Medicine › Oncology

Cutaneous Melanoma Detection and Management

Works Count: 77096

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Description

This cluster of papers focuses on the diagnosis, treatment, and epidemiology of melanoma, a type of skin cancer. It covers topics such as dermatologist-level classification, genetic alterations, sentinel lymph node biopsy, immunotherapy, tumor staging, deep learning for melanoma recognition, and survival analysis. The papers also discuss the epidemiological trends and risk factors associated with melanoma.

Keywords

Melanoma; Dermoscopy; Skin Cancer; Sentinel Lymph Node Biopsy; Genetic Alterations; Immunotherapy; Tumor Staging; Deep Learning; Survival Analysis; Epidemiology

The National Cancer Data Base report on cutaneous and noncutaneous melanoma

1998-10-15

Alfred E. Chang , Lucy Hynds Karnell , Herman R. Menck

BACKGROUND This study reviews the case-mix characteristics, management, and outcomes of melanoma cases occuring in the U. S. within the last decade. METHODS Analyses of the National Cancer Data Base … BACKGROUND This study reviews the case-mix characteristics, management, and outcomes of melanoma cases occuring in the U. S. within the last decade. METHODS Analyses of the National Cancer Data Base (NCDB) were performed on cases diagnosed between 1985 through 1994. A total of 84,836 cases comprised of cutaneous and noncutaneous melanomas were evaluated. RESULTS The percentages of melanomas that were cutaneous, ocular, mucosal, and unknown primaries were 91.2%, 5.2%, 1.3%, and 2.2%, respectively. For cutaneous melanomas, the proportion of patients presenting with American Joint Committee on Cancer Stages 0, I, II, III, and IV were 14.9%, 47.7%, 23.1%, 8.9%, and 5.3%, respectively. Factors associated with decreased survival included more advanced stage at diagnosis, nodular or acral lentiginous histology, increased age, male gender, nonwhite race, and lower income. Multivariate analysis identified stage, histology, gender, age, and income as independent prognostic factors. For ocular melanomas, 85.0% were uveal, 4.8% were conjunctival, and 10.2% occurred at other sites. During the study period, there was a large increase in the proportion of ocular melanoma patients treated with radiation therapy alone. For mucosal melanomas, the distribution of head and neck, female genital tract, anal/rectal, and urinary tract sites was 55.4%, 18.0%, 23.8%, and 2.8%, respectively. Patients with lymph node involvement had a poor prognosis. For unknown primary melanomas, the distribution of metastases as localized to a region or multiple sites at presentation was 43.0% and 57.0%, respectively. Surgical treatment of patients with unknown primary site of the melanoma resulted in better survival compared with no treatment. CONCLUSIONS Treatment of early stage cutaneous melanoma resulted in excellent patient outcomes. In addition to conventional prognostic factors, socioeconomic factors were found to be associated with survival. Cancer 1998;83:1664-1678. © 1998 American Cancer Society.

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Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684.

1996-01-01

J M Kirkwood , M H Strawderman , Marc S. Ernstoff +3 more

PURPOSE Interferon alfa-2b (IFN alpha-2b) exhibits antitumor activity in metastatic melanoma and on this basis has been evaluated as an adjuvant therapy following surgery for deep primary (T4) or regionally … PURPOSE Interferon alfa-2b (IFN alpha-2b) exhibits antitumor activity in metastatic melanoma and on this basis has been evaluated as an adjuvant therapy following surgery for deep primary (T4) or regionally metastatic (N1) melanoma. METHODS A randomized controlled study of IFN alpha-2b (Schering-Plough, Kenilworth, NJ) administered at maximum-tolerated doses of 20 MU/m2/d intravenously (i.v.) for 1 month and 10 MU/m2 three times per week subcutaneously (SC) for 48 weeks versus observation, was conducted by the Eastern Cooperative Oncology Group (ECOG) in 287 patients. RESULTS A significant prolongation of relapse-free survival (P = .0023, one-sided) and prolongation of overall survival (P = .0237, one-sided) was observed with IFN alpha-2b therapy in this trial, which is now mature with a median follow-up time of 6.9 years. The impact of treatment on relapse rate is most pronounced early during the treatment interval. The overall benefit of treatment in this trial was analyzed stratified by tumor burden and the presence or absence of microscopic nonpalpable and palpable regional lymph node metastasis. The benefit of therapy with IFN alpha-2b was greatest among node-positive strata. Toxicity of IFN alpha-2b required dose modification in the majority of patients, but treatment at > or = 80% of the scheduled dose was feasible in the majority of patients through the IV phase of treatment, and for more than 3 months of SC maintenance therapy. Discontinuation of treatment due to toxicity was infrequent after the fourth month of therapy. CONCLUSION IFN alpha-2b prolongs the relapse-free interval and overall survival of high-risk resected melanoma patients. The increment in median disease-free survival (from 1 to 1.7 years) and overall survival (from 2.8 to 3.8 years) that results from this therapy is associated with a 42% improvement in the fraction of patients who are continuously disease-free after treatment with IFN (from 26% to 37%) in comparison to observation. IFN alpha-2b is the first agent to show a significant benefit in relapse-free and overall survival of high-risk melanoma patients in a randomized controlled trial.

