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BACKGROUND: The elastic scattering spectroscopy (ESS) device (DermaSensor Inc., Miami, FL) is a noninvasive, painless, adjunctive tool for skin cancer detection. OBJECTIVES: To investigate the performance of the ESS device in the detection of melanoma. METHODS: A prospective, investigator-blinded, multicenter study was conducted at 8 United States (US) and 2 Australian sites. All eligible skin lesions were clinically concerning for melanoma, examined with the ESS device, subsequently biopsied according to dermatologists standard of care, and evaluated with histopathology. A total of 311 participants with 440 lesions were enrolled, including 44 melanomas (63.6% in situ and 36.4% invasive) and 44 severely dysplastic nevi. RESULTS: The observed sensitivity of the ESS device for melanoma detection was 95.5% (95% CI, 84.5% to 98.8%, 42 of 44 melanomas), and the observed specificity was 32.5% (95% CI, 27.2% to 38.3%). The positive and negative predictive values were 16.0% and 98.1%, respectively. LIMITATIONS: The device was tested in a high-risk population with lesions selected for biopsy based on clinical and dermoscopic assessments of board-certified dermatologists. Most enrolled lesions were pigmented. CONCLUSION: The ESS devices high sensitivity and NPV for the detection of melanoma suggest the device may be a useful adjunctive, point-of-care tool for melanoma detection.

Several cases of elastofibromatous lesion affecting the oral mucosa have been reported. Clinically, these lesions may appear as small exophytic lesions or less often as white lesions. Therefore, fibrous hyperplasia and leukoplakia are not uncommonly considered in clinical differential diagnosis. Microscopically, elastic and fibrous connective tissue deposition is seen. Rarely, elastofibromatous changes can be detected when assessing intraoral lesions, including cysts, salivary gland neoplasms, and epithelial dysplasia. Here we report two oral lesions showing elastofibromatous changes, expanding their clinicopathological spectrum. The first case was a 46‐year‐old man with a history of asymptomatic nodular lesion on the palate 1 year ago, diagnosed as giant cell fibroma with elastofibromatous changes. The second case was a 79‐year‐old woman who presented a pigmented and mildly symptomatic lesion on the mandibular alveolar mucosa several months ago, diagnosed as amalgam tattoo associated with elastofibromatous changes. [ABSTRACT FROM AUTHOR]

Background: Pigmented lesions are largely benign and may lead to extreme distress. Various light and lasers may be used to treat pigmentation, often Q‐switched lasers are considered the method of choice, while intense pulsed light (IPL) devices may offer a less invasive treatment with a shorter downtime. Objective: The purpose of this study is to evaluate the safety and efficacy of a narrowband IPL module for the treatment of pigmented lesions. Methods: A retrospective study of 20 patients with pigmented lesions underwent treatment with an IPL module. Treatment was assessed by blinded evaluation of clinical photographs using a GAIS scale of 0–10, as well as through patient satisfaction ratings on a scale of 0–10. Throughout the treatment, pain levels and adverse events were monitored. Results: The mean GAIS score was 7.55 ± 1.15 (mean ± SD), and the mean patient satisfaction score was 7.3 ± 1.26 (mean ± SD). There was a strong positive correlation between GAIS and patient satisfaction scores (r = 0.83), and no significant difference between them (p‐value = 0.516). The number of treatments did not significantly affect GAIS and patient satisfaction scores (p‐values 0.364 and 0.126). Additional positive unexpected outcomes were improved skin firmness and reduced wrinkles. Conclusion: The results of the study indicate that the IPL module is both safe and effective in treating pigmented lesions and may have the potential to stimulate collagen production. [ABSTRACT FROM AUTHOR]

