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Quest’anno Agorà, con l’obiettivo della ricerca di un costante miglioramento e progresso scientifico, ha voluto approfondire la bibliografia di riferimento per le tematiche delle Sessioni Coordinate e metterle disposizione dei partecipanti alla Sessione in Sede Congressuale.

In questa pagina troverete a disposizione gli abstract degli articoli che Agorà ha selezionato come bibliografia di riferimento per la sessione coordinata "DERMOSCOPIA PER MEDICI DI MEDICINA ESTETICA E LASER-CHIRURGIA AD INDIRIZZO ESTETICO". I Soci Agorà avranno inoltre la possibilità di scaricare gli articoli originali in versione integrale.



International Journal of Trichology

2022 June; 14(3):112-114

PMID: 35755962

PMCID: PMC9231530

Lichen planopilaris arising between two linear surgical scars

Hiroko Sawada, Yukiyasu Arakawa, Norito Katoh, Jun Asai

ABSTRACT: Lichen planopilaris (LPP) is a type of lymphocytic cicatricial alopecia, which can occur at unusual sites. It can be difficult to diagnose at an early stage and may be misdiagnosed as seborrheic dermatitis or psoriasis in early stages before alopecia occurs. We report a rare case in which alopecia occurred between two long surgical scars on the scalp several years after surgery. Dermoscopy and biopsy led to a diagnosis of LPP. The localization of the lesions in our case suggests that oxidative stress from the failure of lymph flow might have induced LPP. Oral roxithromycin, a macrolide antibiotic, with anti-oxidative and anti-inflammatory was effective at stopping its progression.

BMJ Case Reports

2022 June; 15(6):e251200

PMID: 35750429

PMCID: PMC9234806

Dermoscopy in the diagnosis and assessment of treatment response in granulomatous cheilitis

Keshavmurthy A. Adya, Arun Inamadar


2022 June; 14(12):2836

PMID: 35740502

PMCID: PMC9221328

Non-melanoma skin cancer clearance after medical treatment detected with noninvasive skin imaging: a systematic review and meta-analysis

Stefania Guida, Antonio Alma, Kaleci Shaniko, Johanna Chester, Silvana Ciardo, Ilaria Proietti, Roberta Giuffrida, Iris Zalaudek, Marco Manfredini, Caterina Longo, Francesca Farnetani, Giovanni Pellacani

BACKGROUND/OBJECTIVES: Non-melanoma skin cancer (NMSC) treated with nonsurgical therapies can be monitored with noninvasive skin imaging. The precision of dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in detecting clearance is unclear. We aim to report the proportion of persisting tumors identified with noninvasive technologies available in the literature.

METHODS: A systematic literature search was conducted on the PubMed and Cochrane Public Library Databases for articles published prior to November 2021. Statistical analyses were conducted with MedCalc 14.8.1 software.

RESULTS: A total of eight studies (352 lesions) reporting noninvasive imaging for NMSC clearance following nonsurgical treatment were included. Most (n = 7) reported basal cell carcinoma (BCC), and one study reported squamous cell carcinoma (SCC) clearance. A meta-analysis of the BCC clearance revealed that the summary effect for RCM was higher, as compared to the other techniques. Interestingly, the sensitivity and specificity for OCT were 86.4% (95% CI: 65.1-97.1) and 100% (95% CI: 94.8-100.0), respectively, whilst, for RCM, they reached 100% (95%CI: 86.8-100) and 72.5% (95% CI: 64.4-79.7), respectively.

CONCLUSIONS: Routine clinical examination and dermoscopy underperform when employed for NMSC clearance monitoring, although they represent the first approach to the patient. OCT and RCM seem to improve the detection of persistent BCC after medical treatment.

Journal of General Internal Medicine

2022 July; 37(9):2267-2279

PMID: 35710666

PMCID: PMC9202989

Skin cancer education interventions for primary care providers: a scoping review

Ashley E. Brown, Maleka, Najmi, Taylor Duke, Daniel A. Grabell, Misha V. Koshelev, Kelly C. Nelson

ABSTRACT: Primary care physicians (PCPs) are often the first line of defense against skin cancers. Despite this, many PCPs do not receive a comprehensive training in skin conditions. Educational interventions aimed at skin cancer screening instruction for PCPs offer an opportunity to detect skin cancer at earlier stages and subsequent improved morbidity and mortality. A scoping review was conducted to collect data about previously reported skin cancer screening interventions for PCPs. A structured literature search found 51 studies describing 37 unique educational interventions. Curriculum elements utilized by the interventions were divided into categories that would facilitate comparison including curriculum components, delivery format, delivery timing, and outcome measures. The interventions varied widely in design, including literature-based interventions, live teaching sessions, and online courses with durations ranging from 5 min to 24 months. While several interventions demonstrated improvements in skin cancer knowledge and competency by written exams, only a few revealed positive clinical practice changes by biopsy review or referral analysis. Examining successful interventions could aid in developing a skin cancer detection curriculum for PCPs that can produce positive clinical practice and population-based changes in the management of skin cancer.