High- and Low-Dose Interferon Alfa-2b in High-Risk Melanoma: First Analysis of Intergroup Trial E1690/S9111/C9190

2000-06-12

John M. Kirkwood , Joseph G. Ibrahim , Vernon K. Sondak +7 more

PURPOSE: Pivotal trial E1684 of adjuvant high-dose interferon alfa-2b (IFNα2b) therapy in high-risk melanoma patients demonstrated a significant relapse-free and overall survival (RFS and OS) benefit compared with observation (Obs). … PURPOSE: Pivotal trial E1684 of adjuvant high-dose interferon alfa-2b (IFNα2b) therapy in high-risk melanoma patients demonstrated a significant relapse-free and overall survival (RFS and OS) benefit compared with observation (Obs). PATIENTS AND METHODS: A prospective, randomized, three-arm, intergroup trial evaluated the efficacy of high-dose IFNα2b (HDI) for 1 year and low-dose IFNα2b (LDI) for 2 years versus Obs in high-risk (stage IIB and III) melanoma with RFS and OS end points. RESULTS: A total of 642 patients were enrolled (608 patients eligible), of whom a majority (75%) had nodal metastasis (50% had nodal recurrence). Unlike E1684, E1690 allowed entry of patients with T4 (> 4 mm) deep primary tumors, regardless of nodal dissection, and 25% of the patients entered onto this trial had deep primary tumors (compared with 11% in E1684). At 52 months’ median follow-up, HDI demonstrated an RFS benefit exceeding that of LDI compared with Obs. The 5-year estimated RFS rates for the HDI, LDI, and Obs arms were 44%, 40%, and 35%, respectively. The hazards ratio for the intent-to-treat analysis of HDI versus Obs was 1.28 (P 2 = .05); for LDI versus Obs, it was 1.19 (P 2 = .17). By Cox analysis, the impact of HDI on RFS achieved significance (P 2 = .03). The RFS benefit was equivalent for node-negative and node-positive patients. Neither HDI nor LDI has demonstrated an OS benefit compared with Obs at this time. A major improvement in the median OS of patients in the E1690 Obs arm was noted in comparison with E1684 (6 years v 2.8 years). An analysis of salvage therapy for patients who relapsed on E1690 demonstrated that a significantly larger proportion of patients in the Obs arm received IFNα-containing salvage therapy compared with the HDI arm; this therapy was unavailable to patients during E1684, and patients with undissected regional nodes were not included in E1684. This study did not specify therapy at recurrence. Analysis of treatments received at recurrence demonstrated significantly more frequent use of IFNα2b at relapse from Obs than from HDI, which may have confounded interpretation of the survival benefit of assigned treatments in E1690. CONCLUSION: The results of the intergroup E1690 trial demonstrate an RFS benefit of IFNα2b that is dose-dependent and significant for HDI by Cox multivariable analysis.

Prognostic Factors Analysis of 17,600 Melanoma Patients: Validation of the American Joint Committee on Cancer Melanoma Staging System

2001-08-15

Charles M. Balch , Seng‐Jaw Soong , Jeffrey E. Gershenwald +7 more

PURPOSE: The American Joint Committee on Cancer (AJCC) recently proposed major revisions of the tumor-node-metastases (TNM) categories and stage groupings for cutaneous melanoma. Thirteen cancer centers and cancer cooperative groups … PURPOSE: The American Joint Committee on Cancer (AJCC) recently proposed major revisions of the tumor-node-metastases (TNM) categories and stage groupings for cutaneous melanoma. Thirteen cancer centers and cancer cooperative groups contributed staging and survival data from a total of 30,450 melanoma patients from their databases in order to validate this staging proposal. PATIENTS AND METHODS: There were 17,600 melanoma patients with complete clinical, pathologic, and follow-up information. Factors predicting melanoma-specific survival rates were analyzed using the Cox proportional hazards regression model. Follow-up survival data for 5 years or longer were available for 73% of the patients. RESULTS: This analysis demonstrated that (1) in the T category, tumor thickness and ulceration were the most powerful predictors of survival, and the level of invasion had a significant impact only within the subgroup of thin (≤ 1 mm) melanomas; (2) in the N category, the following three independent factors were identified: the number of metastatic nodes, whether nodal metastases were clinically occult or clinically apparent, and the presence or absence of primary tumor ulceration; and (3) in the M category, nonvisceral metastases was associated with a better survival compared with visceral metastases. A marked diversity in the natural history of pathologic stage III melanoma was demonstrated by five-fold differences in 5-year survival rates for defined subgroups. This analysis also demonstrated that large and complex data sets could be used effectively to examine prognosis and survival outcome in melanoma patients. CONCLUSION: The results of this evidence-based methodology were incorporated into the AJCC melanoma staging as described in the companion publication.