Background: IPL devices emit a wide range of wavelengths that can be absorbed by different chromophores in the skin. Selective destruction of a specific chromophore with minimal side effects is controlled by wavelength, pulse duration, and fluence. Aim: This study aims to evaluate the treatment of vascular and pigmented lesions using narrow‐band Intense Pulsed Light (IPL) with Advanced Fluorescence Technology (AFT), which offers more efficient energy usage per pulse to increase safety, and improve clinical outcomes. Methods: A retrospective analysis of data from 100 patients treated with narrow‐band IPL for vascular and pigmented lesions. Efficacy was measured by the Global Aesthetic Improvement Scale (GAIS) and Patient Satisfaction Scale (0–10). Safety was assessed by evaluating pain levels and adverse events. Results: Mean GAIS scores were 8.02 ± 0.84 for vascular and 8.14 ± 0.9 for pigmented lesions with no significant difference between groups (p=0.49, α=0.05). Patient satisfaction correlated with GAIS scores (correlation coefficient 0.8). No pain was reported and two patients experienced temporary and transient side effects. Conclusion: Overall, the advanced IPL treatments provided favorable outcomes for vascular and pigmented lesions. [ABSTRACT FROM AUTHOR]

PURPOSE: To assess central and peripheral retinal and choroidal diseases using ultra-widefield (UWF) fundus imaging in combination with navigated central and peripheral cross-sectional and three-dimensional (3D) swept source optical coherence tomography (SS-OCT) scans. METHODS: Retrospective study involving 332 consecutive patients, with a nearly equal distribution of males and females. The mean age of patients was 52 years (range 18-92 years). Average refractive error was -3.80 D (range +7.75 to -20.75 D). RESULTS: The observations in this study demonstrate the efficacy of peripheral navigated SS-OCT in assessing various ocular conditions. The technology provides high-quality images of the peripheral vitreous, vitreoretinal interface, retina, and choroid, enabling visualization of vitreous floaters and opacities, retinal holes and tears, pigmented lesions, and peripheral retinal degenerations. 3D OCT scans enhance the visualization of these abnormalities and improve diagnostic and therapeutic decisions. CONCLUSION: Navigated central and peripheral cross-sectional and 3D SS-OCT scans offer significant complementary benefits in the assessment and management of retinal diseases. Their addition to UWF imaging provides a comprehensive view of central and peripheral ocular structures, aiding in early detection, precise anatomical measurements, and objective monitoring of disease progression. In addition, this technology serves as a valuable tool for patient education, a teaching tool for trainees, and documentation for medico-legal purposes. [ABSTRACT FROM AUTHOR]

Purpose: The term melanocytoma was recently proposed for intermediate-stage melanocytic lesions with specific histopathologic and molecular genetic features. Prior studies have demonstrated a heightened potential for these intermediate lesions to spread to regional lymph nodes, with decreased likelihood for distant spread, when compared to melanomas. Observations: Herein we present a case of a 28-year-old male who presented with a recurrent right lower eyelid margin combined cutaneous and palpebral conjunctival pigmented lesion, ultimately classified as a melanocytoma, to highlight this new nomenclature, characteristic histopathologic and genetic findings, and prognostic implications. Conclusions: Ophthalmologists should be aware of this new cutaneous histopathologic classification system and apply to the periorbital region to improve melanocytic lesion management and surveillance.

Abstract The study of training hyperparameters optimisation problems remains underexplored in skin lesion research. This is the first report of using hierarchical optimisation to improve computational effort in a four‐dimensional search space for the problem. The authors explore training parameters selection in optimising the learning process of a model to differentiate pigmented lesions characteristics. In the authors' demonstration, pretrained GoogleNet is fine‐tuned with a full training set by varying hyperparameters, namely epoch, mini‐batch value, initial learning rate, and gradient threshold. The iterative search of the optimal global‐local solution is by using the derivative‐based method. The authors used non‐parametric one‐way ANOVA to test whether the classification accuracies differed for the variation in the training parameters. The authors identified the mini‐batch size and initial learning rate as parameters that significantly influence the model's learning capability. The authors' results showed that a small fraction of combinations (5%) from constrained global search space, in contrarily to 82% at the local level, can converge with early stopping conditions. The mean (standard deviation, SD) validation accuracies increased from 78.4 (4.44)% to 82.9 (1.8)% using the authors' system. The fine‐tuned model's performance measures evaluated on a testing dataset showed classification accuracy, precision, sensitivity, and specificity of 85.3%, 75.6%, 64.4%, and 97.2%, respectively. The authors' system achieves an overall better diagnosis performance than four state‐of‐the‐art approaches via an improved search of parameters for a good adaptation of the model to the authors' dataset. The extended experiments also showed its superior performance consistency across different deep networks, where the overall classification accuracy increased by 5% with this technique. This approach reduces the risk of search being trapped in a suboptimal solution, and its use may be expanded to network architecture optimisation for enhanced diagnostic performance.

