Browsing by Author "Dusza, Stephen W."

Now showing 1 - 15 of 15
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    Association of shiny white blotches and strands with nonpigmented basal cell carcinoma: Evaluation of an additional dermoscopic diagnostic criterion
    (2016) Navarrete Dechent, Cristián Patricio; Bajaj, Shirin; Marchetti, Michael A.; Rabinovitz, Harold S.; Dusza, Stephen W.
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    Automated Dermatological Diagnosis: Hype or Reality?
    (2018) Navarrete Dechent, Cristián Patricio; Dusza, Stephen W.; Liopyris, Konstantinos; Marghoob, Ashfaq A.; Halpern, Allan C.; Marchetti, Michael A.
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    Clinical and dermoscopic features associated with lichen planus-like keratoses that undergo skin biopsy: A single-center, observational study
    (2019) Liopyris, Konstantinos; Cristian Navarrete-Dechent; Dusza, Stephen W.; Marghoob, Ashfaq A.; Deng, Liang; Wilson, Barbara B.; Marchetti, Michael A.
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    Clinical size is a poor predictor of invasion in melanoma of the lentigo maligna type
    (2021) Navarrete-Dechent, Cristian; Aleissa, Saud; Connolly, Karen; Hibler, Brian P.; Dusza, Stephen W.; Rossi, Anthony M.; Lee, Erica; Nehal, Kishwer S.
    Background: There are no well-defined clinical factors to predict the risk of occult invasion in melanoma of the lentigo maligna type (LM) before complete histopathologic analysis.
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    Expert Agreement on the Presence and Spatial Localization of Melanocytic Features in Dermoscopy
    (2024) Liopyris, Konstantinos; Navarrete-Dechent, Cristian; Marchetti, Michael A.; Rotemberg, Veronica; Apalla, Zoe; Argenziano, Giuseppe; Blum, Andreas; Braun, Ralph P.; Carrera, Cristina; Codella, Noel C. F.; Combalia, Marc; Dusza, Stephen W.; Gutman, David A.; Helba, Brian; Hofmann-Wellenhof, Rainer; Jaimes, Natalia; Kittler, Harald; Kose, Kivanc; Lallas, Aimilios; Longo, Caterina; Malvehy, Josep; Menzies, Scott; Nelson, Kelly C.; Paoli, John; Puig, Susana; Rabinovitz, Harold S.; Rishpon, Ayelet; Russo, Teresa; Scope, Alon; Soyer, H. Peter; Stein, Jennifer A.; Stolz, Willhelm; Sgouros, Dimitrios; Stratigos, Alexander J.; Swanson, David L.; Thomas, Luc; Tschandl, Philipp; Zalaudek, Iris; Weber, Jochen; Halpern, Allan C.; Marghoob, Ashfaq A.
    Dermoscopy aids in melanoma detection; however, agreement on dermoscopic features, including those of high clinical relevance, remains poor. In this study, we attempted to evaluate agreement among experts on exemplar images not only for the presence of melanocytic-specific features but also for spatial localization. This was a cross-sectional, multicenter, observational study. Dermoscopy images exhibiting at least 1 of 31 melanocytic-specific features were submitted by 25 world experts as exemplars. Using a web-based platform that allows for image markup of specific contrast-defined regions (superpixels), 20 expert readers annotated 248 dermoscopic images in collections of 62 images. Each collection was reviewed by five independent readers. A total of 4,507 feature observations were performed. Good-to-excellent agreement was found for 14 of 31 features (45.2%), with eight achieving excellent agreement (Gwet's AC >0.75) and seven of them being melanomaspecific features. These features were peppering/granularity (0.91), shiny white streaks (0.89), typical pigment network (0.83), blotch irregular (0.82), negative network (0.81), irregular globules (0.78), dotted vessels (0.77), and blue-whitish veil (0.76). By utilizing an exemplar dataset, a good-to-excellent agreement was found for 14 features that have previously been shown useful in discriminating nevi from melanoma. All images are public (www.isic-archive.com) and can be used for education, scientific communication, and machine learning experiments.
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    Incidence of New Primary Cutaneous Melanoma in Patients With Metastatic Melanoma Treated With Immune Checkpoint Inhibitors A Single-Center Cohort Study
    (2021) Nanda, Japbani K.; Dusza, Stephen W.; Navarrete-Dechent, Cristian; Liopyris, Konstantinos; Marghoob, Ashfaq A.; Marchetti, Michael A.
