Browsing by Author "Navarrete-Dechent, C."

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    Dermoscopy of porokeratosis: results from a multicentre study of the International Dermoscopy Society
    (2021) Zaar, O.; Polesie, S.; Navarrete-Dechent, C.; Errichetti, E.; Akay, B. N.; Jaimes, J.; Cabo, H.; Sabban, E. Cohen; Paoli, J.
    Background The diagnosis of porokeratosis can be challenging, and knowledge about its dermoscopic features is limited. Objectives To describe the dermoscopic features of porokeratosis of Mibelli and disseminated superficial actinic porokeratosis (DSAP) and the frequency of these features in a larger case series. The interobserver concordance was also assessed. Methods In this retrospective cohort study, members of the International Dermoscopy Society contributed macroscopic and dermoscopic images of histopathologically verified cases of porokeratosis of Mibelli or DSAP. Three observers independently reviewed the collected images to identify the presence of predefined dermoscopic features. Following this, a consensus meeting was held to agree upon which dermoscopic features were present in each lesion. Results In total, 78 clinical and dermoscopic images of porokeratoses were collected. The most common dermoscopic feature was keratin rim, which was present in 74 lesions (92.3%). The most common vascular structures were dotted or glomerular vessels which were present in almost half of the cases (48.7%). Other relatively frequent dermoscopic findings were as follows: non-peripheral scales (44.9%), grey-brown dots or pigmentation along the keratin rim (38.5%), and light-brown pigmentation within the keratin rim (33.3%). Shiny white structures and blood spots or erosions along the keratin rim were findings never before described in porokeratosis and were detected in 16.7% and 17.9% of the lesions, respectively. Dermoscopic findings in porokeratosis of Mibelli and DSAP were similar except for fewer blood spots or erosions along the keratin rim and more light-brown pigmentation within the keratin rim in DSAP. The interobserver concordance ranged from 0.44 (moderate) to 0.84 (almost perfect). Conclusions The dermoscopic hallmark of porokeratosis is the keratin rim, a finding also allowing for almost perfect interobserver agreement. Pigmentation or erosions along the keratin rim, vascular structures, as well as scales, pigmentation or shiny white structures within the keratin rim are additional dermoscopic clues.
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    Human surface anatomy terminology for dermatology: a Delphi consensus from the International Skin Imaging Collaboration
    (2020) Navarrete-Dechent, C.; Liopyris, K.; Molenda, M. A.; Braun, R.; Curiel-Lewandrowski, C.; Dusza, S. W.; Guitera, P.; Hofmann-Wellenhof, R.; Kittler, H.; Lallas, A.; Malvehy, J.; Marchetti, M. A.; Oliviero, M.; Pellacani, G.; Puig, S.; Soyer, H. P.; Tejasvi, T.; Thomas, L.; Tschandl, P.; Scope, A.; Marghoob, A. A.; Halpern, A. C.
    Background There is no internationally vetted set of anatomic terms to describe human surface anatomy. Objective To establish expert consensus on a standardized set of terms that describe clinically relevant human surface anatomy. Methods We conducted a Delphi consensus on surface anatomy terminology between July 2017 and July 2019. The initial survey included 385 anatomic terms, organized in seven levels of hierarchy. If agreement exceeded the 75% established threshold, the term was considered 'accepted' and included in the final list. Terms added by the participants were passed on to the next round of consensus. Terms with <75% agreement were included in subsequent surveys along with alternative terms proposed by participants until agreement was reached on all terms. Results The Delphi included 21 participants. We found consensus (>= 75% agreement) on 361/385 (93.8%) terms and eliminated one term in the first round. Of 49 new terms suggested by participants, 45 were added via consensus. To adjust for a recently published International Classification of Diseases-Surface Topography list of terms, a third survey including 111 discrepant terms was sent to participants. Finally, a total of 513 terms reached agreement via the Delphi method. Conclusions We have established a set of 513 clinically relevant terms for denoting human surface anatomy, towards the use of standardized terminology in dermatologic documentation.
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    Incompletely excised lentigo maligna melanoma is associated with unpredictable residual disease: clinical features and the emerging role of reflectance confocal microscopy
    (2020) Navarrete-Dechent, C.; Aleissa, S.; Cordova, M.; Liopyris, K.; Lee, E. H.; Rossi, A. M.; Hollman, T.; Pulitzer, M.; Lezcano, C.; Busam, K. J.; Marghoob, A. A.; Chen, C-C J.; Nehal, K. S.
