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4. High charge of cerebroid nests in nodular melanomas predicts tumor aggressiveness and high mutational tumoral burden: a pilot study.

Author

Caramaschi, Stefania, Mangogna, Alessandro, Bertoni, Laura, Manfredini, Marco, Farnetani, Francesca, Parente, Paola, Attino, Vito, Cazzato, Gerardo, Salviato, Tiziana, Pellacani, Giovanni, and Bonetti, Luca Reggiani

Subjects
CELL morphology, ENDOMETRIAL cancer, EPITHELIAL cells, BRAF genes, MELANOCYTES
Abstract

Purpose: Even today, melanoma is a highly aggressive neoplasm with a high mortality rate. The nodular type is very aggressive and has cerebroid nests of melanocytes (CNMs) at the growth edge, morphologically similar to the poorly differentiated neoplastic epithelial cell clusters described in colorectal, breast, and endometrioid endometrial cancers. Patients and methods: We selected 25 nodular melanomas (NMs) with known molecular profiles, of which the entire paraffin-embedded lesion was available. We counted CNMs under a microscopic at a magnification of 20x (i.e., a microscopic field with a major axis of 1 mm). Based on the number of CNMs in the area, melanomas were classified into three groups: G1 (CNMs ranging from 0 to 4), G2 (CNMs ranging from 5 to 9), and G3 (CNMs ≥ 10). The presence of CNMs and their counts were compared with molecular and histopathological data. Results: Seventeen (NMs) were grouped as G1 (68%), 5 as G2 (20%), and 3 as G3 (12%) based on CNMs count. The presence of CNMs correlated with epithelioid cell morphology (p < 0.05), Clark IV and V levels (p < 0.05), vascular invasion (p < 0.05), and biological mutants (p < 0.05). Melanomas with ≥ 10 CNMs more frequently show ulceration (p < 0.02) and the BRAF V600E mutation (p < 0.02). Conclusion: CNMs count has a predictive role regardless of tumor size; their association with the BRAF V600E mutation suggests their predictive significance in response to biologics. However, further investigations are needed to strengthen this hypothesis. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Combined Carbon Dioxide Laser with Photodynamic Therapy for Nodular Basal Cell Carcinoma Monitored by Reflectance Confocal Microscopy

Author

Alma, Antonio, primary, Pongetti, Linda, additional, Clementi, Alessandro, additional, Chester, Johanna, additional, Toccaceli, Matteo, additional, Ciardo, Silvana, additional, Zappia, Elena, additional, Manfredini, Marco, additional, Pellacani, Giovanni, additional, Greco, Maurizio, additional, Bennardo, Luigi, additional, and Farnetani, Francesca, additional

Published
2023
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9. Vitiligo Treated with Combined Piperine-Based Topical Treatment and Narrowband Ultraviolet B Therapy: Follow-Up with Reflectance Confocal Microscopy.

Author

Bertoli, Cristina, Chester, Johanna, Cortelazzi, Chiara, Ciardo, Silvana, Manfredini, Marco, Di Nuzzo, Sergio, Kaleci, Shaniko, Pellacani, Giovanni, and Farnetani, Francesca

Subjects
VITILIGO, CONFOCAL microscopy, REFLECTANCE, DENDRITIC cells, BLOOD vessels, MACULES
Abstract

Background: Reflectance confocal microscopy (RCM) has a defined in vivo morphology of vitiligo and re-pigmentation. Combination therapies seem more effective than monotherapies. Objective: We aim to describe the clinical and RCM features of re-pigmentation with combined narrowband ultraviolet B (NB-UVB) and piperine-based topical treatment in localized vitiligo. Methods: Eight patients enrolled at a single center received combined treatment: topical treatment was applied twice daily + NB-UVB twice weekly for 2 × 2-month periods. Clinical changes were analyzed by the Vitiligo Noticeability Scale (VNS) and percentage of re-pigmentation. The evaluator agreement was assessed. Predefined RCM features had the presence/absence of (i) blood vessels, (ii) dendritic cells, and the quantity of (i) an irregular honeycombed pattern and (ii) non-pigmented papillae. Clinical and RCM monitoring was performed at the baseline, 2, 3, 5, and 7 months. Results: Macules were "slightly less noticeable" with 25–50% re-pigmentation. Irregular honeycomb patterns and non-pigmented papillae were significantly less frequently observed, and in less extended areas (T1 vs. T2, p = 0.039; T0 vs. T1, p = 0.005 and T2 vs. T4, p = 0.033). Dendritic cells and blood vessels improved, with significant changes in blood vessels (T1 vs. T2, p = 0.005 and T3 vs. T4, p = 0.008). Conclusions: RCM confirms the morphological changes induced by combined treatment for localized vitiligo. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Lentigo maligna and lentigo maligna melanoma in vivo differentiation with dermoscopy and reflectance confocal microscopy: A retrospective, multicentre study