Background: Upper extremity tumors (UETs) and their treatment may impair hand functions. Successful prediction of the histopathological examination before surgery will speed up the treatment process. The aim of this study is to determine the frequency and prediction accuracy of tumors encountered in the upper extremity. Patients and Methods: Records of patients operated for UETs between January 2010 and December 2019 were reviewed. Patient gender, initial complaint, the anatomic region of the tumor, comorbidities predisposing to malignancy, method of biopsy, preliminary diagnosis and predicted malignancy status after initial examination, definitive histopathological diagnosis, and malignancy status were extracted retrospectively. Prediction accuracy rates were calculated for each tumor group. Chi-square analysis was used for comparative analysis of prediction accuracy rates between cutaneous pigmented versus soft-tissue lesions and patients with/without a predisposition to malignancy. Results: The study included 416 pathological specimens from 290 patients. The most common tumors of the upper extremity were lipoma (20%), ganglion cyst (10.1%), and epidermoid cyst (5.8%). After pathological evaluation, 23 specimens were diagnosed as malignant (5.5%) and 32 specimens as premalignant (7.7%). The prediction of malignancy status was accurate in 390 specimens (93.7%). Soft-tissue sarcomas (67.7%) and vascular lesions (58.1%) have the lowest accuracy rates among all tumors. Conclusion: Definitive diagnosis and malignity status can be predicted after the initial examination in the majority of the cases. However, imaging studies or incisional biopsies are needed for soft-tissue sarcomas, vascular tumors, or tumors of patients with a predisposing condition to malignancy.

Treatment of pigmented lesions is one of the major challenges of laser and cosmetic practitioners. The most common pigmented lesions that are treated by lasers are melanocytic nevi, ephelides, solar lentigines, and café au lait macules. Melanin absorbs different wavelengths (500–1100 nm); thereby, treatment of various pigmented lesions requires the application of lasers with different wavelengths. Choosing the most appropriate type of laser depends on various factors such as the chromophore and the location of a specific lesion in the skin. In this paper, we aim to review the most efficient laser treatment protocols for each pigmented skin lesion and compare their efficacy in each part based on the previous studies. [ABSTRACT FROM AUTHOR]

The study of training hyperparameters optimisation problems remains underexplored in skin lesion research. This is the first report of using hierarchical optimisation to improve computational effort in a four‐dimensional search space for the problem. The authors explore training parameters selection in optimising the learning process of a model to differentiate pigmented lesions characteristics. In the authors' demonstration, pretrained GoogleNet is fine‐tuned with a full training set by varying hyperparameters, namely epoch, mini‐batch value, initial learning rate, and gradient threshold. The iterative search of the optimal global‐local solution is by using the derivative‐based method. The authors used non‐parametric one‐way ANOVA to test whether the classification accuracies differed for the variation in the training parameters. The authors identified the mini‐batch size and initial learning rate as parameters that significantly influence the model's learning capability. The authors' results showed that a small fraction of combinations (5%) from constrained global search space, in contrarily to 82% at the local level, can converge with early stopping conditions. The mean (standard deviation, SD) validation accuracies increased from 78.4 (4.44)% to 82.9 (1.8)% using the authors' system. The fine‐tuned model's performance measures evaluated on a testing dataset showed classification accuracy, precision, sensitivity, and specificity of 85.3%, 75.6%, 64.4%, and 97.2%, respectively. The authors' system achieves an overall better diagnosis performance than four state‐of‐the‐art approaches via an improved search of parameters for a good adaptation of the model to the authors' dataset. The extended experiments also showed its superior performance consistency across different deep networks, where the overall classification accuracy increased by 5% with this technique. This approach reduces the risk of search being trapped in a suboptimal solution, and its use may be expanded to network architecture optimisation for enhanced diagnostic performance. [ABSTRACT FROM AUTHOR]