Germline p16 mutations in familial melanoma

1994-09-01

Christopher J. Hussussian , Jeffery P. Struewing , Alisa M. Goldstein +6 more

Thickness, Cross-Sectional Areas and Depth of Invasion in the Prognosis of Cutaneous Melanoma

1970-11-01

Alexander Breslow

Dermoscopy of pigmented skin lesions: Results of a consensus meeting via the Internet

2003-05-01

Giuseppe Argenziano , H. Peter Soyer , Sergio Chimenti +7 more

Distinct Sets of Genetic Alterations in Melanoma

2005-11-16

John A. Curtin , Jane Fridlyand , Toshiro Kageshita +7 more

Exposure to ultraviolet light is a major causative factor in melanoma, although the relationship between risk and exposure is complex. We hypothesized that the clinical heterogeneity is explained by genetically … Exposure to ultraviolet light is a major causative factor in melanoma, although the relationship between risk and exposure is complex. We hypothesized that the clinical heterogeneity is explained by genetically distinct types of melanoma with different susceptibility to ultraviolet light.We compared genome-wide alterations in the number of copies of DNA and mutational status of BRAF and N-RAS in 126 melanomas from four groups in which the degree of exposure to ultraviolet light differs: 30 melanomas from skin with chronic sun-induced damage and 40 melanomas from skin without such damage; 36 melanomas from palms, soles, and subungual (acral) sites; and 20 mucosal melanomas.We found significant differences in the frequencies of regional changes in the number of copies of DNA and mutation frequencies in BRAF among the four groups of melanomas. Samples could be correctly classified into the four groups with 70 percent accuracy on the basis of the changes in the number of copies of genomic DNA. In two-way comparisons, melanomas arising on skin with signs of chronic sun-induced damage and skin without such signs could be correctly classified with 84 percent accuracy. Acral melanoma could be distinguished from mucosal melanoma with 89 percent accuracy. Eighty-one percent of melanomas on skin without chronic sun-induced damage had mutations in BRAF or N-RAS; the majority of melanomas in the other groups had mutations in neither gene. Melanomas with wild-type BRAF or N-RAS frequently had increases in the number of copies of the genes for cyclin-dependent kinase 4 (CDK4) and cyclin D1 (CCND1), downstream components of the RAS-BRAF pathway.The genetic alterations identified in melanomas at different sites and with different levels of sun exposure indicate that there are distinct genetic pathways in the development of melanoma and implicate CDK4 and CCND1 as independent oncogenes in melanomas without mutations in BRAF or N-RAS.

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Management of Cutaneous Melanoma

2004-09-01

Hensin Tsao , Michael B. Atkins , Arthur J. Sober

Cutaneous melanoma remains a management challenge. This year an estimated 55,000 Americans will receive a diagnosis of cutaneous melanoma, and 7900 will die from the disease. The authors of this … Cutaneous melanoma remains a management challenge. This year an estimated 55,000 Americans will receive a diagnosis of cutaneous melanoma, and 7900 will die from the disease. The authors of this review discuss the pathogenesis and management of cutaneous melanoma and provide perspective on treatment options.

The ABCD rule of dermatoscopy

1994-04-01

F. Nachbar , Wilhelm Stolz , Tanja Merkle +6 more

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Validation of the Accuracy of Intraoperative Lymphatic Mapping and Sentinel Lymphadenectomy for Early-Stage Melanoma

1999-10-01

Donald L. Morton , John F. Thompson , Richard Essner +7 more

Objective To evaluate the multicenter application of intraoperative lymphatic mapping, sentinel lymphadenectomy, and selective complete lymph node dissection (LM/SL/SCLND) for the management of early-stage melanoma. Summary Background Data The multidisciplinary … Objective To evaluate the multicenter application of intraoperative lymphatic mapping, sentinel lymphadenectomy, and selective complete lymph node dissection (LM/SL/SCLND) for the management of early-stage melanoma. Summary Background Data The multidisciplinary technique of LM/SL/SCLND has been widely adopted, but not validated in a multicenter trial. The authors began the international Multicenter Selective Lymphadenectomy Trial (MSLT) 5 years ago to evaluate the survival of patients with early-stage primary melanoma after wide excision alone versus wide excision plus LM/SL/SCLND. This study examined the accuracy of LM/SL/SCLND in the MSLT, using the experience of the organizing center (John Wayne Cancer Institute [JWCI]) as a standard for comparison. Methods Before entering patients into the randomization phase, each center in the MSLT was required to finish a 30-case learning phase with complete nuclear medicine, pathology, and surgical review. Selection of MSLT patients in the LM/SL/SCLND treatment arm was based on complete pathologic and surgical data. The comparison group of JWCI patients was selected using these criteria: primary cutaneous melanoma having a thickness ≥1 mm with a Clark level ≥III, or a thickness <1 mm with a Clark level ≥IV (MSLT criterion); LM/SL performed between June 1, 1985, and December 30, 1998; and patient not entered in the MSLT. The accuracy of LM/SL/SCLND was determined by comparing the rates of sentinel node (SN) identification and the incidence of SN metastases in the MSLT and JWCI groups. Results There were 551 patients in the MSLT group and 584 patients in the JWCI group. In both groups, LM performed with blue dye plus a radiocolloid was more successful (99.1%) than LM performed with blue dye alone (95.2%) (p = 0.014). After a center had completed the 30-case learning phase, the success of SN identification in the MSLT group was independent of the center's case volume or experience in the MSLT. Conclusions Lymphatic mapping and sentinel lymphadenectomy can be successfully learned and applied in a standardized fashion with high accuracy by centers worldwide. Successful SN identification rates of 97% can be achieved, and the incidence of nodal metastases approaches that of the organizing center. A multidisciplinary approach (surgery, nuclear medicine, and pathology) and a learning phase of ≥30 consecutive cases per center are sufficient for mastery of LM/SL in cutaneous melanoma. Lymphatic mapping performed using blue dye plus radiocolloid is superior to LM using blue dye alone.

