm the diagnostic performance was increased by 15% in young and 17% in experts. Conclusions: The body location of an aMSL can affect the quality of intuitive dermoscopic diagnosis, especially in sun‐protected areas. Accuracy can be improved by using the iDScore algorithm that assigns a different partial score of each body site. Linked Commentary: T. Deinlein. J Eur Acad Dermatol Venereol 2021; 35: 566. https://doi.org/10.1111/jdv.17141. [ABSTRACT FROM AUTHOR]

Published
2021
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48. Radiotherapy‐induced subclinical skin changes revealed by dynamic optical coherence tomography: a case‐controlled pilot study.

Author

Chello, C., Ciardo, S., Chester, J., Guanti, M., Farnetani, F., Guida, S., Sticchi, A., Giacobazzi, P., Meduri, B., Lohr, F., Pellacani, G., and Manfredini, M.

Subjects
OPTICAL coherence tomography, SKIN ulcers, PILOT projects, COHERENCE (Optics), RADIATION injuries, RADIODERMATITIS
Abstract

Radiotherapy-induced subclinical skin changes revealed by dynamic optical coherence tomography: a case-controlled pilot study Radiotherapy (RT) is often used in the treatment of several cancers, including breast cancer.1-3 However, RT can invoke toxic cutaneous effects, depending directly on the amount of RT irradiation and duration and individual clinical patient characteristics. Images (VivoSight SP ® sp D-OCT Michelson Diagnostics Ltd, Maidstone, Kent, UK) were acquired at the superior anterior axillary line that was directly included in the target region of one of the RT fractions, 21-28 days from final RT session (treatment group). [Extracted from the article]

Published
2022
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49. Update on non-invasive imaging techniques in early diagnosis of non-melanoma skin cancer

Author

Reggiani, C., Manfredini, M., Mandel, V. D., Farnetani, F., Ciardo, S., Bassoli, S., Casari, A., Stefania Guida, Argenziano, G., Lallas, A., Ulrich, M., Pellacani, G., Longo, C., Reggiani, C, Manfredini, M, Mandel, Vd, Farnetani, F, Ciardo, S, Bassoli, S, Casari, A, Guida, S, Argenziano, Giuseppe, Lallas, A, Ulrich, M, Pellacani, G, and Longo, C.

Subjects
Diagnostic Imaging, Microscopy, Confocal, Skin Neoplasms, Humans, Dermoscopy, Skin neoplasms, Carcinoma, basal cell, Keratosis, actinic, Carcinoma, squamous cell, Tomography, optical coherence, Early Detection of Cancer, Tomography, Optical Coherence
Abstract

Non-melanoma skin cancer (NMSC) is the most common malignancy in fair skinned populations. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) are non-invasive imaging techniques that play an important role in diagnosis of skin tumors. The aim of this study was to provide new insights into the role of non-invasive tecniques in the diagnosis of non-melanoma skin cancers, concentrating especially on dermoscopy, RCM and OCT. The analysis of the studies obtained from the most recent literature, taking into account previous essential reported information in this field. A search concerning the role of dermoscopy, RCM and OCT in the diagnosis of NMSC was performed on PubMed.duplicated studies, single case report, and papers with language other than English New and old literature about early diagnosis of NMSC through non-invasive imaging techniques were analyzed. The role and the diagnostic accuracy of dermoscopy, RCM and OCT for the diagnosis of NMSC were reported according to the data given by literature. The development of non-invasive diagnostic devices (especially dermoscopy, RCM and OCT) allows tissue imaging in-vivo contributing to a more accurate diagnosis of skin cancer, sparing time for the patient and costs for the public health system.

Published
2015

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