Journal of Biomedical Optics

2022 June; 27(6):66002

PMID: 35701871

PMCID: PMC9196925

Discrimination of cancerous from benign pigmented skin lesions based on multispectral autofluorescence lifetime imaging dermoscopy and machine learning

Priyanka Vasanthakumari, Renan A. Romano, Ramon G. T. Rosa, Ana G. Salvio, Vladislav Yakovlev, Cristina Kurachi, Jason M. Hirshburg, Javier A. Jo

SIGNIFICANCE: Accurate early diagnosis of malignant skin lesions is critical in providing adequate and timely treatment; unfortunately, initial clinical evaluation of similar-looking benign and malignant skin lesions can result in missed diagnosis of malignant lesions and unnecessary biopsy of benign ones.

AIM: To develop and validate a label-free and objective image-guided strategy for the clinical evaluation of suspicious pigmented skin lesions based on multispectral autofluorescence lifetime imaging (maFLIM) dermoscopy.

APPROACH: We tested the hypothesis that maFLIM-derived autofluorescence global features can be used in machine-learning (ML) models to discriminate malignant from benign pigmented skin lesions. Clinical widefield maFLIM dermoscopy imaging of 41 benign and 19 malignant pigmented skin lesions from 30 patients were acquired prior to tissue biopsy sampling. Three different pools of global image-level maFLIM features were extracted: multispectral intensity, time-domain biexponential, and frequency-domain phasor features. The classification potential of each feature pool to discriminate benign versus malignant pigmented skin lesions was evaluated by training quadratic discriminant analysis (QDA) classification models and applying a leave-one-patient-out cross-validation strategy.

RESULTS: Classification performance estimates obtained after unbiased feature selection were as follows: 68% sensitivity and 80% specificity with the phasor feature pool, 84% sensitivity, and 71% specificity with the biexponential feature pool, and 84% sensitivity and 32% specificity with the intensity feature pool. Ensemble combinations of QDA models trained with phasor and biexponential features yielded sensitivity of 84% and specificity of 90%, outperforming all other models considered.

CONCLUSIONS: Simple classification ML models based on time-resolved (biexponential and phasor) autofluorescence global features extracted from maFLIM dermoscopy images have the potential to provide objective discrimination of malignant from benign pigmented lesions. ML-assisted maFLIM dermoscopy could potentially assist with the clinical evaluation of suspicious lesions and the identification of those patients benefiting the most from biopsy examination.

International Journal of Trichology

2021 December; 13(6):9-16

PMID: 34934295

PMCID: PMC8647712

A clinico-trichological study of female androgenetic alopecia

Isha Verma, Bhushan Madke, Adarsh lata Singh, Sanjiv Choudhary

BACKGROUND: Female Androgenetic Alopecia (FAGA) is one of the most common cause of diffuse scalp hair loss in women. FAGA is insidious in onset, gradually progressive, non scarring alopecia. Trichoscopy is a newly developed non invasive, objective, bed side analytical method of hair imaging based on video dermoscopy of scalp. The objective of this study is to study the clinical features of female androgenetic alopecia, to study the trichoscopic features in patients of female androgenetic alopecia and to correlate the trichoscopic features according to clinical grade of female androgenetic alopecia.

METHODS: Study enrolled 50 females with FAGA and 50 normal females. FAGA cases were divided into subgroups according to sinclair scale. Laboratory investigations including hemoglobin level, triiodothyronine (T3), thyroxine (T4) thyroid stimulating hormone (TSH) and serum ferritin level were carried out in both cases and controls. After clinical diagnosis, trichoscopic examination was done and categorised using Diagnostic Criteria set by Rakowska A. et al and trichoscopic findings were coorelated with clinical grades.

RESULTS: >4 yellow dots in frontal area , >2:1 ratio of single hair units (frontal: occiput) & >3:1 ratio of hair with perifollicular discoloration (frontal: occiput) are mainly seen in late stages of FAGA i.e. grade 4 & 5 and >1.5:1 ratio of vellus hairs (frontal :occiput) in early stages i.e. grade 2 & 3 while lower mean hair thickness in frontal area & > 10% thin hairs in frontal area are seen in all stages of FAGA Conclusion: Trichoscopy not only confirms the diagnosis by assessing the trichoscopic features of FAGA but also coorelates them with clinical severity. And as the age increases, grade of clinical severity increases. Not necessarily hemoglobin, thyroid and serum ferritin levels will be dearranged in FAGA cases.

LIMITATION: The study is done on few number of patients. Further studies needs to be done to validate results.