Background: Upper extremity tumors (UETs) and their treatment may impair hand functions. Successful prediction of the histopathological examination before surgery will speed up the treatment process. The aim of this study is to determine the frequency and prediction accuracy of tumors encountered in the upper extremity. Patients and Methods: Records of patients operated for UETs between January 2010 and December 2019 were reviewed. Patient gender, initial complaint, the anatomic region of the tumor, comorbidities predisposing to malignancy, method of biopsy, preliminary diagnosis and predicted malignancy status after initial examination, definitive histopathological diagnosis, and malignancy status were extracted retrospectively. Prediction accuracy rates were calculated for each tumor group. Chi‑square analysis was used for comparative analysis of prediction accuracy rates between cutaneous pigmented versus soft‑tissue lesions and patients with/without a predisposition to malignancy. Results: The study included 416 pathologicalspecimensfrom 290 patients. The most common tumors of the upper extremity were lipoma (20%), ganglion cyst (10.1%), and epidermoid cyst (5.8%).After pathological evaluation, 23 specimens were diagnosed as malignant (5.5%) and 32 specimens as premalignant (7.7%). The prediction of malignancy status was accurate in 390 specimens (93.7%). Soft‑tissue sarcomas(67.7%) and vascular lesions(58.1%) have the lowest accuracy rates among all tumors. Conclusion: Definitive diagnosis and malignity status can be predicted after the initial examination in the majority of the cases. However, imaging studies or incisional biopsies are needed for soft‑tissue sarcomas, vascular tumors, or tumors of patients with a predisposing condition to malignancy. [ABSTRACT FROM AUTHOR]

Objectives: Agminated nevi are rare, grouped lesions, which are confined to one anatomic area. Herein, we report a case of successful cosmetic treatment of bilateral, acquired agminated nevi with a picosecond 532 nm Nd:YAG laser device., Materials and Methods: Literature search was completed on acquired agminated nevi. A healthy 21-year-old woman presented with numerous, grouped 1-mm brown-to-dark brown macules in the axillae bilaterally. Biopsies revealed lentiginous junctional nevi with mild atypia, leading to the diagnosis of agminated nevi. She was referred for laser treatment to improve cosmetic appearance. Two different laser devices were utilized initially, a picosecond 532 nm Nd:YAG laser on the left axilla and a millisecond domain 532 nm laser on the right. Greater improvement was noted with the picosecond 532 nm device. Three additional treatments were completed with the picosecond laser with significant improvement in pigmentation of melanocytic nevi., Results: Various pigmented and melanocytic lesions have been noted to occur in an agminated pattern although their pathway of development remains unknown. While various devices have demonstrated efficacy for pigmented lesions, treatment of agminated nevi specifically is less reported or established. Our patient's presentation is novel because of the axillary location and bilateral distribution of multiple acquired agminated nevi, neither of which have been previously reported in the literature. We also report successful treatment utilizing a picosecond 532 nm laser. While laser can help improve the cosmetic appearance of pigmented lesions, most lasers do not remove all melanocytes, highlighting the need for close monitoring, as atypia and melanoma have been reported to develop in acquired agminated nevi., Conclusion: Thus, we present a case of acquired agminated nevi in a novel bilateral distribution in a healthy female successfully treated with a picosecond 532 nm laser., (© 2024 Wiley Periodicals LLC.)

