Search

Background: Solar lentigo, a common epidermal hyperpigmented lesion found in sun‐exposed areas, results from the proliferation of melanocytes and the accumulation of melanin. Although various treatments for solar lentigo have been explored, they often lead to complications, including prolonged erythema and post‐inflammatory hyperpigmentation (PIH), posing significant concerns. Objectives and methods: This study evaluated the safety and efficacy of the Vasculature Salvage Laser Surgery (VSLS) system. We treated six Korean patients, each with solar lentigo, in a single session using the 532‐nm nanosecond neodymium‐doped yttrium aluminum garnet (Nd:YAG) VSLS system, with follow‐up periods ranging from 3 to 10 weeks. Results: The treatment led to the complete removal of pigmented lesions in all patients without resulting in PIH, even in cases where previous laser treatments had failed. The only side effect observed was mild erythema, which resolved over the long term in most instances. Conclusions: The VSLS system emerges as a safe and effective treatment for pigmented lesions, including refractory solar lentigines. Nonetheless, additional studies are required to verify its long‐term efficacy. [ABSTRACT FROM AUTHOR]

Background: Laser technology is a viable therapeutic option for treating a number of skin pathologic conditions, including pigmented lesions, vascular lesions and acne scars. Aim: In this work, through in vitro and clinical investigations we test the efficacy, the safety and the speed of treatment of high‐powered laser system emitting a 675‐nm in the management of various skin condition. Materials and methods: In vitro experiments were performed irradiating adult human dermal fibroblasts cells (HDFa) with 675‐nm laser for 24, 48 and 72 h with different fluences and Ki‐67+ cells were counted. The confocal microscopy images of control and treated samples were acquired. Clinical skin rejuvenation/diseases treatments with 675 nm laser device were performed with different laser parameters in 11 patients with pigmented lesions, 5 patients with acne scars and 23 patients for skin rejuvenation. Data were evaluated with the validated global score using 5‐point scales (GAIS) and patient's satisfaction scale. Results: The application of the high‐power 675 nm laser has proven effective in stimulating cell proliferation in in vitro experiments and it led to good results for all skin pathologies. GAIS showed values between 3 and 4 points for all treated pathologies, all scores between '75%‐good improvements' and '100%‐excellent improvements'. The treatment time was reduced by 50% compared to the old parameters setting, resulting in a faster and good patient's satisfying technique. No serious adverse effects were recorded. Conclusion: the preclinical and clinical data confirm the efficacy and safety of this high‐powered 675 nm laser for several skin condition. [ABSTRACT FROM AUTHOR]

Background: Lentigo maligna (LM) exhibits a particular epidemiological profile compared to other histopathologic subtypes of melanoma, with a propensity for the head and neck area and a higher mean age at diagnosis. Few small‐scale studies have exclusively evaluated the risk factors for the development of LM. Objective: This study aims to compare LM to other histological subtypes of melanoma for the prevalence of known melanoma risk factors, including pigmentary characteristics, history of occupational sun exposure, nevus count, and familial melanoma history. Patients and methods: We conducted a case–control study of 152 patients with LM and 784 patients with other melanoma subtypes (OM). The Mann–Whitney t‐test and Pearson chi‐squared test were used to detect differences between the two groups in continuous and categorical variables, respectively. Univariate and multivariate logistic regression models were then constructed to identify risk factors for developing LM compared to other melanoma subtypes. Results: In multivariate logistic regression analysis, LM was positively associated with a lentigines count >50 and occupational sun exposure compared to OM (OR 2.10, 95% CI 1.35–3.29 and OR 2.18, 95% CI 1.33–3.57, respectively). In contrast, patients with an increased nevus count and fair or medium skin color were less likely to develop LM than OM (OR 0.93, P < 0.001, 95% CI 0.91–0.94, and OR 0.28, P < 0.001, 95% CI 0.17–0.46, respectively). In univariate analysis, LM exhibited a weaker association with all pigmentary traits than OM. No significant associations were found for atypical nevi count and family history. Conclusion: We found significant differences in the prevalence of known melanoma risk factors between LM and other melanoma subtypes, which supports the hypothesis of a distinct pathogenetic pathway of LM. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper addresses the complex diagnostic challenges of pigmented lesions in the oral mucosa, ranging from benign to potentially malignant conditions. Our study provides a narrative review with a clinical case overview to guide clinicians in differentiating these lesions. By classifying pigmented lesions based on clinical and histological features, we emphasize the need for a structured approach to diagnosis. The study incorporates a retrospective analysis of cases from our oral medicine experience, utilizing clinical pictures and relevant histology. Our findings aim to enhance early and precise diagnosis, improving patient management and outcomes in dental and medical practice. This paper examines the clinical differentiation of pigmented lesions in the oral mucosa, which poses significant diagnostic challenges across dental and medical disciplines due to their spectrum from benign to potentially malignant conditions. Through a literature review and analysis of clinical cases, this study clarifies current diagnostic methodologies, with an emphasis on differential diagnosis, to provide a practical guide for clinicians. The classification of pigmented lesions, such as endogenous, focal melanocytic, and multifocal pigmentation, based on clinical and histological features, highlights the necessity for a structured and informed approach. A retrospective examination of cases from our oral medicine and pathology clinic, coupled with analysis of photographic and histological records, aids in classifying these lesions. This fosters a better understanding and promotes informed discussions among clinicians, ultimately aiming to enhance early and precise diagnosis, thus improving patient management and outcomes. [ABSTRACT FROM AUTHOR]

