Browsing by Author "Marghoob, Ashfaq"

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    Acral persistent papular mucinosis (APPM): Dermoscopy of an uncommon disease
    (2017) Navarrete Dechent, Cristián Patricio; Bajaj, Shirin; Marghoob, Ashfaq; González Bombardiere, Sergio; Jaque Silva, Ana Alejandra
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    Dermoscopy of linear basal cell carcinomas, a potential mimicker of linear lesions: a descriptive case series
    (2022) Navarrete-Dechent, Cristián; Marchetti, Michael; Uribe González, Pablo Francisco; Schwartz, Rodrigo; Liopyris, Konstantinos; Marghoob, Nadeem; Galimany Navajas, Lucas Fernando; Castro, Juan; Jaimes, Natalia; Rabinovitz, Harold; Moraes, Ana; Marghoob, Ashfaq; Abarzúa-Araya, Alvaro
    Introduction: Among the various widely recognized basal cell carcinoma (BCC) clinical patterns, linear basal cell carcinoma (LBCC) is an uncommon morphologic variant of BCC. Objectives: Describe the clinical and dermoscopic characteristics of LBCC. Methods: Retrospective study including LBCC cases from 5 dermatology centers in North and South America. Biopsy-proven primary BCCs, that presented with at least 3:1 length:width ratio on physical examination, irrespective of tumor subtype or location, were included. Clinical and dermoscopic analysis were performed by 2 experts in dermoscopy. Results: Eighteen cases of LBCC met our inclusion criteria and were included in the study. Median age at diagnosis was 86.0 years, 10 patients (58.8%) were males. Regarding anatomic location, 11/18.
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    Importance of Both Clinical and Dermoscopic Findings in Predicting High-Risk Histopathological Subtype in Facial Basal Cell Carcinomas
    (2024) Ceder, Hannah; Backman, Eva; Marghoob, Ashfaq; Navarrete-Dechent, Cristian; Polesie, Sam; Reiter, Ofer; Paoli, John
    Introduction: Being able to recognize high-risk facial basal cell carcinoma (BCC) may lead to fewer incomplete excisions and inappropriate treatments. Objectives: We sought to investigate clinical and dermoscopic criteria for predicting facial BCC subtypes, analyze the interobserver agreement between readers, and develop a diagnostic algorithm to predict high-risk histopathological subtype. Methods: In this single-center, retrospective investigation, 6 independent readers evaluated predefined clinical and dermoscopic criteria in images of histopathologically verified primary facial BCCs including: topography, border demarcation, vessels, ulceration, white porcelain areas, shiny white blotches and strands, and pigmented structures and vessels within ulceration. Results: Overall, 297 clinical and dermoscopic image pairs were analyzed. The strongest associations with high-risk subtype were: "bumpy" topography (OR 3.8, 95% CI, 3.1-4.7), ill-defined borders (OR 3.4, 95% CI 3.1-4.7), white porcelain area (OR 3.5, 95% CI 2.8-4.5), and vessels within ulceration (OR 3.1, 95% CI 2.4-4.1). Predominantly focused vessels were a positive diagnostic criterium for either nodular (OR 1.7, 95% CI 1.3-2.2) or high-risk (OR 2.0, 95% CI 1.6-2.5) subtypes and a strong negative diagnostic criterium for superficial BCC (OR 14.0, 95% CI 9.6-20.8). Interobserver agreement ranged from fair to substantial (kappa = 0.36 to 0.72). A diagnostic algorithm based on these findings demonstrated a sensitivity of 81.4% (95% CI, 78.9-83.7%) and a specificity of 53.3% (95% CI, 49.7-56.9%) for predicting high-risk BCC subtype. Conclusions: Integration of both clinical and dermoscopic features (including novel features such as topography and vessels within ulceration) are essential to improve subtype prediction of facial BCCs and management decisions.