International Journal of Trichology

2020 June; 12(3):126-128

PMID: 33223739

PMCID: PMC7659735

Transient treatment response of platelet-rich plasma injection for temporal triangular alopecia: a case report with dermoscopic examination follow-up

Suparuj Lueangarun, Sarun Pacharapakornpong, Therdpong Tempark

ABSTRACT: Temporal triangular alopecia (TTA) is congenital anomalies that usually develops in childhood, with rarely acquired cases in adults. TTA shares common clinical, dermoscopic, and histologic features of characterized vellus hair formation change, similar to androgenetic alopecia (AGA). Whereas, platelet-rich plasma (PRP) with multiple growth factors can provide treatment efficacy in AGA. Due to limited treatment for TTA, such as topical minoxidil, complete surgical excision, and hair transplantation, the multiple growth factors in PRP is thus postulated to be also effective for TTA treatment, just as in AGA. We present a case of TTA with unsatisfactory treatment outcome of only increased number and thickness of vellus hair by dermoscopic examination follow-up after the 5-session PRP injection and only transient response for 6 months. Unlike, AGA, the PRP injection might not consequently be a suitable treatment option for TTA. Nonetheless, further studies should be performed to investigate the potential treatment modality for TTA.

International Journal of Trichology

2020 June; 12(3):107-113

PMID: 33223734

PMCID: PMC7659740

Utility of dermoscopic evaluation in predicting clinical response to diphencyprone in a cohort of patients with alopecia areata

Robabeh Abedini, Elham Alipour, Narges Ghandi, Maryam Nasimi

BACKGROUND: Alopecia areata (AA) is a chronic and inflammatory disease of hair follicles, causing nonscarring alopecia. While the various types of treatment have been investigated, the definite cure for AA has not been established yet.

OBJECTIVES: The objective of this study is to evaluate the clinical and dermoscopic features of patients with AA to identify the factors with prognostic values in diphenylcyclopropenone (DPCP) response rate.

METHODS: Eighty patients with AA were included, and baseline hair loss was calculated based on the severity alopecia tool (SALT) score. The characteristic dermoscopic features of AA were evaluated by two skilled dermatologists separately at baseline, 12 and 24 weeks afterward.

RESULTS: The mean SALT score in the 1st, 12th, and 24th week was 77 ± 24.7, 80 ± 27, and 71 ± 35.6, respectively, which were not significantly different over this time period (P = 0.085). SALT score correlated negatively with the short vellus hair/field (ρ = -0.361, P = 0.02), broken hair/field (ρ = -0.317, P = 0.044), and tapering hair/field (ρ = -0.388, P = 0.012) in the 1st week. Forty-one patients continued treatment courses over 24 weeks. Six patients had good response, 11 achieved partial response, and 24 had no hair regrowth. Statistically significant correlation was observed between treatment response and duration of disease (P = 0.04), frequency of relapses (P = 0.033), type of alopecia, and number of black dots (P = 0.028). The mean for all dermoscopic findings showed descending process during our three follow-up sessions which was statistically significant for black dot (P = 0.015) and broken hair (P = 0.006).

CONCLUSION: The number of black dot per field initially was negatively correlated to DPCP therapy and the frequency of dermoscopic findings reduced during the treatment process.

Clinical, Cosmetic and Investigational Dermatology

2021 October; 14:1459-1464

PMID: 34675582

PMCID: PMC8520414

755 nm alexandrite picosecond laser with a diffractive lens array or zoom handpiece for post-inflammatory hyperpigmentation: two case reports with a three-year follow-up

Rongxin Ren, Shiwei Bao, Wenjiang Qian, Hongyi Zhao

OBJECTIVE: Post-inflammatory hyperpigmentation (PIH) is a reactive hypermelanosis of various skin types, which occurs as a sequela of cutaneous inflammation or injury. Despite generally a self-limited and temporary condition, PIH is still a frustrating problem that can have significant psychosocial effects on patients, especially those with darker skin types. Laser therapy is one of the effective treatments for PIH, and various wavelength lasers and light devices have been utilized in PIH therapy. Nonetheless, data on the long-term efficacy of the 755-nm alexandrite picosecond laser are limited.

METHODS: This study analyzed two cases of PIH treated with a combination of a 755-nm alexandrite picosecond laser and a diffractive lens array or zoom handpiece. Efficacy of the treatment was determined by the images of skin lesions under a fixed light source before and after each treatment, which were independently reviewed by two plastic-surgery specialists blinded to the clinical data. Improvement was classified as complete (>75%), significant (50-75%), mild (25-50%), and inefficient (<25% or no obvious change). Skin imaging analysis was carried out using the VISIA system (Canfield, USA), and dermoscopy was performed at the same time.

RESULTS: After two to three courses of treatment, all cases showed significant or complete improvement, and no recurrence was observed during the three years of follow-up.

CONCLUSION: A 755-nm alexandrite picosecond laser in combination with a diffractive lens array or zoom handpiece had significant and long-term efficacy for the treatment of PIH caused by trauma. However, attention should be paid to the problem of transient deepening of pigmentation during treatment.

Indian Journal of Dermatology, Venereology and Leprology

2021 December; 87(6):856-858

PMID: 34491684

Treatment of pyogenic granuloma in children with copper vapor laser radiation (578 nm)

Igor V. Ponomarev, Sergey B. Topchiy, Yury N. Andrusenko, Lyudmila D. Shakina



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