Background: Pediatric longitudinal melanonychia (LM) can exhibit atypical features that mimic red‐flag signs for subungual melanoma in adults and lead to diagnostic uncertainty. Nail biopsy may be unnecessary if clinical inspection and dermoscopy suggest a benign nature. Methods: We searched PubMed and Embase from inception to February 2023 for studies of any design reporting either the number or proportion of clinical and dermoscopic features in at least five children (≤18 years) with LM. Non‐English articles, reviews, and abstracts were excluded. We performed a systematic review and meta‐analysis to collate all existing data. Results: A total of 1218 articles were screened and 24 studies with 1391 pediatric patients were included. Nevus was the most common diagnosis (86.3%). The most prevalent sites were fingernails (76.2%) and first digits (45.4%). Pooled proportions of common features were: dark‐color bands (69.8%), multi‐colored bands (47.6%), broad bandwidth (41.1%), pseudo‐Hutchinson sign (41.0%), irregular patterns (38.1%), Hutchinson sign (23.7%), dots and globules (22.5%), nail dystrophy (18.2%), and triangular sign (10.9%). Outcomes included progression (widening or darkening, 29.9%), stability (23.3%), and spontaneous regression (narrowing or fading, 19.9%). Only eight cases of subungual melanoma in situ were reported, and no invasive melanomas were identified. Conclusion: Although atypical characteristics are common in pediatric LM, the probability of malignant transformation is exceedingly low. Appropriate evaluation and management of pediatric LM includes careful clinical and dermoscopic inspection with attention to benign features followed by long‐term interval follow‐up. [ABSTRACT FROM AUTHOR]

Changhan Chen,1,2 Youhui Ke1 1Department of Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China; 2Wenzhou Key Laboratory of Laser Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of ChinaCorrespondence: Youhui Ke, Department of Cosmetology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Zhejiang Chinese Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China, Tel +86-13867776098, Email 672673450@qq.comAbstract: The long-pulse alexandrite laser uses Cr3+:BeAl2O4 crystals as the activation medium and has a 755nm wavelength and millisecond pulse duration. The long-pulse alexandrite laser has been utilized for hair removal, vascular lesions, pigmented lesions, and other conditions because melanin and hemoglobin in the skin, subcutaneous tissues, and skin appendages can specifically absorb this type of laser. To serve as a guide and source of inspiration for the clinical use of this type of laser, we review the present research status and advancement of the long-pulse alexandrite laser in the treatment of the aforementioned categories of disorders.Keywords: long-pulse alexandrite laser, hair removal, vascular lesions, pigmented lesions