Origin of Familial Malignant Melanomas From Heritable Melanocytic Lesions

1978-05-01

Wallace H. Clark

• Distinctive melanocytic moles are described in 37 patients from six melanoma families. Among the family members examined by the authors, 15 of 17 patients with melanoma and 22 of … • Distinctive melanocytic moles are described in 37 patients from six melanoma families. Among the family members examined by the authors, 15 of 17 patients with melanoma and 22 of 41 nonmelanoma relatives had the unique moles. The clinical and histological features of these moles have been designated the "B-K mole syndrome." The clinical features of the syndrome include the presence of < 10 to > 100 moles prominent on the upper trunk and extremities, and variability of mole size (5 mm to 15 mm), outline, and color combination. Histologically, B-K moles show atypical melanocytic hyperplasia, lymphocytic infiltration, delicate fibroplasia, and new blood vessels that occur within a compound nevus or de novo. The transformation of two B-K moles into malignant melanomas was documented photographically. (<i>Arch Dermatol</i>114:732-738, 1978)

Lymphatic Mapping and Sentinel Lymphadenectomy for Breast Cancer

1994-09-01

Armando E. Giuliano , Daniel Kirgan , Julia Guenther +1 more

Objective The authors report the feasibility and accuracy of intraoperative lymphatic mapping with sentinel lymphadenectomy in patients with breast cancer. Summary Background Data Axillary lymph node dissection (ALND) for breast … Objective The authors report the feasibility and accuracy of intraoperative lymphatic mapping with sentinel lymphadenectomy in patients with breast cancer. Summary Background Data Axillary lymph node dissection (ALND) for breast cancer generally is accepted for its staging and prognostic value, but the extent of dissection remains controversial. Blind lymph node sampling or level I dissection may miss some nodal metastases, but ALND may result in lymphedema. In melanoma, intraoperative lymph node mapping with sentinel lymphadenectomy is an effective and minimally invasive alternative to ALND for identifying nodes containing metastases. Methods One hundred seventy-four mapping procedures were performed using a vital dye injected at the primary breast cancer site. Axillary lymphatics were identified and followed to the first ("sentinel") node, which was selectively excised before ALND. Results Sentinel nodes were identified in 114 of 174 (65.5%) procedures and accurately predicted axillary nodal status in 109 of 114 (95.6%) cases. There was a definite learning curve, and all false-negative sentinel nodes occurred in the first part of the study; sentinel nodes identified in the last 87 procedures were 100% predictive. In 16 of 42 (38.0%) clinically negative/pathologically positive axillae, the sentinel node was the only tumor-involved lymph node identified. The anatomic location of the sentinel node was examined in the 54 most recent procedures; ten cases had only level II nodal metastases that could have been missed by sampling or low (level I) axillary dissection. Conclusions This experience indicates that intraoperative lymphatic mapping can accurately identify the sentinel node–i.e., the axillary lymph node most likely to contain breast cancer metastases–in some patients. The technique could enhance staging accuracy and, with further refinements and experience, might alter the role of ALND.

A study of tumor progression: The precursor lesions of superficial spreading and nodular melanoma

1984-12-01

Wallace H. Clark , David E. Elder , DuPont Guerry +3 more

Adjuvant ipilimumab versus placebo after complete resection of high-risk stage III melanoma (EORTC 18071): a randomised, double-blind, phase 3 trial

2015-04-05

Alexander M.M. Eggermont , Vanna Chiarion‐Sileni , Jean‐Jacques Grob +7 more

Model Predicting Survival in Stage I Melanoma Based on Tumor Progression

1989-12-20

W. H. Clark , David E. Elder , DuPont Guerry +5 more

We used the lesional steps in tumor progression and multi-variable logistic regression to develop a prognostic model for primary, clinical stage I cutaneous melanoma. This model is 89% accurate in … We used the lesional steps in tumor progression and multi-variable logistic regression to develop a prognostic model for primary, clinical stage I cutaneous melanoma. This model is 89% accurate in predicting survival. Using histologic criteria, we assigned melanomas to tumor progression steps by ascertaining their particular growth phase. These phases were the in situ and invasive radial growth phase and the vertical growth phase (the focal formation of a dermal tumor nodule or dermal tumor plaque within the radial growth phase or such dermal growth without an evident radial growth phase). After a minimum follow-up of 100.6 months and a median follow-up of 150.2 months, 122 invasive radial-growth-phase tumors were found to be without metastases. Eight-year survival among the 264 patients whose tumors had entered the vertical growth phase was 71.2%. Survival prediction in these patients was enhanced by the use of a multivariable logistic regression model. Twenty-three attributes were tested for entry into this model. Six had independently predictive prognostic information: (a) mitotic rate per square millimeter, (b) tumor-infiltrating lymphocytes, (c) tumor thickness, (d) anatomic site of primary melanoma, (e) sex of the patient, and (f) histologic regression. When mitotic rate per square millimeter, tumor-infiltrating lymphocytes, primary site, sex, and histologic regression are added to a logistic regression model containing tumor thickness alone, they are independent predictors of 8-year survival (P <.0005). [J Natl Cancer Inst 81: 1893–1904, 1989]