Objectives: This study aimed to evaluate the efficacy and safety of nanosecond laser treatment of pigmented lesions in silico using a model of melanosome disruption threshold fluence (MDTF) based on skin optical properties., Methods: Particle size analysis and scanning electron microscopy were performed to determine the threshold fluence for melanosome disruption using a nanosecond laser. By inputting the obtained threshold fluence into the MDTF model and considering the variability in skin optical properties, irradiation parameters were calculated and compared with the results from clinical studies., Results: The threshold fluences for 532 and 755 nm nanosecond laser irradiation were determined to be 3.0 and 15.0 J/cm 2 , respectively. In silico analysis showed that the incident fluence for moderately pigmented skin should be 1.2 times that for lightly pigmented skin, whereas it should be 50% lower than that for lightly pigmented skin to achieve the same level of energy deposition. Clinically applied fluences for moderately pigmented skin are at the low end of the calculated range of values, suggesting that the clinical fluence is chosen to minimize energy deposition in normal tissues., Conclusions: Our results showed that the MDTF model can be used to evaluate nanosecond laser treatments and provide clinical guidance on fluence settings based on laser-tissue interactions in moderately pigmented skin. The in silico method can, therefore, provide a robust and quantitative retrospective evaluation of the treatment effects that accounts for variation in irradiation parameters among patients by combining the MDTF model with the in vivo optical properties of individual skin types., (© 2024 Wiley Periodicals LLC.)

Competing Interests: None disclosed.

Spitz nevi of special sites, such as the ear, appear rarely and pose a challenge with worrisome clinical, dermoscopic, or histopathological features. Our aim was to evaluate the morphological findings of a series of Spitz nevi of the ear in order to obtain more knowledge about their clinical‐dermoscopic patterns. Of a total of six cases, three main dermoscopic structures were found: pseudonetwork, structureless areas, and cobblestone pattern. Our preliminary findings suggest that dermoscopy may be helpful in improving the diagnostic accuracy of Spitz nevus of the ear and minimize surgery in a sensitive location. [ABSTRACT FROM AUTHOR]

Background and Objectives: A threshold fluence for melanosome disruption has the potential to provide a robust numerical indicator for establishing clinical endpoints for pigmented lesion treatment using a picosecond laser. Although the thresholds for a 755-nm picosecond laser were previously reported, the wavelength dependence has not been investigated. In this study, wavelength-dependent threshold fluences for melanosome disruption were determined. Using a mathematical model based on the thresholds, irradiation parameters for 532-, 730-, 755-, 785-, and 1064-nm picosecond laser treatments were evaluated quantitatively., Study Design/materials and Methods: A suspension of melanosomes extracted from porcine eyes was irradiated using picosecond lasers with varying fluence. The mean particle size of the irradiated melanosomes was measured by dynamic light scattering, and their disruption was observed by scanning electron microscopy to determine the disruption thresholds. A mathematical model was developed, combined with the threshold obtained and Monte Carlo light transport to calculate irradiation parameters required to disrupt melanosomes within the skin tissue., Results: The threshold fluences were determined to be 0.95, 2.25, 2.75, and 6.50 J/cm² for 532-, 730-, 785-, and 1064-nm picosecond lasers, respectively. The numerical results quantitatively revealed the relationship between irradiation wavelength, incident fluence, and spot size required to disrupt melanosomes distributed at different depths in the skin tissue. The calculated irradiation parameters were consistent with clinical parameters that showed high efficacy with a low incidence of complications., Conclusion: The wavelength-dependent thresholds for melanosome disruption were determined. The results of the evaluation of irradiation parameters from the threshold-based analysis provided numerical indicators for setting the clinical endpoints for 532-, 730-, 755-, 785-, and 1064-nm picosecond lasers., (© 2024 Wiley Periodicals LLC.)