Oral melanoma is a rare malignancy with poor prognosis because of its invasive and metastasizing tendencies. It is derived from the melanocytes and is clinically asymptomatic initially but in later stages may show ulceration, pain, bleeding, tooth mobility, and parasthesia. Because of its silent progression, diagnosis is often delayed leading to poor survival rate. This article presents the clinical, histopathological, and immunohistochemical findings of a rare case of melanoma involving the maxilla and also highlights the importance of dental professionals in maintaining a high degree of surveillance for all oral pigmented lesions. [ABSTRACT FROM AUTHOR]

Previous studies suggest that Spitz neoplasms occur primarily in younger patients, leading pathologists to shy away from diagnosing a benign Spitz neoplasm in the elderly. With the advent of genomic sequencing, there is a need for reappraisal of the epidemiology of Spitz neoplasms in the modern molecular era. We aim to reassess the epidemiology of Spitz neoplasms incorporating next-generation sequencing. We looked at 53,814 non-Spitz neoplasms and 1260 Spitz neoplasms including 286 Spitz neoplasms with next-generation sequencing testing and collected various epidemiologic data. In our general pool of cases, the proportion of Spitz neoplasm cases occurring is relatively the same in each of the first 4 decades of life with a precipitous drop in the fifth decade. In assessing a group of genomically verified cases of Spitz neoplasms, the drop was much less significant and up to 20% of all Spitz neoplasm cases occurred in patients over 50 years of age. Limitations included the number of genetically verified Spitz neoplasm cases available and a possible bias as to which cases undergo genomic testing. Genomic verification may allow more confident diagnosis of Spitz neoplasms in patients over 50 years of age and avoid melanoma overdiagnosis. [ABSTRACT FROM AUTHOR]

Copyright of Gyermekgyógyászat is the property of Semmelweis Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and objectivesNon-invasive optical imaging has the potential to provide a diagnosis without the need for biopsy. One such technology is reflectance confocal microscopy (RCM), which uses low power, near-infrared laser light to enable real-time in vivo visualization of superficial human skin from the epidermis down to the papillary dermis. Although RCM has great potential as a diagnostic tool, there is a need for the development of reliable image analysis programs, as acquired grayscale images can be difficult and time-consuming to visually assess. The purpose of this review is to provide a clinical perspective on the current state of artificial intelligence (AI) for the analysis and diagnostic utility of RCM imaging.Study design/materials and methodsA systematic PubMed search was conducted with additional relevant literature obtained from reference lists.ResultsAlgorithms used for skin stratification, classification of pigmented lesions, and the quantification of photoaging were reviewed. Image segmentation, statistical methods, and machine learning techniques are among the most common methods used to analyze RCM image stacks. The poor visual contrast within RCM images and difficulty navigating image stacks were mediated by machine learning algorithms, which allowed the identification of specific skin layers.ConclusionsAI analysis of RCM images has the potential to increase the clinical utility of this emerging technology. A number of different techniques have been utilized but further refinements are necessary to allow consistent accurate assessments for diagnosis. The automated detection of skin cancers requires more development, but future applications are truly boundless, and it is compelling to envision the role that AI will have in the practice of dermatology. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Objective: This study aimed to analyse the clinical and histopathological characteristics of focal oral melanocytic lesions in a Brazilian reference service in Oral and Maxillofacial Pathology. Materials and Methods: A cross‐sectional study was conducted over an 18‐year period. Demographic data and clinical features were collected from the archives, and all biopsy specimens diagnosed as oral melanocytic lesions were retrieved and reviewed. Results: We identified 339 melanocytic lesions. Of these, 191 were melanotic macules, 112 melanocytic nevi, 14 mucosal lentigo simplex, 12 melanomas, 9 solar lentigos, and 1 melanoacanthoma. Lesions occurred mostly in white‐skinned (74.2%) women (65.2%). The main reported clinical aspect was the macule (67.4%), and the most affected site was the lip vermilion (25.4%), followed by the palate (22.9%). Melanomas were larger in size and were observed in older patients with an overall shorter time of onset. The most frequent subtypes of melanocytic nevi were intramucosal (44.6%), compound (24.1%), and blue nevus (20.5%). They showed a heterogeneous architectural pattern with the presence of the three cell types. Conclusion: The most frequent lesions are melanotic macule and nevus, especially the intramucosal subtype. Patients are usually white‐skinned women presenting a small, long‐lasting, macular lesion on the lip vermilion or palate. [ABSTRACT FROM AUTHOR]