    Question What is the incidence of new primary cutaneous melanoma (CM) after initiating immune checkpoint inhibitor therapy for metastatic melanoma? Findings In this single-center observational cohort study, 42 of 2251 patients (1.9%) who received immune checkpoint inhibitors were diagnosed with 48 melanomas. The incidence rate was approximately 1100 cases per 100000 person-years, and the cumulative cause-specific risk of new CM after 5 years was 4.9%; patients diagnosed with a new primary CM were more likely to have a family history of melanoma. Meaning Patients who receive checkpoint inhibitors for treatment of metastatic melanoma remain at risk for the development of new primary CMs.
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    Lentigo maligna melanoma mapping using reflectance confocal microscopy correlates with staged excision: A prospective study
    (2023) Navarrete-Dechent, Cristian; Cordova, Miguel; Aleissa, Saud; Liopyris, Konstantinos; Dusza, Stephen W.; Kose, Kivanc; Busam, Klaus J.; Hollman, Travis; Lezcano, Cecilia; Pulitzer, Melissa; Chen, Chih-Shan J.; Lee, Erica H.; Rossi, Anthony M.; Nehal, Kishwer S.
    Background: Lentigo maligna/lentigo maligna melanoma (LM/LMM) can present with subclinical extension that may be difficult to define preoperatively and lead to incomplete excision and potential recurrence. Preliminarily studies have used reflectance confocal microscopy (RCM) to assess LM/LMM margins.
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    Paradoxical effect of epinephrine on lesion redness and vascularity
    (2023) Nazir, Zaeem H.; Rishpon, Ayelet; Kose, Kivanc; Marghoob, Nadeem G.; Liopyris, Konstantinos; Navarrete-Dechent, Cristian; Dusza, Stephen W.; Daoud, Alexander; Marghoob, Ashfaq A.
    IntroductionEpinephrine is commonly used in combination with local anesthetic (lidocaine/epinephrine) due to its beneficial vasoconstrictive properties. Typically, pallor is appreciated after injection as a sign of effect; however, we observed that some cutaneous malignancies paradoxically revealed increased redness and vascularity after injection of lidocaine/epinephrine. In this study, we investigate this phenomenon among a series of biopsied lesions to identify characteristics of lesions associated with increased redness and/or vascularity.ObjectivesTo determine characteristics of lesions which become redder or more vascular after injection with lidocaine/epinephrine prior to biopsy.MethodsThis cross-sectional study consisted of a convenience sample of lesions scheduled for biopsy. Lesions were photographed prior to and 7 min after injection of lidocaine/epinephrine as a part of standard care. Two readers blinded to study objectives and histopathological diagnosis assessed lesions for changes in redness and vascular features.ResultsFifty-four lesions from 47 patients-61.7% male, mean age 64.8 years, age-range 24-91 were included. Thirty-six lesions were biopsy confirmed malignant, with 5 in situ and 31 invasive malignancies; the remaining 18 lesions were benign. In comparison with non-malignant lesions, malignant lesions were associated with an increase in clinically appreciable vascular features after injection of lidocaine/epinephrine, X-2 (1) = 21.600, p < 0.001. Further stratification into benign, in situ, and invasive lesions strengthened the association, X-2 (1) = 23.272, p < 0.001.ConclusionsCombination lidocaine/epinephrine has been shown to paradoxically increase the visibility of vessels seen in cutaneous malignancies. This is consistent with prior literature suggesting aberrant adrenergic signaling in neoangiogenic vessels.
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    Patterns of reconstruction following margin-controlled surgery for melanoma of the lentigo maligna type of the head and neck
    (Springer Nature, 2025) Navarrete Dechent, Cristian Patricio; Veldhuizen, Inge J.; Aleissa, Saud; Dusza, Stephen W.; Rossi, Anthony M.; Lee, Erica H.; Nehal, Kishwer S.