Author

Guida, Stefania, primary, Alma, Antonio, additional, Fiorito, Flavio, additional, Megna, Andrea, additional, Chester, Johanna, additional, Kaleci, Shaniko, additional, Ciardo, Silvana, additional, Manfredini, Marco, additional, Rongioletti, Franco, additional, Perrot, Jean L., additional, Rubegni, Pietro, additional, Chello, Camilla, additional, Cantisani, Carmen, additional, Pellacani, Giovanni, additional, Cinotti, Elisa, additional, and Farnetani, Francesca, additional

Published
2023
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12. Characterization of Acne-Prone Skin with Reflectance Confocal Microscopy and Optical Coherence Tomography and Modifications Induced by Topical Treatment and Probiotic Supplementation

Author

Manfredini, Marco, primary, Sticchi, Alberto, additional, Lippolis, Nicola, additional, Pedroni, Gioia, additional, Giovani, Matteo, additional, Ciardo, Silvana, additional, Chello, Camilla, additional, Guida, Stefania, additional, Farnetani, Francesca, additional, and Pellacani, Giovanni, additional

Published
2023
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13. Combined Carbon Dioxide Laser with Photodynamic Therapy for Nodular Basal Cell Carcinoma Monitored by Reflectance Confocal Microscopy.

Author

Alma, Antonio, Pongetti, Linda, Clementi, Alessandro, Chester, Johanna, Toccaceli, Matteo, Ciardo, Silvana, Zappia, Elena, Manfredini, Marco, Pellacani, Giovanni, Greco, Maurizio, Bennardo, Luigi, and Farnetani, Francesca

Subjects
CARBON dioxide lasers, BASAL cell carcinoma, CONFOCAL microscopy, PHOTODYNAMIC therapy, LASER therapy, SKIN cancer
Abstract

Introduction: Basal cell carcinoma (BCC) represents around 80% of all malignant skin cancers worldwide, constituting a substantial burden on healthcare systems. Due to excellent clearance rates (around 95%), surgery is the current gold-standard treatment. However, surgery is not always possible or preferred by patients. Numerous non-surgical therapies, sometimes combined, have been associated with promising tumor free survival rates (80–90%) in non-melanoma skin cancers (NMSCs). Most research has enrolled superficial basal cell carcinomas (sBCCs), with limited recent studies also involving low-risk nodular BCCs (nBCCs). Given lower efficacy rates compared to surgery, close monitoring during the follow-up period is essential for patients treated with non-surgical therapies. Monitoring with dermoscopy is constrained by low sensitivity rates. Reflectance confocal microscopy (RCM) is more sensitive in monitoring non-surgically treated NMSCs. Case presentation: A 41-year-old woman with a single nBCC relapse following photodynamic therapy (PDT) located on the dorsum of the nose presented to our center. Given the aesthetically sensitive location of the lesion and the patient's preference for a non-surgical approach, a combined treatment of CO2 laser and PDT was prescribed. A superpulsed CO2 laser (power: 0.5–3 W, frequency: 10 Hz, spot size 2 mm) with two PDT sessions (2 weeks apart) were conducted. At 6 weeks follow-up, monitoring performed with RCM revealed a reduction but not eradication of basaloid tumor islands. Another 2 sessions of PDT were recommended. At 3, 12 and 30 months of follow-up, the nasal dorsum area of the previous nBBC lesion was noted to be slightly hypopigmented (observed clinically), with a mild erythematous background (observed by dermoscopy). RCM evaluation confirmed the absence of RCM BCC criteria. The cosmetic outcome was very much improved. Conclusions: Combined CO2 laser and PDT for the treatment of a localized nBCC on the dorsum of the nose of a 41-year-old proved to offer tumor free survival at 30-month follow-up, as monitored with RCM. RCM is useful for the evaluation of non-surgical therapies as it has comparably higher sensitivity than dermoscopy and is especially useful in cases of suspected late recurrence. Further studies are needed to validate ongoing tumor free survival following this combined nonsurgical approach in the treatment of nBCC. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Laser Treatment Monitoring with Reflectance Confocal Microscopy