A study published in the International Journal of Dermatology examines the impact of sex on the presentation and survival of conjunctival melanoma. The study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database and found that male patients had a higher incidence of the disease compared to females. Female patients, however, had higher rates of advanced disease stages and thicker tumors at the time of diagnosis. Despite this, male patients had a 45% increased risk of disease-specific mortality compared to females. The study suggests that the higher systemic availability of estrogen in females and differences in health-seeking behaviors may contribute to the survival disparities. However, the study acknowledges limitations in the database and reporting practices. [Extracted from the article]

Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPMs). We hypothesized that individuals with MPMs might have an increased incidence of internal malignancies. To identify the risk for subsequent malignancies in MPM patients. Multiple primary standardized incidence ratios were analyzed for individuals with ≥1, ≥2 and ≥3 primary melanomas (PMs) recorded in the Surveillance, Epidemiology, and End Results database during 1973-2014. We identified 223,799 individuals with ≥1 PM, 19,709 with ≥2 PMs, and 3,995 with ≥3 PMs. Risks of subsequent internal malignancy increased with number of PMs, with observed:expected ratios of 0.99, 1.14, and 1.23 (P <.05) for patients with ≥1 PM, ≥2 PMs, and ≥3 PMs, respectively. Internal malignancy was higher in younger MPM patients and those with superficial spreading melanoma. The most common malignancies among MPM patients included breast, prostate, thyroid, soft tissue, brain, kidney, non-Hodgkin lymphoma, and chronic lymphocytic leukemia. Risk for subsequent cutaneous melanoma increased with observed:expected ratios of 8.09, 22.52, 41.03 (P <.05) for patients with ≥1 PM, ≥2 PMs, and ≥3 PMs, respectively. Surveillance, Epidemiology, and End Results records limited information about pigmentation phenotypes, histology, and treatments. Patients with MPMs have an increased risk for subsequent internal and cutaneous malignancies and might benefit from tight adherence to age-specific cancer screening. [ABSTRACT FROM AUTHOR]

Utilization of dermoscopy and novel molecular triage technologies augments visual triage of pigmented skin lesions, promoting early detection of melanoma. One emerging in vivo genomic test, 3‐GEP pigmented lesion assay (3‐GEP PLA) aids in pigmented lesion triage by noninvasively detecting the presence of three genes associated with melanoma: LINC00518, PRAME, and TERT. The purpose of our retrospective case‐control study was to identify dermoscopic features uniquely associated with the presence of LINC00518, PRAME, or TERT in the stratum corneum as determined by 3‐GEP PLA testing. Images of suspicious pigmented lesions that had undergone 3‐GEP PLA testing and received a definitive positive or negative result (n = 393) were evaluated for the presence of specific clinical and dermoscopic features associated with melanoma. We found that asymmetry of color was a significant predictor for PRAME expression (Odds Ratio (OR) 5.5, 95% Confidence Interval (CI) 1.6–34.5, p = 0.004), blue color and negative pigment network were significant predictors for LINC00518 expression (adjusted OR 2.7, 95% CI 1.2–5.5, p = 0.014 and adjusted OR 5.4, 95% CI 1.6–16.9, p = 0.010, respectively), and atypical polymorphous vessels present in a pigmented skin lesion were a significant predictor for TERT promoter mutations (OR 5.8, 95% CI 1.3–23.4, p = 0.022). The results presented suggest a hierarchy in the significance of these dermoscopic features and may help guide evaluation and management of pigmented skin lesions. [ABSTRACT FROM AUTHOR]

Pigmented and irritated types of seborrheic keratosis (SK) can be confused with melanoma, basal cell carcinoma, or pigmented actinic keratosis. Dermoscopic examination may give many clues for the diagnosis of SK, but in equivocal cases the accurate diagnosis can only be made by microscopic features. Herein, we report a striking, isolated pigmented and inflamed SK, located on the waist in an elderly man. Although the duration of the lesion was not clear, a recent change in color was reported. The striking dark pigmentation and lack of visible characteristic features for SK led us to consider other pigmented lesions, mainly melanoma, which it closely resembled. Dermoscopic examination was inconclusive with subtle clues for SK, such as brown-gray dots, small brownish clods, a few curved short lines, and few small pinkish round structures. Histopathological and immunohistochemical examinations revealed an inflamed and pigmented SK. In conclusion, pigmented and inflamed SK does not usually tend to show typical dermoscopic features of SK and may mimic other pigmented lesions, including melanoma. All skin lesions that cannot be classified as clearly benign should undergo biopsy.