Analysis of the p16 gene (CDKN2) as a candidate for the chromosome 9p melanoma susceptibility locus

1994-09-01

Alexander Kamb , Donna Shattuck-Eidens , Rosalind A. Eeles +7 more

Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe

1993-12-01

David N. Krag , Donald L. Weaver , James C. Alex +1 more

Malignant melanoma. A clinicopathological analysis of the criteria for diagnosis and prognosis

1953-01-01

Arthur C. Allen , Sophie Spitz

Epiluminescence Microscopy for the Diagnosis of Doubtful Melanocytic Skin Lesions

1998-12-01

Giuseppe Argenziano , Gabriella Fabbrocini , Paolo Carli +3 more

To compare the reliability of a new 7-point checklist based on simplified epiluminescence microscopy (ELM) pattern analysis with the ABCD rule of dermatoscopy and standard pattern analysis for the diagnosis … To compare the reliability of a new 7-point checklist based on simplified epiluminescence microscopy (ELM) pattern analysis with the ABCD rule of dermatoscopy and standard pattern analysis for the diagnosis of clinically doubtful melanocytic skin lesions.In a blind study, ELM images of 342 histologically proven melanocytic skin lesions were evaluated for the presence of 7 standard criteria that we called the "ELM 7-point checklist." For each lesion, "overall" and "ABCD scored" diagnoses were recorded. From a training set of 57 melanomas and 139 atypical nonmelanomas, odds ratios were calculated to create a simple diagnostic model based on identification of major and minor criteria for the "7-point scored" diagnosis. A test set of 60 melanomas and 86 atypical nonmelanomas was used for model validation and was then presented to 2 less experienced ELM observers, who recorded the ABCD and 7-point scored diagnoses.University medical centers.A sample of patients with excised melanocytic lesions.Sensitivity, specificity, and accuracy of the models for diagnosing melanoma.From the total combined sets, the 7-point checklist gave a sensitivity of 95% and a sepcificity of 75% compared with 85% sensitivity and 66% specificity using the ABCD rule and 91% sensitivity and 90% specificity using standard pattern analysis (overall ELM diagnosis). Compared with the ABCD rule, the 7-point method allowed less experienced observers to obtain higher diagnostic accuracy values.The ELM 7-point checklist provides a simplification of standard pattern analysis because of the low number of features to identify and the scoring diagnostic system. As with the ABCD rule, it can be easily learned and easily applied and has proven to be reliable in diagnosing melanoma.

Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting

2008-06-01

M. Vestergaard , Petra Macaskill , Phoebe E Holt +1 more

Background Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic examination of diagnostic features, not seen by the naked eye, in pigmented skin lesions. Diagnostic accuracy … Background Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic examination of diagnostic features, not seen by the naked eye, in pigmented skin lesions. Diagnostic accuracy of dermoscopy has previously been assessed in meta-analyses including studies performed in experimental and clinical settings. Objectives To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked eye examination by performing a meta-analysis exclusively on studies performed in a clinical setting. Methods We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked eye examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical examination with, and without, the use of dermoscopy. Results We found the relative diagnostic odds ratio for melanoma, for dermoscopy compared with naked eye examination, to be 15·6 [95% confidence interval (CI) 2·9–83·7, P = 0·016]; removal of two outlier studies changed this to 9·0 (95% CI 1·5–54·6, P = 0·03). Conclusions Dermoscopy is more accurate than naked eye examination for the diagnosis of cutaneous melanoma in suspicious skin lesions when performed in the clinical setting.

Sentinel-Node Biopsy or Nodal Observation in Melanoma

2006-09-27

Donald L. Morton , John F. Thompson , Alistair J. Cochran +7 more

We evaluated the contribution of sentinel-node biopsy to outcomes in patients with newly diagnosed melanoma. We evaluated the contribution of sentinel-node biopsy to outcomes in patients with newly diagnosed melanoma.

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Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi

2004-12-16

Sara Gandini , Francesco Sera , Maria Sofia Cattaruzza +4 more

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Final Version of 2009 AJCC Melanoma Staging and Classification

2009-11-17

Charles M. Balch , Jeffrey E. Gershenwald , Seng-Jaw Soong +7 more

To revise the staging system for cutaneous melanoma on the basis of data from an expanded American Joint Committee on Cancer (AJCC) Melanoma Staging Database.The melanoma staging recommendations were made … To revise the staging system for cutaneous melanoma on the basis of data from an expanded American Joint Committee on Cancer (AJCC) Melanoma Staging Database.The melanoma staging recommendations were made on the basis of a multivariate analysis of 30,946 patients with stages I, II, and III melanoma and 7,972 patients with stage IV melanoma to revise and clarify TNM classifications and stage grouping criteria.Findings and new definitions include the following: (1) in patients with localized melanoma, tumor thickness, mitotic rate (histologically defined as mitoses/mm(2)), and ulceration were the most dominant prognostic factors. (2) Mitotic rate replaces level of invasion as a primary criterion for defining T1b melanomas. (3) Among the 3,307 patients with regional metastases, components that defined the N category were the number of metastatic nodes, tumor burden, and ulceration of the primary melanoma. (4) For staging purposes, all patients with microscopic nodal metastases, regardless of extent of tumor burden, are classified as stage III. Micrometastases detected by immunohistochemistry are specifically included. (5) On the basis of a multivariate analysis of patients with distant metastases, the two dominant components in defining the M category continue to be the site of distant metastases (nonvisceral v lung v all other visceral metastatic sites) and an elevated serum lactate dehydrogenase level.Using an evidence-based approach, revisions to the AJCC melanoma staging system have been made that reflect our improved understanding of this disease. These revisions will be formally incorporated into the seventh edition (2009) of the AJCC Cancer Staging Manual and implemented by early 2010.