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    In vivo optical imaging-guided targeted sampling for precise diagnosis and molecular pathology
    (2021) Sahu, Aditi; Oh, Yuna; Peterson, Gary; Cordova, Miguel; Navarrete-Dechent, Cristian; Gill, Melissa; Alessi-Fox, Christi; Gonzalez, Salvador; Phillips, William; Wilson, Steven; Afzalneia, Reza; Rose, Raven; Mohsere, Abu-Akeel; Bello, Danielle; Marghoob, Ashfaq; Rossi, Anthony; Wolchok, Jedd D.; Merghoub, Taha; Rotemberg, Veronica; Chen, Chih-Shan Jason; Rajadhyaksha, Milind
    Conventional tissue sampling can lead to misdiagnoses and repeated biopsies. Additionally, tissue processed for histopathology suffers from poor nucleic acid quality and/or quantity for downstream molecular profiling. Targeted micro-sampling of tissue can ensure accurate diagnosis and molecular profiling in the presence of spatial heterogeneity, especially in tumors, and facilitate acquisition of fresh tissue for molecular analysis. In this study, we explored the feasibility of performing 1-2 mm precision biopsies guided by high-resolution reflectance confocal microscopy (RCM) and optical coherence tomography (OCT), and reflective metallic grids for accurate spatial targeting. Accurate sampling was confirmed with either histopathology or molecular profiling through next generation sequencing (NGS) in 9 skin cancers in 7 patients. Imaging-guided 1-2 mm biopsies enabled spatial targeting for in vivo diagnosis, feature correlation and depth assessment, which were confirmed with histopathology. In vivo 1-mm targeted biopsies achieved adequate quantity and high quality of DNA for next-generation sequencing. Subsequent mutational profiling was confirmed on 1 melanoma in situ and 2 invasive melanomas, using a 505-gene mutational panel called Memorial Sloan Kettering-Integrated mutational profiling of actionable cancer targets (MSK-IMPACT). Differential mutational landscapes, in terms of number and types of mutations, were found between invasive and in situ melanomas in a single patient. Our findings demonstrate feasibility of accurate sampling of regions of interest for downstream histopathological diagnoses and molecular pathology in both in vivo and ex vivo settings with broad diagnostic, therapeutic and research potential in cutaneous diseases accessible by RCM-OCT imaging.
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    In vivo tumor immune microenvironment phenotypes correlate with inflammation and vasculature to predict immunotherapy response
    (2022) Sahu, Aditi; Kose, Kivanc; Kraehenbuehl, Lukas; Byers, Candice; Holland, Aliya; Tembo, Teguru; Santella, Anthony; Alfonso, Anabel; Li, Madison; Cordova, Miguel; Gill, Melissa; Fox, Christi; Gonzalez, Salvador; Kumar, Piyush; Wang, Amber Weiching; Kurtansky, Nicholas; Chandrani, Pratik; Yin, Shen; Mehta, Paras; Navarrete-Dechent, Cristian; Peterson, Gary; King, Kimeil; Dusza, Stephen; Yang, Ning; Liu, Shuaitong; Phillips, William; Guitera, Pascale; Rossi, Anthony; Halpern, Allan; Deng, Liang; Pulitzer, Melissa; Marghoob, Ashfaq; Chen, Chih-Shan Jason; Merghoub, Taha; Rajadhyaksha, Milind
    Response to immunotherapies can be variable and unpredictable. Pathology-based phenotyping of tumors into 'hot' and 'cold' is static, relying solely on T-cell infiltration in single-time single-site biopsies, resulting in suboptimal treatment response prediction. Dynamic vascular events (tumor angiogenesis, leukocyte trafficking) within tumor immune microenvironment (TiME) also influence anti-tumor immunity and treatment response. Here, we report dynamic cellular-level TiME phenotyping in vivo that combines inflammation profiles with vascular features through non-invasive reflectance confocal microscopic imaging. In skin cancer patients, we demonstrate three main TiME phenotypes that correlate with gene and protein expression, and response to toll-like receptor agonist immune-therapy. Notably, phenotypes with high inflammation associate with immunostimulatory signatures and those with high vasculature with angiogenic and endothelial anergy signatures. Moreover, phenotypes with high inflammation and low vasculature demonstrate the best treatment response. This non-invasive in vivo phenotyping approach integrating dynamic vasculature with inflammation serves as a reliable predictor of response to topical immune-therapy in patients.
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    Ink-enhanced dermoscopy is a useful tool to differentiate acquired solitary plaque porokeratosis from other scaly lesions
    (2017) Navarrete Dechent, Cristián Patricio; Uribe González, Pablo Francisco; Marghoob, Ashfaq