Introduction: Case-based training improves novices pattern recognition and diagnostic accuracy in skin cancer diagnostics. However, it is unclear how pattern recognition is best taught in conjunction with the knowledge needed to justify a diagnosis. Objectives: The aim of this study was to examine whether an explanation of the underlying histopathological reason for dermoscopic criteria improves skill acquisition and retention during case-based training in skin cancer diagnostics. Methods: In this double-blinded randomized controlled trial, medical students underwent eight days of case-based training in skin cancer diagnostics, which included access to written diagnosis modules. The modules dermoscopic subsections differed between the study groups. All participants received a general description of the criteria, but the intervention group additionally received a histopathological explanation. Results: Most participants (78%) passed a reliable test in skin cancer diagnostics, following a mean training time of 217 minutes. Access to histopathological explanations did not affect participants' learning curves or skill retention. Conclusions: The histopathological explanation did not affect the students, but the overall educational approach was efficient and scalable.

Mucosal malignant melanoma arising from the head and neck region is a rare entity, and it is more aggressive than cutaneous melanoma. Furthermore, the complexity of the oral cavity makes surgical excision more difficult. Oral malignant melanoma is a rare tumour of melanocytic origin, accounting for 20–30% of malignant melanomas at the mucosal surface and 16% intra-orally. Hard palate and maxillary gingiva are the most common involved sites. The age of reported patients ranges from 20 years to 80 years. Hence, we do hereby present a case of malignant melanoma of mandibular gingiva with review of the literature in a 42-year-old female patient. [ABSTRACT FROM AUTHOR]

Background: Dermoscopy enhances detection of basal cell carcinoma (BCC), especially for the pigmented subtype common among Asians. However, there is limited data on dermoscopic features of BCC in Filipinos., Objectives: The objective of this study is to describe the clinicopathologic profile and dermoscopic features of BCC in Filipinos seen in a tertiary care clinic., Methods: A cross-sectional study was conducted in the Philippines from November 2019 to December 2021 in a tertiary care clinic. Fifty-three (53) lesions suspicious for BCC were analyzed using dermoscopy prior to histologic confirmation. Fifty (50) biopsy-proven BCC lesions were included in the analysis., Results: Lesions were more commonly seen in females (72.50%), and located on the head and neck (88%). The most common histopathologic subtype was nodular (74%). The most common dermoscopic features were large blue-gray ovoid nests (86%) and ulcerations (70%)., Conclusion: The most common BCC type among the study participants was nodular, with large blue-gray ovoid nests and ulceration seen on dermoscopy., Competing Interests: All authors declared no conflicts of interest., (© 2024 Acta Medica Philippina.)