Author

Guida, Stefania, primary, Longo, Caterina, additional, Amato, Simone, additional, Rossi, Anthony M., additional, Manfredini, Marco, additional, Ciardo, Silvana, additional, Spadafora, Marco, additional, Nisticò, Steven P., additional, Mercuri, Santo R., additional, Rongioletti, Franco, additional, Zerbinati, Nicola, additional, and Pellacani, Giovanni, additional

Published
2023
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18. Skin ageing: Clinical aspects and in vivo microscopic patterns observed with reflectance confocal microscopy and optical coherence tomography

Author

Pezzini, Claudia, primary, Ciardo, Silvana, additional, Guida, Stefania, additional, Kaleci, Shaniko, additional, Chester, Johanna, additional, Casari, Alice, additional, Manfredini, Marco, additional, Longo, Caterina, additional, Farnetani, Francesca, additional, Brugués, Ariadna Ortiz, additional, and Pellacani, Giovanni, additional

Published
2022
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20. Non-Melanoma Skin Cancer Clearance after Medical Treatment Detected with Noninvasive Skin Imaging: A Systematic Review and Meta-Analysis

Author

Guida, Stefania, primary, Alma, Antonio, additional, Shaniko, Kaleci, additional, Chester, Johanna, additional, Ciardo, Silvana, additional, Proietti, Ilaria, additional, Giuffrida, Roberta, additional, Zalaudek, Iris, additional, Manfredini, Marco, additional, Longo, Caterina, additional, Farnetani, Francesca, additional, and Pellacani, Giovanni, additional

Published
2022
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22. Skin ageing: Clinical aspects and in vivo microscopic patterns observed with reflectance confocal microscopy and optical coherence tomography.

Author

Pezzini, Claudia, Ciardo, Silvana, Guida, Stefania, Kaleci, Shaniko, Chester, Johanna, Casari, Alice, Manfredini, Marco, Longo, Caterina, Farnetani, Francesca, Brugués, Ariadna Ortiz, and Pellacani, Giovanni

Subjects
SKIN aging, OPTICAL coherence tomography, MICROSCOPY, CONFOCAL microscopy, REFLECTANCE, HYPERPIGMENTATION
Abstract

Few studies have combined high‐resolution, non‐invasive imaging, such as standardized clinical images, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT), for age‐related skin change characterization according to age groups. This study aimed to correlate clinical manifestations of ageing with skin cytoarchitectural background observed with high‐resolution, non‐invasive imaging according to age‐related skin pattern distribution. A set of 140 non‐pathological facial skin images were retrospectively retrieved from a research database. Subjects, aged between 20 and 89, were divided into 7 age groups. Clinical features were explored with VISIA, including hyperpigmentation, skin texture, wrinkles, pores and red areas, quantified and expressed as automated absolute scores. Previously described RCM and OCT epidermal and dermal features associated with ageing were investigated. All features were assessed for distribution and correlation among age groups. Significant direct correlations between age and clinical features were proven for cutaneous hyperpigmentation, skin texture, wrinkles and red areas. As age advances, RCM epidermal irregular honeycomb and mottled pigmentation are more frequently observed and collagen is more frequently coarse, huddled and curled, while the epidermis in OCT is thickened and the dermal density is decreased with more disrupted collagen fibres. RCM and OCT feature changes correlate directly and indirectly as well as correlating directly and indirectly with standardized clinical images. Clinical manifestations of ageing correlate with skin cytoarchitectural background observed with RCM and OCT. In conclusion, complimentary information between standardized clinical images and high‐resolution, non‐invasive imaging will assist in the development of future studies dedicated to skin ageing assessment and treatment effectiveness. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Cutaneous Melanoma Systematic Diagnostic Workflows and Integrated Reflectance Confocal Microscopy Assessed with a Retrospective, Comparative Longitudinal (2009–2018) Study