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Prevalence of Skin Cancer in an Endemic Area of Chronic Arsenicism in Taiwan<xref ref-type="fn" rid="FN2">2</xref>

1968-03-01

Wen-Ping Tseng , Hao-Yu Chu , S W How +3 more

In a limited area on the southwest coast of Taiwan where artesian well water with a high concentration of arsenic has been used for more than 45 years, a high … In a limited area on the southwest coast of Taiwan where artesian well water with a high concentration of arsenic has been used for more than 45 years, a high prevalence of chronic arsenic poisoning has been observed in recent years. The total population of this endemic area, which is defined by the presence of both patients and contaminated wells, is approximately 100,000. A general survey of 40,421 inhabitants (19,269 males and 21,152 females) of the area was made. The overall prevalence rates for skin cancer, hyperpigmentation, and keratosis were 10.6, 183.5, and 71.0/1000, respectively. The male-to-female ratio was 2.9: 1 for skin cancer and 1.1: 1 for hyperpigmentation and keratosis, respectively. Generally speaking, the prevalence increased steadily with age in all three conditions, though there was a decline in age groups above 69 in females with cancer or hyperpigmentation. The prevalence rate for skin cancer showed an ascending gradient according to the arsenic content of the well water, i.e., the higher the arsenic content, the more patients with skin cancer. The results were the same for hyperpigmentation and keratosis. Blackfoot disease, so-termed locally, a peripheral vascular disorder resulting in gangrene of the extremities, especially of the feet, had an overall prevalence rate of 8.9/1000. A dose-response relationship between this disease and the amount of arsenic in the well water was similar to that observed for skin cancer. The association of Blackfoot disease with hyperpigmentation, keratosis, and skin cancer was significantly higher than expected. The causal relationship between Blackfoot disease and chronic arsenicism is discussed.

The histogenesis and biologic behavior of primary human malignant melanomas of the skin.

1969-03-01

Wallace H. Clark , Lynn From , Evelina A. Bernardino +1 more

Summary This paper describes the histogenesis of 3 forms of human malignant melanoma: superficial spreading melanoma, nodular melanoma, and lentigo maligna melanoma. A comparative analysis by computer of the biologic … Summary This paper describes the histogenesis of 3 forms of human malignant melanoma: superficial spreading melanoma, nodular melanoma, and lentigo maligna melanoma. A comparative analysis by computer of the biologic behavior and clinical characteristics of the different neoplasms has been done. An additional 60 tumors have been studied by serial block sectioning. Evidence is presented suggesting that superficial spreading melanoma and lentigo maligna melanoma (Hutchinson9s melanotic freckle), though evolving at different rates, show a long period of superficial growth, followed by the relatively rapid appearance of nodules or deeper invasion within the primary lesion. This change in the nature of the primary lesion may be due to the appearance of one or more strains of cells of aggressive biologic potential. Thus the primary melanoma may exist for a relatively long period of time during which host selectional forces act to permit the growth of quite malignant strains of cells. It is these cells that seem to be capable of deeper growth. The subdivision of each of the forms of melanoma into 5 anatomic levels of invasion permits the accurate assignment of prognosis to each case. It is suggested that melanomas are tumors of the epidermal melanocytes and are not necessarily derived from melanocytic nevi. Each melanoma has a distinctive clinical appearance, even in its superficial and curable phases, and this appearance is the same whether or not the process arose in association with a melanocytic nevus.

Final Version of the American Joint Committee on Cancer Staging System for Cutaneous Melanoma

2001-08-15

Charles M. Balch , Antônio C. Buzaid , Seng‐Jaw Soong +7 more

PURPOSE: To revise the staging system for cutaneous melanoma under the auspices of the American Joint Committee on Cancer (AJCC). MATERIALS AND METHODS: The prognostic factors analysis described in the … PURPOSE: To revise the staging system for cutaneous melanoma under the auspices of the American Joint Committee on Cancer (AJCC). MATERIALS AND METHODS: The prognostic factors analysis described in the companion publication (this issue), as well as evidence from the published literature, was used to assemble the tumor-node-metastasis criteria and stage grouping for the melanoma staging system. RESULTS: Major changes include (1) melanoma thickness and ulceration but not level of invasion to be used in the T category (except for T1 melanomas); (2) the number of metastatic lymph nodes rather than their gross dimensions and the delineation of clinically occult (ie, microscopic) versus clinically apparent (ie, macroscopic) nodal metastases to be used in the N category; (3) the site of distant metastases and the presence of elevated serum lactic dehydrogenase to be used in the M category; (4) an upstaging of all patients with stage I, II, and III disease when a primary melanoma is ulcerated; (5) a merging of satellite metastases around a primary melanoma and in-transit metastases into a single staging entity that is grouped into stage III disease; and (6) a new convention for defining clinical and pathologic staging so as to take into account the staging information gained from intraoperative lymphatic mapping and sentinel node biopsy. CONCLUSION: This revision will become official with publication of the sixth edition of the AJCC Cancer Staging Manual in the year 2002.