In recent years, there has been a significant improvement in the accuracy of the classification of pigmented skin lesions using artificial intelligence algorithms. Intelligent analysis and classification systems are significantly superior to visual diagnostic methods used by dermatologists and oncologists. However, the application of such systems in clinical practice is severely limited due to a lack of generalizability and risks of potential misclassification. Successful implementation of artificial intelligence-based tools into clinicopathological practice requires a comprehensive study of the effectiveness and performance of existing models, as well as further promising areas for potential research development. The purpose of this systematic review is to investigate and evaluate the accuracy of artificial intelligence technologies for detecting malignant forms of pigmented skin lesions. For the study, 10,589 scientific research and review articles were selected from electronic scientific publishers, of which 171 articles were included in the presented systematic review. All selected scientific articles are distributed according to the proposed neural network algorithms from machine learning to multimodal intelligent architectures and are described in the corresponding sections of the manuscript. This research aims to explore automated skin cancer recognition systems, from simple machine learning algorithms to multimodal ensemble systems based on advanced encoder-decoder models, visual transformers (ViT), and generative and spiking neural networks. In addition, as a result of the analysis, future directions of research, prospects, and potential for further development of automated neural network systems for classifying pigmented skin lesions are discussed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Melanoma detection, prognosis, and treatment represent challenging and complex areas of cutaneous oncology with considerable impact on patient outcomes and healthcare economics. Artificial intelligence (AI) applications in these tasks are rapidly developing. Neural networks with increasing levels of sophistication are being implemented in clinical image, dermoscopic image, and histopathologic specimen classification of pigmented lesions. These efforts hold promise of earlier and highly accurate melanoma detection, as well as reliable prognostication and prediction of therapeutic response. Herein, we provide a brief introduction to AI, discuss contemporary investigational applications of AI in melanoma, and summarize challenges encountered with AI. [ABSTRACT FROM AUTHOR]

An optical approach for pigmented lesions detection in human skin is presented. As differences between normal skin tissue and pigmentation tissue (and even a change in pigmentation development) can be detected by their optical properties, this paper presents a new, potentially noninvasive approach for skin cancer detection. Since each wavelength has different penetration depth into the tissue and different absorption, the goal was to check whether a combination of information obtained from five different wavelengths, can increase the detection probability and reduce the false positive probability, compared to using only one wavelength. Temporal tracking of back-reflected secondary speckle patterns generated while illuminating the tested area with several lasers and applying periodic vibrations to the surface via a controlled vibration source at several stimulation frequencies. As a sequel to the previous work conducted in our laboratory which investigated pigmented lesions interaction with one light source, this work deals with increasing the number of parameters that are being looked at and considered at the same time. Using five wavelengths, 9 vibration frequencies and 19 signal analysis parameters, ex-vivo experiments were performed on porcine skin tissues and were analyzed using artificial intelligence tools which could detect the strong features for each wavelength individually. Combining the wavelengths produced impressive results compared to the results by each wavelength separately: both types of errors, false positive and false negative, decreased to less than 2%. Such a significant change in its impact on patients shows the value of this method. This paper shows the possibility of optically separating normal skin from pigmentation tissue, by using the advantages of multi-spectral optimization. This is a necessary proof of concept as a preliminary step toward our future experiments, which may differentiate between different types of pigmentation, and even malignancy and benign tissues.

Introduction: Passive smoker individuals whom live near the smokers and pigmentation appears on their oral mucosa due to proximity from smokers. Materials and methods: This study was carried-out on 50 patients suffering from pigmentation of the mouth that were collected from the private dental clinic were obtained and 50 individual’s neighbouring to them and considered as the passive smoking group. Discussion: For passive smoker the pigmentation increasing with duration of smoking, in non-filtered cigarettes than filtered cigarette and in heavy smokers than mild smokers The intraoral distribution of melanin pigmentations commonly observed in the buccal region, Lingual, gingival and palatal of the mouth.

Background: The use of artificial intelligence (AI) for skin cancer assessment has been an emerging topic in dermatology. Leadership of dermatologists is necessary in defining how these technologies fit into clinical practice.Objective: To characterize the evolution of AI in skin cancer assessment and characterize the involvement of dermatologists in developing these technologies.Methods: An electronic literature search was performed using PubMed by searching machine learning or artificial intelligence combined with skin cancer or melanoma. Articles were included if they used AI for screening and diagnosis of skin cancer using data sets consisting of dermoscopic images or photographs of gross lesions.Results: Fifty-one articles were included, and 41% of these had dermatologists included as authors. Articles that included dermatologists described algorithms built with more images versus articles that did not include dermatologists (mean, 12,111 vs 660 images, respectively). In terms of underlying technology, AI used for skin cancer assessment has followed trends in the field of image recognition.Limitations: This review focused on models described in the medical literature and did not account for those described elsewhere.Conclusions: Greater involvement of dermatologists is needed in thinking through issues in data collection, data set biases, and applications of technology. Dermatologists can provide access to large, diverse data sets that are increasingly important for building these models. [ABSTRACT FROM AUTHOR]