    Background Lentigo maligna/lentigo maligna melanoma (LM/LMM) poses a treatment and surgical challenge given unpredictable subclinical extension resulting in incomplete excision. Objectives To describe the demographic, clinical and pathologic characteristics of incompletely excisedLM/LMM. To evaluate the potential role of reflectance confocal microscopy (RCM). Patients and methods A retrospective review of a melanoma database at a tertiary cancer centre for patients referred with 'incompletely excisedLM/LMM' or 'incompletely excised melanoma' between October 2006 and July 2017. We recorded clinical and pathological data and surgical margins needed to clear the residualLM/LMM. The second part consisted of a prospective cohort of patients in whichRCMwas performed when presenting with incompletely excisedLM/LMM. Results We included a total of 67 patients (retrospective + prospective cohort); mean age was 64.9 (standard deviation: 11.3) years and 52.2% were males. For the retrospective cohort (n = 53), the mean scar size was 3.4 cm. The average initial margins excised prior to presentation were 4.8 mm (range 3-7 mm). The average additional margin needed to clear the residual, incompletely excisedLM/LMMwas 7.8 mm. For the prospective cohort (n = 14), there were no differences in age, gender or size when compared to the retrospective cohort.RCMhad a diagnostic accuracy of 78.6%, a sensitivity of 90.9%, a specificity of 33.3% and a positive predictive value of 83.3% for the detection of incompletely excisedLM/LMM. Conclusions Incompletely excisedLM/LMMis a poorly characterized clinical-pathological scenario that may require considerable extra margins for microscopic clearance.RCMmay emerge as a valuable tool for the evaluation of patients with incompletely excisedLM/LMM.
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    Keloids and silicone therapy. Summary of the available evidence
    (2012) Hasson N., Ariel; Navarrete-Dechent, C.; Montoya, J.
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    Oral propranolol for treating infantile hemangiomas: a case series of 57 patients
    (2012) Zegpi Trueba, María Soledad; Abarzúa, Alvaro; Silva-Valenzuela, S.; Navarrete-Dechent, C.; Uribe-Gonzalez, P.; Nicklas-Diaz, C.
    Abstract Introduction and objectives Infantile hemangiomas (IH) are a frequent vascular tumor. In recent years, propranolol has emerged as an alternative in the treatment of IH. The objective of the present study was to evaluate the effectiveness of propranolol for the treatment of IH. Materials and methods Patients with IH requiring treatment were included. Cardiologic evaluation was made to every patient and electrocardiogram (ECG) and echocardiogram were done. Oral propranolol was started in an ambulatory way at a dose of 2 mg/kg daily divided in two doses. At ten days all the patients were evaluated with a 24-h rhythm holter. Evaluation of effectiveness: In clinical controls and by images IH were formally analyzed, without blindness. Response was categorized as complete response (CR), partial response (PR) and no response (NR). Adverse events: Adverse events were registered in a special category of the formulary. Results 57 patients were included. Mean age was 9.7 months. There were 80.8% females. Mean duration of treatment was 7.3 months (1–24 months). Efficacy: 50.6% had CR, 49.3% had PR. There were a 7% of adverse events. No differences in response rate exist according to age or location. No rhythm holter was altered at ten-day control. Conclusion Our study highlights the possibility of starting propranolol in an ambulatory way, establishes a dose of 2 mg/kg/day and confirms the security profile of the drug. We consider propranolol as a first line treatment for IH.
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    Performance of a deep neural network in teledermatology: a single-centre prospective diagnostic study
    (2021) Munoz-Lopez, C.; Ramirez-Cornejo, C.; Marchetti, M. A.; Han, S. S.; Del Barrio-Diaz, P.; Jaque, A.; Uribe, P.; Majerson, D.; Curi, M.; Del Puerto, C.; Reyes-Baraona, F.; Meza-Romero, R.; Parra-Cares, J.; Araneda-Ortega, P.; Guzman, M.; Millan-Apablaza, R.; Nunez-Mora, M.; Liopyris, K.; Vera-Kellet, C.; Navarrete-Dechent, C.
    Background The use of artificial intelligence (AI) algorithms for the diagnosis of skin diseases has shown promise in experimental settings but has not been yet tested in real-life conditions.
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    Reflectance Confocal Microscopy Terminology in Spanish: A Delphi Consensus Study
    (2024) Abarzua-Araya, A.; Banuls, J.; Cabo, H.; Carrera, C.; Gamo, R.; Gonzalez, S.; Jaimes, N.; Navarrete-Dechent, C.; Anker, J. Perez; Roldan-Marin, R.; Segura, S.; Yelamos, O.; Puig, S.; Malvehy, J.
    The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists. (c) 2024 Published by Elsevier Espan a, S.L.U. on behalf of AEDV. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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    Variation in dermoscopic features of basal cell carcinoma as a function of anatomical location and pigmentation status
    (2018) Wolner, Z. J.; Bajaj, S.; Flores, E.; Carrera, C.; Navarrete-Dechent, C.; Dusza, S. W.; Rabinovitz, H. S.; Marchetti, M. A.; Marghoob, A. A.