Spitz nevus is a benign melanocytic lesion composed of epithelioid, fusiform and/or big cells frequently found in childhood. Typically they are small melanocytic lesions, of less than 6 mm diameter with benign histological features: regular architecture, few or absent mitosis and lack of cellular atypia. The two most frequent dermoscopic hallmarks are starburst and dotted vascular pattern. Conservative vs excisional management relies on clinical features and patient age. [ABSTRACT FROM AUTHOR]

Shave excision is a simple and cost‐effective technique for the removal of suitable skin lesions. We performed a prospective study over six months, collecting data from pigmented lesions that were treated with shave excision by dermatologists. Only shave excisions with the intent to remove the lesion in toto were included. A total of 349 lesions were included in this study, 50 (14%) of these were melanomas and no melanoma diagnosed had deep margin involvement, while 13 (26%) had lateral margin involvement. [ABSTRACT FROM AUTHOR]

Oral melanoacanthoma is an uncommon reactive condition that appears as a solitary pigmented lesion and is most often found on the buccal mucosa. For it to appear in the gingiva is extremely rare—only 11 cases are reported in the literature. This article presents a case of gingival melanoacanthoma and reviews the previously published cases. Because gingival melanoacanthoma shares clinical features with other pigmented lesions with diverse genesis, the differential diagnosis of a solitary pigmented lesion on the gingiva is also discussed. [ABSTRACT FROM AUTHOR]

Color has great diagnostic significance in dermatoscopy. Several diagnosis methods are based on the colors detected within a lesion. Malignant lesions frequently show more than three colors, whereas in benign lesions, three or fewer colors are usually observed. Black, red, white, and blue-gray are found more frequently in melanomas than in benign nevi. In this paper, a method to automatically identify the colors of a lesion is presented. A color label identification problem is proposed and solved by maximizing the posterior probability of a pixel to belong to a label, given its color value and the neighborhood color values. The main contribution of this paper is the estimation of the different terms involved in the computation of this probability. Two evaluations are performed on a database of 200 dermoscopic images. The first one evaluates if all the colors detected in a lesion are indeed present in it. The second analyzes if each pixel within a lesion is assigned the correct color label. The results show that the proposed method performs correctly and outperforms other methods, with an average F-measure of 0.89, an accuracy of 0.90, and a Spearman correlation of 0.831. [ABSTRACT FROM AUTHOR]

Vulvar melanoma is a rare and deadly cancer in women, and the prognosis is often poor. There are limited studies on the dermoscopic features of vulvar melanoma. Described criteria include the presence of blue, gray, or white colors. Herein we present the clinical and dermoscopic characteristics of a hypopigmented and heavily pigmented nodule in a 92-year-old and an 80-year-old woman. Dermoscopy in the former revealed structureless milky-red to white areas, remnants of brown pigmentation at the base and polymorphic vessels, while the latter displayed structureless blue-gray areas with black dots and peripheral lines at the base. In both cases, histopathology revealed a stage III melanoma. Our two cases along with a review of the literature suggest that the dermoscopic features described for diagnosing cutaneous nodular melanoma, apply also for vulvar melanoma. Clinicians should always raise the suspicion if observing plaques or nodules with a dermoscopic polymorphic vascular pattern and blue-black color on the genitals of postmenopausal women.

Background: The elastic scattering spectroscopy (ESS) device (DermaSensor Inc., Miami, FL) is a noninvasive, painless, adjunctive tool for skin cancer detection., Objectives: To investigate the performance of the ESS device in the detection of melanoma., Methods: A prospective, investigator-blinded, multicenter study was conducted at 8 United States (US) and 2 Australian sites. All eligible skin lesions were clinically concerning for melanoma, examined with the ESS device, subsequently biopsied according to dermatologists' standard of care, and evaluated with histopathology. A total of 311 participants with 440 lesions were enrolled, including 44 melanomas (63.6% in situ and 36.4% invasive) and 44 severely dysplastic nevi., Results: The observed sensitivity of the ESS device for melanoma detection was 95.5% (95% CI, 84.5% to 98.8%, 42 of 44 melanomas), and the observed specificity was 32.5% (95% CI, 27.2% to 38.3%). The positive and negative predictive values were 16.0% and 98.1%, respectively., Limitations: The device was tested in a high-risk population with lesions selected for biopsy based on clinical and dermoscopic assessments of board-certified dermatologists. Most enrolled lesions were pigmented., Conclusion: The ESS device's high sensitivity and NPV for the detection of melanoma suggest the device may be a useful adjunctive, point-of-care tool for melanoma detection., Competing Interests: Drs Tepedino, McNiff, Fung, and Hartman were all provided funding for their participation in the study. Mr Gianacas is a paid consultant for DermaSensor, Inc. Dr Grant-Kels is an uncompensated member of the Advisory Board for DermaSensor, Inc.