Technical Details of Intraoperative Lymphatic Mapping for Early Stage Melanoma

1992-04-01

Donald L. Morton

The initial route of metastases in most patients with melanoma is via the lymphatics to the regional nodes. However, routine lymphadenectomy for patients with clinical stage I melanoma remains controversial … The initial route of metastases in most patients with melanoma is via the lymphatics to the regional nodes. However, routine lymphadenectomy for patients with clinical stage I melanoma remains controversial because most of these patients do not have nodal metastases, are unlikely to benefit from the operation, and may suffer troublesome postoperative edema of the limbs. A new procedure was developed using vital dyes that permits intraoperative identification of the sentinel lymph node, the lymph node nearest the site of the primary melanoma, on the direct drainage pathway. The most likely site of early metastases, the sentinel node can be removed for immediate intraoperative study to identify clinically occult melanoma cells. We successfully identified the sentinel node(s) in 194 of 237 lymphatic basins and detected metastases in 40 specimens (21%) on examination of routine hematoxylin-eosin-stained slides (12%) or exclusively in immunohistochemically stained preparations (9%). Metastases were present in 47 (18%) of 259 sentinel nodes, while nonsentinel nodes were the sole site of metastasis in only two of 3079 nodes from 194 lymphadenectomy specimens that had an identifiable sentinel node, a false-negative rate of less than 1%. Thus, this technique identifies, with a high degree of accuracy, patients with early stage melanoma who have nodal metastases and are likely to benefit from radical lymphadenectomy.

Final Trial Report of Sentinel-Node Biopsy versus Nodal Observation in Melanoma

2014-02-12

Donald L. Morton , John F. Thompson , Amalia Cochran +7 more

Sentinel-node biopsy, a minimally invasive procedure for regional melanoma staging, was evaluated in a phase 3 trial. Sentinel-node biopsy, a minimally invasive procedure for regional melanoma staging, was evaluated in a phase 3 trial.

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Early Detection of Malignant Melanoma: The Role of Physician Examination and Self-Examination of the Skin

1985-05-01

R. J. Friedman , Darrell S. Rigel , A Kopf

The combination of routine physician examination of the skin coupled with self-examination provides a realistic opportunity for the identification of early malignant melanomas. Removal of such thin lesions can significantly … The combination of routine physician examination of the skin coupled with self-examination provides a realistic opportunity for the identification of early malignant melanomas. Removal of such thin lesions can significantly reduce the mortality rate from this potentially serious form of cutaneous cancer.

Somatic Activation of KIT in Distinct Subtypes of Melanoma

2006-08-15

John A. Curtin , Klaus J. Busam , Daniel Pinkel +1 more

Melanomas on mucosal membranes, acral skin (soles, palms, and nail bed), and skin with chronic sun-induced damage have infrequent mutations in BRAF and NRAS, genes within the mitogen-activated protein (MAP) … Melanomas on mucosal membranes, acral skin (soles, palms, and nail bed), and skin with chronic sun-induced damage have infrequent mutations in BRAF and NRAS, genes within the mitogen-activated protein (MAP) kinase pathway commonly mutated in melanomas on intermittently sun-exposed skin. This raises the question of whether other aberrations are occurring in the MAP kinase cascade in the melanoma types with infrequent mutations of BRAF and NRAS.We analyzed array comparative genomic hybridization data from 102 primary melanomas (38 from mucosa, 28 from acral skin, and 18 from skin with and 18 from skin without chronic sun-induced damage) for DNA copy number aberrations specific to melanoma subtypes where mutations in BRAF and NRAS are infrequent. A narrow amplification on 4q12 was found, and candidate genes within it were analyzed.Oncogenic mutations in KIT were found in three of seven tumors with amplifications. Examination of all 102 primary melanomas found mutations and/or copy number increases of KIT in 39% of mucosal, 36% of acral, and 28% of melanomas on chronically sun-damaged skin, but not in any (0%) melanomas on skin without chronic sun damage. Seventy-nine percent of tumors with mutations and 53% of tumors with multiple copies of KIT demonstrated increased KIT protein levels.KIT is an important oncogene in melanoma. Because the majority of the KIT mutations we found in melanoma also occur in imatinib-responsive cancers of other types, imatinib may offer an immediate therapeutic benefit for a significant proportion of the global melanoma burden.