Author

Pellacani, Giovanni, primary, Farnetani, Francesca, additional, Chester, Johanna, additional, Kaleci, Shaniko, additional, Ciardo, Silvana, additional, Bassoli, Sara, additional, Casari, Alice, additional, Longo, Caterina, additional, Manfredini, Marco, additional, Cesinaro, Anna Maria, additional, Giusti, Francesca, additional, Iacuzio, Antonio, additional, and Migaldi, Mario, additional

Published
2022
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26. Unusual dermoscopic patterns of basal cell carcinoma mimicking melanoma

Author

Di Matteo, Eleonora, primary, Pampena, Riccardo, additional, Pizzichetta, Maria A., additional, Cinotti, Elisa, additional, Chester, Johanna, additional, Kaleci, Shaniko, additional, Manfredini, Marco, additional, Guida, Stefania, additional, Dika, Emi, additional, Moscarella, Elvira, additional, Lallas, Aimilios, additional, Apalla, Zoe, additional, Argenziano, Giuseppe, additional, Perrot, Jian L, additional, Tognetti, Linda, additional, Lai, Michela, additional, Cantisani, Carmen, additional, Roberti, Vincenzo, additional, Fiorani, Diletta, additional, Baraldi, Carlotta, additional, Veneziano, Leonardo, additional, Papageorgiou, Chryssoula, additional, Ciardo, Silvana, additional, Rubegni, Pietro, additional, Zalaudek, Iris, additional, Patrizi, Annalisa, additional, Longo, Caterina, additional, Bianchi, Luca, additional, Pellacani, Giovanni, additional, and Farnetani, Francesca, additional

Published
2022
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28. Leg‐type cutaneous B‐cell lymphoma: The description of a rare and aggressive skin tumor with D‐OCT imaging

Author

Chello, Camilla, primary, Caramaschi, Stefania, additional, Sticchi, Alberto, additional, Naselli, Andrea, additional, Pezzini, Claudia, additional, Farnetani, Francesca, additional, Reggiani Bonetti, Luca, additional, Ciardo, Silvana, additional, Di Matteo, Eleonora, additional, Pellacani, Giovanni, additional, and Manfredini, Marco, additional

Published
2021
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29. Recurrent Aphthous Stomatitis: Treatment and Management

Author

Manfredini, Marco, primary, Guida, Stefania, additional, Giovani, Matteo, additional, Lippolis, Nicola, additional, Spinas, Enrico, additional, Farnetani, Francesca, additional, Dattola, Annunziata, additional, Di Matteo, Eleonora, additional, Pellacani, Giovanni, additional, and Giannetti, Luca, additional

Published
2021
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30. Skin Cancer Diagnosis With Reflectance Confocal Microscopy: Reproducibility of Feature Recognition and Accuracy of Diagnosis

Author

Farnetani, Francesca, Scope, Alon, Braun, Ralph P., Gonzalez, Salvador, Guitera, Pascale, Malvehy, Josep, Manfredini, Marco, Marghoob, Ashfaq A., Moscarella, Elvira, Oliviero, Margaret, Puig, Susana, Rabinovitz, Harold S., Stanganelli, Ignazio, Longo, Caterina, Malagoli, Carlotta, Vinceti, Marco, and Pellacani, Giovanni

Published
2015
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32. Dermoscopy, confocal microscopy and optical coherence tomography features of main inflammatory and autoimmune skin diseases: A systematic review

Author

Guida, Stefania, primary, Longhitano, Sabrina, additional, Ardigò, Marco, additional, Pampena, Riccardo, additional, Ciardo, Silvana, additional, Bigi, Laura, additional, Mandel, Victor Desmond, additional, Vaschieri, Cristina, additional, Manfredini, Marco, additional, Pezzini, Claudia, additional, Arginelli, Federica, additional, Farnetani, Francesca, additional, Zerbinati, Nicola, additional, Longo, Caterina, additional, and Pellacani, Giovanni, additional

Published
2021
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33. Reflectance confocal microscopy of neurothekeoma: case report

