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Imaging of desmoplastic trichoepithelioma by high-definition optical coherence tomography
No full textDesmoplastic trichoepithelioma (DTE) is a rare benign adnexal tumor with follicular differentiation that appears most frequently on the face of young women. It can clinically mimic a variety of skin tumors such as intradermal nevus, sebaceous hyperplasia, and basal cell carcinoma (BCC).1 Because of its overlapping clinical features, the diagnosis of DTE is usually established on histopathology. However, given the predilection of DTE on cosmetically sensitive areas on the face, the indication for biopsy should be as accurate as possible. Several noninvasive imaging techniques have emerged in recent years, aiming for higher accuracy of in vivo diagnosis. These include dermoscopy, reflectance confocal microscopy (RCM), and conventional optical coherence tomography (OCT). High-definition (HD) OCT (Skintell; Agfa HealthCare, Brussels, Belgium) is a recently introduced technique based on the same principles of conventional OCT but differing on its ability to give optical imaging up to 570 μm deep within the skin, with high resolution of 3 μm both in axial and lateral directions. The field of view is 1.8 × 1.5 mm, and the total light power at the tissue is less than 3.5 mW. The system works in direct contact with the skin. The interference signal detected by the 2-dimensional imaging sensor is digitized, subsequently transferred to a computer, and displayed through a grayscale or color palette resulting in an OCT image. High-definition OCT is capable of capturing not only slice but also en face images in real time and fast 3-dimensional acquisition. Therefore, HD-OCT allows in vivo examination of the skin, enabling visualization of individual cells with a greater depth than RCM. It also provides cross-sectional imaging like the conventional OCT. Additional technical details are discussed elsewhere.
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Imaging of Desmoplastic Trichoepithelioma by High-Definition Optical Coherence Tomography
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Desmoplastic trichoepithelioma and melanocytic nevus: Dermoscopic and reflectance confocal microscopy presentation of a rare collision tumor
No full textA 27-year-old woman presented with a 2-year history of an asymptomatic papule located on her right cheek. The physical examination revealed a firm, well-defined with a raised annular border, skin-colored papule, 5 mm in maximum diameter
Dermoscopy and reflectance confocal microscopy in verruciform xanthoma of the glans penis
No full textIn accordance to the International Conference on Harmonisation–Good Clinical Practice (ICH-GCP) the patient confirmed his willingness to participate in the imaging procedure, after having been informed of all aspects of the trial. The informed consent was documented by a written, signed, and dated informed consent form
A dangerous fruit of Belladonna
No full textA 34-year-old woman recently noticed a rapidly growing pigmented lesion arising within a tattoo on her right lower leg. Clinical examination found an irregular pigmented, focally ulcerated nodule located in the center of the tattoo reminiscent of the flower of the herbaceous plant, Atropa belladonna, also known as deadly nightshade (Fig 1)
Dermoscopy, reflectance confocal microscopy and immunohistochemical analysis in melanocytic lesions with Meyerson's phenomenon
No full textBACKGROUND:
Meyerson's phenomenon is characterized by a symmetrical halo of erythema and scale around central, mostly melanocytic lesions.
OBJECTIVE:
Our aim was to describe the dermoscopic and reflectance confocal microscopy (RCM) features of melanocytic tumors less frequently associated with Meyerson's phenomenon, with histopathology and immunohistochemistry correlation.
METHODS:
Clinical, dermoscopic and RCM images of 4 histopathologically confirmed melanocytic tumors associated with Meyerson's phenomenon (3 dysplastic compound nevi and 1 melanoma) were retrospectively collected, with additional immunohistochemical analysis.
RESULTS:
RCM showed in vivo features of both melanocytic and spongiotic nature of the lesion associated with Meyerson's phenomenon, even in cases with absent halo. Our study also supported the involvement of immune-mediated CD4+ T lymphocyte mechanisms and Langerhans cells.
CONCLUSION:
Our case series supports the potential of RCM in the evaluation of tumoral and inflammatory skin diseases. RCM features of rare Meyerson's melanoma were also described for the first time. © 2014 S. Karger AG, Basel
Der Einsatz der Dermatoskopie in der Diagnose und Therapie von Nichtmelanozytären Hautkrebsformen
No full textToday, dermatoscopy is an integral part of every clinical skin examination, as it mar-kedly enhances the early detection of melanocytic and nonmelanocytic skin cancer (NMSC) compared to naked-eye inspection. Besides its diagnostic use, this noninva-sive method is increasingly important in the selection of as well as the response as-sessment to various therapies used for NMSC, including basal cell carcinoma, actinic keratoses, squamous cell carcinoma, and also rare tumors such as Merkel cell carci-noma, angiosarcoma, or dermatofibrosarcoma protuberans. Thus, dermatoscopy is a valid tool for the preoperative assessment of tumor margins in basal cell carcinoma, but also for follow-up of actinic keratoses after topical treatment. The present article presents an overview on the use of dermatoscopy in the diagnosis and therapy of various types of NMSC
Verrucous melanoma simulating melanoacanthoma: Dermoscopic, reflectance confocal microscopic and high-definition optical coherence tomography presentation of a rare melanoma variant
Get PDFMelanoma is characterised by a variety of clinical and histopathological presentations. Dermoscopy is a fast, non‐invasive technique that increases diagnostic accuracy for both melanocytic and non‐melanocytic skin tumours. One example of a potential pitfall in melanoma diagnosis using dermoscopy is represented by seborrheic keratosis (SK) that looks like melanomas, which may show overlapping features of both tumours
Reflectance Confocal Microscopy for Diagnosis of Mammary Paget's Disease
Get PDFMammary Paget’s disease (MPD) is an uncommon intra-epidermal adenocarcinoma of the nipple-areola complex, occurring in 1–5% of all breast carcinomas (1). MPD is difficult to diagnose clinically as it mimics a variety of both inflammatory and neoplastic skin diseases (2). Pigmented mammary Paget’s disease (PMPD) corresponds to an even less common variant, frequently simulating other pigmented lesions of the nipple, including melanoma (3–5). According to the epidermotropic theory, Paget cells (PCs) originate from cancer cells that migrate via the lactiferous ducts along the basal membrane, to invade the epidermis of the nipple and areola (6, 7). Considering its intra-epidermal spreading, PCs are therefore potentially demonstrable using non-invasive diagnostic techniques with near-cellular resolution, such as reflectance confocal microscopy (RCM) (8). The aim of this study was retrospectively to describe the RCM features of 5 cases of MPD, with dermoscopic and histopathological correlation
Dermoscopy and reflectance confocal microscopy in cutaneous leishmaniasis on the face
No full textLeishmaniasis is a vector-borne intracellular parasitic infection that can present in two major forms, visceral and cutaneous. Cutaneous leishmaniasis (CL) is widely distributed, Spain and Croatia being hypoendemic regions.
The disease usually presents as an asymptomatic reddish, mostly ulcerated, papule, often located on the face. The diagnosis is confirmed by histopathology and immunohistochemistry. Characteristic dermoscopic structures have
been identified in CL in several studies. Reflectance confocal microscopy (RCM) is a technique that allows in vivo visualisation of skin structures at a nearly histological resolution. To the best of our knowledge, only one case of RCM of CL has been published until now
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