Introduction: Passive smoker individuals whom live near the smokers and pigmentation appears on their oral mucosa due to proximity from smokers. Materials and methods: This study was carried-out on 50 patients suffering from pigmentation of the mouth that were collected from the private dental clinic were obtained and 50 individual's neighbouring to them and considered as the passive smoking group. Discussion: For passive smoker the pigmentation increasing with duration of smoking, in non-filtered cigarettes than filtered cigarette and in heavy smokers than mild smokers The intraoral distribution of melanin pigmentations commonly observed in the buccal region, Lingual, gingival and palatal of the mouth. [ABSTRACT FROM AUTHOR]

The evaluation of pigmented lesions on tattooed skin poses a diagnostic challenge for dermatologists, as a nevus may be partially or completely obscured by tattoo pigment. Because of incidences of melanoma arising from tattooed skin, the current gold standard is to biopsy these lesions. Reflectance confocal microscopy (RCM) is a noninvasive imaging modality used in the diagnosis and management of skin diseases that may allow for diagnosis, while preserving the tattoo design. Retrospective chart review was conducted to identify pigmented lesions on or near tattooed skin that were evaluated with RCM. Confocal characteristics and diagnoses were recorded and analyzed. Nineteen lesions from 15 patients were retrospectively reviewed. Tattoo pigment did not hinder evaluation and diagnosis of pigmented lesions on RCM. About 94.7% of lesions were diagnosed as benign melanocytic nevi by an expert confocal reader. One lesion was confocally diagnosed as melanocytic nevus with atypia but was found to be an inflamed melanocytic nevus on histology. Tattoo pigment particles were differentiated from other hyper-refractile entities by an expert confocal reader based on size, morphology, and clinical correlation. RCM may provide a solution to the diagnostic challenge of pigmented lesions on or near tattooed skin. [ABSTRACT FROM AUTHOR]

Nevus of Ota is cosmetically burdensome and often prompts patients to seek treatment. Lasers are commonly used in removing these lesions; however, no systemic analysis has been conducted to support a gold standard laser. To conduct a meta-analysis of the efficacy and safety of Q-switched Nd:YAG lasers (QSNL), Q-switched ruby lasers (QSRL), Q-switched alexandrite lasers (QSAL), and picosecond alexandrite lasers (PSAL) in removing nevus of Ota. Inclusion criteria were nevus of Ota patients treated with QSNL, QSRL, QSAL, or PSAL and documentation of percent clearance and the rate of at least one adverse event. Articles in English, Chinese, or Japanese were included. The prespecified outcome measures were efficacy (percent clearance) and safety (rates of hyperpigmentation, hypopigmentation, scarring, and recurrence). The review included 57 studies and 13,417 patients. The pooled success rate was 64% for QSNL (95% CI 52-76%), 54% for QSRL (95% CI 39-69%), 58% for QSAL (95% CI 44-72%), and 100% for PSAL (95% CI 98-102%). The pooled adverse event rate was 5% for QSNL (95% CI 4-6%), 14% for QSRL (95% CI 9-19%), 9% for QSAL (95% CI 6-12%), and 44% (95% CI 31-57%) for PSAL. QSNL has the most evidence for effectively and safely treating nevus of Ota. PSAL potentially has a superior efficacy; however, further studies are needed to elucidate its side effect profile when treating nevus of Ota. [ABSTRACT FROM AUTHOR]

The diagnosis of junctional and lentiginous naevi on sun‐damaged skin of the head and neck in adults has been questioned in the literature, with the implication that these lesions should be classified as melanoma in situ. This could result in the overdiagnosis and overtreatment of non‐malignant lesions. We conducted a cross‐sectional study of the histopathological diagnosis of pigmented lesions biopsied from the head and neck of adults ≥40 years of age that were submitted to a large, Queensland‐based pathology centre over seven months. Out of 543 lesions assessed, 293 (54.0%) were flat and 250 (46.0%) were raised. Flat naevi consisted of junctional/lentiginous and compound naevi, either with or without dysplasia. Collectively, flat naevi had a prevalence slightly less than that of melanoma (15.0% versus 19.0% among flat lesions, respectively, and 8.1% versus 11.2% among all lesions, respectively). The mean age of biopsy for all junctional/lentiginous naevi was significantly greater than that of all compound naevi (65.0 years versus 52.2 years; P = 0.001). Junctional/lentiginous naevi were significantly more associated with the neck than intradermal naevi (P < 0.001). In conclusion, benign, flat naevi account for a significant proportion of head and neck lesions in adults ≥40 years of age, and their location alone should not outweigh their histopathology when reaching a diagnosis. [ABSTRACT FROM AUTHOR]