Author

Sticchi, Alberto, primary, Manfredini, Marco, additional, Ciardo, Silvana, additional, Cotena, Claudia, additional, Longhitano, Sabrina, additional, Chello, Camilla, additional, Cesinaro, Anna M., additional, Farnetani, Francesca, additional, Pellacani, Giovanni, additional, and Puviani, Mario, additional

Published
2021
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35. Especialização em Saúde da Família UNA-SUS UNIFESP: dez anos de experiência em capacitação profissional

Author

Salvador, Maria Elisabete, primary, Lino Tarcia, Rita Maria, additional, Pimenta de Souza, Morris, additional, Almeida Gonçalves, Daniel, additional, Manfredini, Marco Antonio, additional, Coelho de Abreu, Silvio Carlos, additional, Sakumoto Akiyama, Marlene, additional, Vieira Pacheco, Felipe, additional, dos Anjos Afonso dos Anjos Afonso, Daniel Lico, additional, Pereira, Ana Lucia, additional, Bandiera Paiva, Paulo, additional, and Harada, Jorge, additional

Published
2021
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37. A plea for standardization of confocal microscopy and optical coherence tomography parameters to evaluate physiological and para‐physiological skin conditions in cosmetic science

Author

Ciardo, Silvana, primary, Pezzini, Claudia, additional, Guida, Stefania, additional, Del Duca, Ester, additional, Ungar, Jonathan, additional, Guttman‐Yassky, Emma, additional, Manfredini, Marco, additional, Farnetani, Francesca, additional, Longo, Caterina, additional, and Pellacani, Giovanni, additional

Published
2021
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38. Daylight photodynamic therapy with 5-aminolevulinic acid 5% gel for the treatment of mild-to-moderate inflammatory acne

Author

DEL DUCA, Ester, primary, MANFREDINI, Marco, additional, PETRINI, Nerella, additional, FARNETANI, Francesca, additional, CHESTER, Johanna, additional, BENNARDO, Luigi, additional, SCHIPANI, Giusy, additional, TAMBURI, Federica, additional, SANNINO, Mario, additional, CANNAROZZO, Giovanni, additional, PELLACANI, Giovanni, additional, and NISTICÒ, Steven P., additional

Published
2021
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39. Homocysteine (Hcy) assessment to predict outcomes of hospitalized Covid-19 patients: a multicenter study on 313 Covid-19 patients

Author

Ponti, Giovanni, primary, Roli, Laura, additional, Oliva, Gabriella, additional, Manfredini, Marco, additional, Trenti, Tommaso, additional, Kaleci, Shaniko, additional, Iannella, Raffaele, additional, Balzano, Brigida, additional, Coppola, Antonietta, additional, Fiorentino, Giuseppe, additional, Ozben, Tomris, additional, Paoli, Venere Delli, additional, Debbia, Daria, additional, De Santis, Elena, additional, Pecoraro, Valentina, additional, Melegari, Alessandra, additional, Sansone, Monica Rosalia, additional, Lugara, Marina, additional, and Tomasi, Aldo, additional

Published
2021
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49. Dermoscopy, confocal microscopy and optical coherence tomography features of main inflammatory and autoimmune skin diseases: A systematic review.

Author

Guida, Stefania, Longhitano, Sabrina, Ardigò, Marco, Pampena, Riccardo, Ciardo, Silvana, Bigi, Laura, Mandel, Victor Desmond, Vaschieri, Cristina, Manfredini, Marco, Pezzini, Claudia, Arginelli, Federica, Farnetani, Francesca, Zerbinati, Nicola, Longo, Caterina, and Pellacani, Giovanni

Subjects
OPTICAL coherence tomography, CONFOCAL microscopy, MICROSCOPY, SKIN diseases, AUTOIMMUNE diseases, SCLERODERMA (Disease), BULLOUS pemphigoid
Abstract