    Melanoma of the lentigo maligna (LM) type is most commonly located on the head and neck region. This subtype of melanoma poses surgical challenges due to its location on anatomically sensitive areas and frequent presence of subclinical extension. To analyze the reconstruction patterns of LM patients undergoing margin-controlled surgery. An observational study was conducted at Memorial Sloan Kettering Cancer Center, enrolling patients who underwent staged excision for the LM between November 2006 and April 2019. The study included 519 patients. Following margin-controlled surgery, the size of the surgical defects varied: <10 mm(36.2%), 10 and 30 mm (36.8%), and > 30 mm (27%). A flap reconstruction was the most common reconstructive technique (42.6%), followed by primary closure (32.6%), and graft (21.8%). Age was significantly associated with reconstruction type, with older patients more likely to undergo graft reconstructions (p = 0.014). Larger defects (> 30 mm) were reconstructed with grafts and flaps more often compared to smaller defects (p < 0.001 and p = 0.02, respectively). Understanding the scope of reconstruction is important for effective pre-surgical counseling and treatment planning. These findings highlight the importance of personalized strategies considering patients’ age and defect size.
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    Perifollicular linear projections: A dermatoscopic criterion for the diagnosis of lentigo maligna on the face
    (2024) Navarrete-Dechent, Cristian; Jaimes, Natalia; Dusza, Stephen W.; Liopyris, Konstantinos; Marchetti, Michael A.; Cordova, Miguel; Oliviero, Margaret; Villaseca, Miguel A.; Pulitzer, Melissa; Busam, Klaus J.; Rossi, Anthony M.; Rabinovitz, Harold S.; Nehal, Kishwer S.; Scope, Alon; Marghoob, Ashfaq A.
    Background: Lentigo maligna (LM) can mimic benign, flat, pigmented lesions and can be challenging to diagnose. Objective: To describe a new dermatoscopic feature termed "perifollicular linear projections (PLP)"as a diagnostic criterion for LM on the face. Methods: Retrospective study on reflectance confocal microscopy and dermatoscopy images of flat facial pigmented lesions originating from 2 databases. PLP were defined as short, linear, pigmented projections emanating from hair follicles. Dermatoscopy readers were blinded to the final histopathologic diagnosis. Results: From 83 consecutive LMs, 21/83 (25.3%) displayed "bulging of hair follicles"on reflectance confocal microscopy and 18 of these 21 (85.7%), displayed PLP on dermatoscopy. From a database of 2873 consecutively imaged and biopsied lesions, 252 flat-pigmented facial lesions were included. PLP was seen in 47/76 melanomas (61.8%), compared with 7/176 lesions (3.9%) with other diagnosis (P \ .001). The sensitivity was 61.8% (95% CI, 49.9%-72.7%), specificity 96.0% (95% CI, 92.9%-98.4%). PLP was independently associated with LM diagnosis on multivariate analysis (OR 26.1 [95% CI, 9.6%-71.0]). Limitations: Retrospective study. Conclusion: PLP is a newly described dermatoscopic criterion that may add specificity and sensitivity to the early diagnosis of LM located on the face. We postulate that PLP constitutes an intermediary step in the LM progression model. ( J Am Acad Dermatol 2024;90:52-7.)
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    Reflectance confocal microscopy terminology for non-melanocytic skin lesions: A Delphi consensus of experts
    (Elsevier Inc., 2025) Navarrete Dechent, Cristian Patricio; Longo, Caterina; Liopyris, Konstantinos; Ardigo, Marco; Ahlgrimm-Siess, Verena; Bahadoran, Phillipe; Carrera, Cristina; Braga, Juliana Casagrande Tavoloni; Chen, Chih-Shan J.; Correa, Lilia; Carvahlo, Nathalie de; Durkin, John; Farnetani, Francesca; Grant-Kels, Jane M.; Gill, Melissa; Gonzalez, Salvador; Hartmann, Daniela; Hoffman-Wellenhof, Rainer; Huho, Albert; Ludzik, Joanna; Malvehy, Josep; Marghoob, Ashfaq A.; Moscarella, Elvira; Oliviero, Margaret; Puig, Susana; Rabinovitz, Harold; Rao, Babar; Rezze, Gisele G.; Rossi, Anthony M.; Rubinstein, Gene; Ruini, Cristel; Sattler, Elke; Soyer, H. Peter; Schwartz, Rodrigo; Thng, Steven; Ulrich, Martina; Witkowski, Alexander; Dusza, Stephen W.; Guitera, Pascale; Pellacani, Giovanni; Scope, Alon; Jain, Manu
    Background There is lack of uniformity in reflectance confocal microscopy (RCM) terminology. Objective To establish expert consensus on a standardized set of RCM terms that describe non-melanocytic lesions (NML). Methods We invited RCM experts to participate in a Delphi-consensus study. Fifty-nine RCM descriptors were extracted from a previous systematic review on RCM terminology for describing NML. Of these, 35 items were presented as 4 groups of synonymous terms and 24 items as single, non-synonymous terms. For the first round, an agreement threshold was set at >70%. Participants could also propose new terms. Terms with ≤70% agreement and newly proposed terms were carried over to the next round. For subsequent rounds, agreement threshold was set at >50%. Results The study was conducted between June 2021 and May 2023. Forty-two of 44 (95%) invited experts participated. Three iterative Delphi rounds were completed, resulting in a consensus list of 36 terms, including 32 synonymous- and 4 non-synonymous- terms for describing NML. Limitations Only experts were included. We did not evaluate definitions of terms in the study. Conclusions We propose a simplified list of RCM terms, vetted by RCM experts, for describing and diagnosing NML. Uniform terminology could benefit clinical practice, research, and education.