A healthy 66 year-old man presented with a complaint of changes within a nodule on the scalp, which had first appeared over 10 years prior. He had no previous history of skin cancer.  On physical examination a solitary, asymmetric, purple-black nodule with irregular borders was identified on the right vertex of his scalp. The remainder of his examination did not reveal any additional lesions.

An optical approach for pigmented lesions detection in human skin is presented. As differences between normal skin tissue and pigmentation tissue (and even a change in pigmentation development) can be detected by their optical properties, this paper presents a new, potentially noninvasive approach for skin cancer detection. Since each wavelength has different penetration depth into the tissue and different absorption, the goal was to check whether a combination of information obtained from five different wavelengths, can increase the detection probability and reduce the false positive probability, compared to using only one wavelength. Temporal tracking of back-reflected secondary speckle patterns generated while illuminating the tested area with several lasers and applying periodic vibrations to the surface via a controlled vibration source at several stimulation frequencies. As a sequel to the previous work conducted in our laboratory which investigated pigmented lesions interaction with one light source, this work deals with increasing the number of parameters that are being looked at and considered at the same time. Using five wavelengths, 9 vibration frequencies and 19 signal analysis parameters, ex-vivo experiments were performed on porcine skin tissues and were analyzed using artificial intelligence tools which could detect the strong features for each wavelength individually. Combining the wavelengths produced impressive results compared to the results by each wavelength separately: both types of errors, false positive and false negative, decreased to less than 2%. Such a significant change in its impact on patients shows the value of this method. This paper shows the possibility of optically separating normal skin from pigmentation tissue, by using the advantages of multi-spectral optimization. This is a necessary proof of concept as a preliminary step toward our future experiments, which may differentiate between different types of pigmentation, and even malignancy and benign tissues. [ABSTRACT FROM AUTHOR]

Objective: To provide a formal statistical comparison of the efficacy of melanoma detection among different clinical settings.Methods: A systematic review and meta-analysis of all relevant observational studies on number needed to treat (NNT) in relation to melanoma was performed in MEDLINE. We performed a random-effects model meta-analysis and reported NNTs with 95% confidence intervals (CIs). The subgroup analysis was related to clinical setting.Results: In all, 29 articles including a total of 398,549 biopsies/excisions were analyzed. The overall NNT was 9.71 (95% CI, 7.72-12.29): 22.62 (95% CI, 12.95-40.10) for primary care, 9.60 (95% CI, 6.97-13.41) for dermatology, and 5.85 (95% CI, 4.24-8.27) for pigmented lesion specialists.Limitations: There is heterogeneity in data reporting and the possibility of missing studies. In addition, the incidence of melanoma varies among clinical settings, which could affect NNT calculations.Conclusion: Pigmented lesion specialists have the lowest NNT, followed by dermatologists, suggesting that involving specialists in the diagnosis and treatment of pigmented skin lesions can likely improve patient outcomes. [ABSTRACT FROM AUTHOR]

Dyschromatosis Universalis Heriditaria (DUH) is an autosomal dominant disorder that usually presents in infancy or early childhood in Asian families and is characterized by pinpoint to pea-sized hypo- and hyper- pigmented macules, distributed in a reticulated pattern over the trunk, abdomen, and limbs, usually sparing the face and palmoplantar surfaces. It was reported initially and mainly in Japan. However, subsequent cases have been reported from other countries. This report describes DUH in four members of the same family. Skin biopsies of representative lesions from all the affected family members were taken and processed for histopathological examination. The tissue sections were stained with hematoxylin and eosin, and also a special stain for melanocytes was performed to arrive at a diagnosis.