Background/Objectives: Non‐invasive skin imaging features of main skin inflammatory and autoimmune diseases have been reported, although a comprehensive review of their correlation with histopathologic features is currently lacking. Therefore, the aim of this paper was to review the correlation of dermoscopic, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) criteria of main inflammatory and autoimmune skin diseases with their corresponding histopathologic criteria correlation. Methods: Studies on human subjects affected by main inflammatory and autoimmune diseases, defining the correlation of dermoscopic, RCM or OCT with histopathologic criteria, were included in the review. Five groups of diseases were identified and described: psoriasiform, spongiotic and interface dermatitis, bullous diseases and scleroderma. Results: Psoriasiform dermatitis was typified by white scales, corresponding to hyperkeratosis, and vessels, observed with RCM and OCT. Spongiosis, corresponding to dark areas within the epidermis with RCM and OCT, was the main feature of spongiotic dermatitis. Interface dermatitis was characterised by dermoepidermal junction obscuration. Blisters, typical of bullous diseases, were visualised as dark areas with RCM and OCT while scleroderma lesions were characterised by dermoscopic fibrotic beams, related to dermal thickness variations, with specific OCT and histopathologic correlations. Conclusions: Although the role of RCM and OCT has yet to be defined in clinical practice, non‐invasive skin imaging shows promising results on inflammatory and autoimmune skin diseases, due to the correlation with histopathologic features. [ABSTRACT FROM AUTHOR]

Published
2022
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50. Correlation between the training of the Specialization Course in Family Health UNA - SUS UNIFESP and the professional practice of students

Author

Salvador, Maria Elisabete, Tarcia, Rita Maria Lino, Sakumoto, Marlene, Gonçalves, Daniel Almeida, Souza, Morris Pimenta de, Manfredini, Marco Antonio, Abreu, Silvio Carlos Coelho de, Pacheco, Felipe Vieira, Afonso, Daniel Lico dos Anjos, Pereira, Ana Lucia, Paiva, Paulo Bandiera, and Harada, Jorge

Subjects
Capacitação de Recursos Humanos em Saúde, Educação a Distância, Atenção Primária à Saúde
Abstract

Introduction : the maintenance of the quality of specialization courses in the distance modality requires careful studies considering the pedagogical course, the educational technologies, but above all, the approximation of professional practice. Objective : analyze the correlation of the Specialization Course in Family Health UNA - SUS Unifesp with the professional practice of students, considering pedagogical and technological aspects. Method : it is an observational, retrospective, descriptive and e xploratory study of quantitative approach, carried out in 2018 and 2019. The course counted on 600 physicians who work in Primary Care and 302 answered an evaluation instrument. Data analysis was described by absolute numbers and corresponding percentage f requencies. Results and Discussion : it was possible to observe the relevant performance of the tutors and the quality / approximation of the contents / activities with the professional practice of students in responses categorized as "optimal" (77% and 73% ), respectively. Conclusion : The best outcomes for patients, community, and society are directly linked to quality educational events, where the ultimate goal is best defined by rigorous course evaluation efforts. It is imperative to analyze the specializa tion offers in the distance modality for the qualification of professionals in Primary Care from the perspective of the students. Introdução: a manutenção da qualidade dos cursos de especialização na modalidade a distância requer criteriosos estudos considerando - se o percurso pedagógico, as tecnologias educacionais adotadas, mas, sobretudo, a aproximação da prática profissional. Objetivo : analisar a correlação do curso Especialização em Saúde da Família UNA - SUS Unifesp com a prática profissional dos estudantes, considerando - se aspectos pedagógicos e tecnológicos. Método: trata - se de um estudo observacional, retrospectivo, descritivo e exp loratório de abordagem quantitativa, realizado em 2018 e 2019. O curso contou com 600 médicos que atuam na Atenção Básica e desses, 302 responderam instrumento de avaliação. A análise dos dados foi descrita por números absolutos e correspondentes frequênci as percentuais. Resultados e Discussões: foi possível observar o desempenho relevante dos tutores e a qualidade/aproximação dos conteúdos/atividades com a prática profissional dos estudantes em respostas categorizadas como “ótimo” (77% e 73%), respectivame nte. Conclusão: os melhores resultados para os pacientes, comunidade e sociedade estão ligados diretamente aos eventos educacionais de qualidade, em que o objetivo final é melhor definido por esforços rigorosos de avaliação dos cursos. É premente analisar as ofertas de especialização na modalidade a distância para qualificação de profissionais em Atenção Básica sob a ótica dos estudantes.

Published
2019

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