Introduction: The presence of a pigmented lesion of the oral mucosa raises numerous diagnostic hypotheses. The INCa (National Cancer Institute) considers "any pigmented lesion of the oral mucosa as a melanoma until proven otherwise." A histological confirmation is thus necessary. Clinical observation: A 64-year-old female patient consulted for a pigmented lesion of the marginal gingiva of 11 and 21, corresponding to a single round macule of approximately 0.5 cm diameter, brown, homogeneous, covered with a slight keratinization, with regular edges. The rest of the clinical examination was unremarkable. An excisional biopsy confirmed the diagnosis of essential melanosis or Laugier-Hunziker syndrome. Discussion: Pigmented lesions may occur in an isolated form or may be a component of major syndromes. Unique pigmentation of the oral mucosa can be of endogenous origin (e.g., malignant melanoma, essential melanosis, lentigo, different nevi) or of exogenous origin (e.g., ethnic pigmentations, metallic or medicinal origin, vascular lesions, and neuroectodermal tumor in children). Conclusion: Although rare at the gingival level, essential melanosis must be considered in the differential diagnosis of a single flat lesion. Nevertheless, melanoma should always be ruled out, and its early diagnosis is the only favorable prognostic factor in its evolution. [ABSTRACT FROM AUTHOR]

We developed an automated approach for generating quantitative image analysis metrics (imaging biomarkers) that are then analysed with a set of 13 machine learning algorithms to generate an overall risk score that is called a Q-score. These methods were applied to a set of 120 'difficult' dermoscopy images of dysplastic nevi and melanomas that were subsequently excised/classified. This approach yielded 98% sensitivity and 36% specificity for melanoma detection, approaching sensitivity/specificity of expert lesion evaluation. Importantly, we found strong spectral dependence of many imaging biomarkers in blue or red colour channels, suggesting the need to optimize spectral evaluation of pigmented lesions. [ABSTRACT FROM AUTHOR]

Lasers are the therapeutic modalities becoming more commonly used and the incidence of complications increases in direct proportion to diversity. Pigmented lesions of skin are common situations that can lead to cosmetical and psychological disorders.Pigment specific and pigment nonspecific lasers can be used safely and effectively in the treatment of various pigmented lesions including lentigo, nevus, melasma, ephelides, cafe au lait macules, Becker's nevus and postinflammatory hyperpigmentation. The risk of complications and malignancy should be considered very carefuly before the treatment and the most appropriate laser system should be chosen for the patient. It is aimed to provide updated information about complications encountered in laser treatment of pigmented lesions and their management in this review. [ABSTRACT FROM AUTHOR]

Background: Dysplastic nevi with severe atypia (severely dysplastic nevi [SDN]) are frequently re-excised because of the concern that these lesions may in fact represent early melanoma. Data on long-term follow-up of these patients are limited.Objective: We sought to determine the rate of subsequent melanoma development in patients with SDN who underwent re-excision versus those who did not and to determine factors associated with decision to re-excise.Methods: A retrospective single institutional study was conducted with 451 adult patients (mean age 41.3 years) with SDN biopsied between November 1994 and November 2004, with clinical follow-up of at least 5 years.Results: In 451 patients with SDN, re-excision was performed on 36.6%. Two melanomas were diagnosed in the re-excision specimens. Subsequent metastatic melanoma developed in 7 patients, all of whom had a history of melanoma. Margin comments influenced decision to re-excise.Limitations: This was a retrospective study at a single institution.Conclusion: Re-excision of all SDN may not be necessary. [ABSTRACT FROM AUTHOR]