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    Staging System Performance and Clinical Outcomes for Cutaneous Squamous Cell Carcinoma of the Ear: A Single-Center Retrospective Study
    (2023) Navarrete-Dechent, Cristian; Mori, Shoko; Connolly, Karen; Shah, Kalee; Dusza, Stephen W.; Rossi, Anthony M.; Lee, Erica H. H.; Busam, Klaus J.; Nehal, Kishwer S.
    BACKGROUNDCutaneous squamous cell carcinoma (cSCC) of the ear is associated with poor outcomes. No studies have evaluated current staging system performance in this specific location.OBJECTIVEDescribe clinicopathologic characteristics and outcomes of ear cSCC and evaluate the performance of current staging systems.METHODSRetrospective study including cases diagnosed and treated at a cancer center from January 2000 to December 2014. Demographic, clinical, and pathologic data were collected from clinical records. Biopsy slides were rereviewed and patients were staged according to the American Joint Committee on Cancer (AJCC) seventh, eighth, and Brigham Women's Hospital (BWH) staging.RESULTSOf 125 patients, the mean age at diagnosis was 71.9 years (SD 12.5), with most men (89.6%, n = 112). Median follow-up was 22.3 months. Local recurrence and survival risk factors were similar to cSCC outside the ear. The Akaike's Information Criterion (AIC) estimates showed that the BWH system better predicted outcomes than the AJCC seventh, and the AJCC eighth, with AIC values of 189.9, 270.5, and 274.1, respectively. Limitations of the study include retrospective design, single center study, and no control group.CONCLUSIONCurrent staging systems perform well at stratifying risk in ear cSCC.
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    The Role of Color and Morphologic Characteristics in Dermoscopic Diagnosis
    (2016) Bajaj, Shirin; Marchetti, Michael A.; Navarrete Dechent, Cristián Patricio; Dusza, Stephen W.; Kose, Kivanc; Marghoob, Ashfaq A.
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    The role of ultraviolet-induced fluorescence dermatoscopy for the detection of multiple aggregated yellow-white globules in basal cell carcinoma
    (American Academy of Dermatology, Inc., 2024) Navarrete Dechent, Cristian Patricio; Pietkiewicz, Pawel; Astronave, Gisel; Marghoob, Nadeem G.; Dusza, Stephen W.; Lorenzoni Gaete, María Josefina; Boleira, Manuela; Cristopher, Michael; Valdivia Agüero, Rosario del Pilar; Bustos, Sergio; Jaimes, Natalia; Kurpis, María; Hidalgo Acuña, Leonel Esteban; Abarzúa Araya, Alvaro Rodrigo; Zoroquiain Velez, José Pablo; Uribe González, Pablo Francisco; Cárdenas de la Torre, Consuelo Paz; Droppelmann Droppelmann Katherine Ann; Marghoob, Ashfaq A.
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    Ultraviolet-induced fluorescent dermoscopy for biopsy site identification prior to dermatologic surgery: a retrospective study
    (2023) Navarrete-Dechent, Cristián; Pietkiewicz, Pawel; Dusza, Stephen W.; Andreani, Sebastian; Nehal, Kishwer S.; Rossi, Anthony M.; Córdova, Miguel; H. Lee, Erica; Chih-Shan J. Chen; Abarzúa Araya, Álvaro Rodrigo; Uribe González, Pablo Francisco; Castro, Juan C.; Droppelmann, Katherine; Cárdenas de la Torre, Consuelo; Marghoob, Ashfaq A.