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Diagnostic accuracy of dermoscopy

2002-03-01

Harald Kittler , Hubert Pehamberger , K Wolff +1 more

The Genetic Evolution of Melanoma from Precursor Lesions

2015-11-11

A. Hunter Shain , Iwei Yeh , Ivanka Kovalyshyn +7 more

The pathogenic mutations in melanoma have been largely catalogued; however, the order of their occurrence is not known.We sequenced 293 cancer-relevant genes in 150 areas of 37 primary melanomas and … The pathogenic mutations in melanoma have been largely catalogued; however, the order of their occurrence is not known.We sequenced 293 cancer-relevant genes in 150 areas of 37 primary melanomas and their adjacent precursor lesions. The histopathological spectrum of these areas included unequivocally benign lesions, intermediate lesions, and intraepidermal or invasive melanomas.Precursor lesions were initiated by mutations of genes that are known to activate the mitogen-activated protein kinase pathway. Unequivocally benign lesions harbored BRAF V600E mutations exclusively, whereas those categorized as intermediate were enriched for NRAS mutations and additional driver mutations. A total of 77% of areas of intermediate lesions and melanomas in situ harbored TERT promoter mutations, a finding that indicates that these mutations are selected at an unexpectedly early stage of the neoplastic progression. Biallelic inactivation of CDKN2A emerged exclusively in invasive melanomas. PTEN and TP53 mutations were found only in advanced primary melanomas. The point-mutation burden increased from benign through intermediate lesions to melanoma, with a strong signature of the effects of ultraviolet radiation detectable at all evolutionary stages. Copy-number alterations became prevalent only in invasive melanomas. Tumor heterogeneity became apparent in the form of genetically distinct subpopulations as melanomas progressed.Our study defined the succession of genetic alterations during melanoma progression, showing distinct evolutionary trajectories for different melanoma subtypes. It identified an intermediate category of melanocytic neoplasia, characterized by the presence of more than one pathogenic genetic alteration and distinctive histopathological features. Finally, our study implicated ultraviolet radiation as a major factor in both the initiation and progression of melanoma. (Funded by the National Institutes of Health and others.).

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From melanocytes to melanomas

2016-04-29

A. Hunter Shain , Boris C. Bastian

Automated Melanoma Recognition in Dermoscopy Images via Very Deep Residual Networks

2016-12-21

Lequan Yu , Hao Chen , Qi Dou +2 more

Automated melanoma recognition in dermoscopy images is a very challenging task due to the low contrast of skin lesions, the huge intraclass variation of melanomas, the high degree of visual … Automated melanoma recognition in dermoscopy images is a very challenging task due to the low contrast of skin lesions, the huge intraclass variation of melanomas, the high degree of visual similarity between melanoma and non-melanoma lesions, and the existence of many artifacts in the image. In order to meet these challenges, we propose a novel method for melanoma recognition by leveraging very deep convolutional neural networks (CNNs). Compared with existing methods employing either low-level hand-crafted features or CNNs with shallower architectures, our substantially deeper networks (more than 50 layers) can acquire richer and more discriminative features for more accurate recognition. To take full advantage of very deep networks, we propose a set of schemes to ensure effective training and learning under limited training data. First, we apply the residual learning to cope with the degradation and overfitting problems when a network goes deeper. This technique can ensure that our networks benefit from the performance gains achieved by increasing network depth. Then, we construct a fully convolutional residual network (FCRN) for accurate skin lesion segmentation, and further enhance its capability by incorporating a multi-scale contextual information integration scheme. Finally, we seamlessly integrate the proposed FCRN (for segmentation) and other very deep residual networks (for classification) to form a two-stage framework. This framework enables the classification network to extract more representative and specific features based on segmented results instead of the whole dermoscopy images, further alleviating the insufficiency of training data. The proposed framework is extensively evaluated on ISBI 2016 Skin Lesion Analysis Towards Melanoma Detection Challenge dataset. Experimental results demonstrate the significant performance gains of the proposed framework, ranking the first in classification and the second in segmentation among 25 teams and 28 teams, respectively. This study corroborates that very deep CNNs with effective training mechanisms can be employed to solve complicated medical image analysis tasks, even with limited training data.

Dermatologist-level classification of skin cancer with deep neural networks

2017-01-25

Andre Esteva , Brett Kuprel , Roberto A. Novoa +4 more

Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma

2017-06-07

Mark B. Faries , John F. Thompson , Alistair J. Cochran +7 more

Sentinel-lymph-node biopsy is associated with increased melanoma-specific survival (i.e., survival until death from melanoma) among patients with node-positive intermediate-thickness melanomas (1.2 to 3.5 mm). The value of completion lymph-node dissection … Sentinel-lymph-node biopsy is associated with increased melanoma-specific survival (i.e., survival until death from melanoma) among patients with node-positive intermediate-thickness melanomas (1.2 to 3.5 mm). The value of completion lymph-node dissection for patients with sentinel-node metastases is not clear.

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Melanoma staging: Evidence‐based changes in the American Joint Committee on Cancer eighth edition cancer staging manual

2017-10-13

Jeffrey E. Gershenwald , Richard A. Scolyer , Kenneth R. Hess +7 more

Answer questions and earn CME/CNE To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers … Answer questions and earn CME/CNE To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since 1998. Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria. Key changes in the eighth edition AJCC Cancer Staging Manual include: 1) tumor thickness measurements to be recorded to the nearest 0.1 mm, not 0.01 mm; 2) definitions of T1a and T1b are revised (T1a, <0.8 mm without ulceration; T1b, 0.8-1.0 mm with or without ulceration or <0.8 mm with ulceration), with mitotic rate no longer a T category criterion; 3) pathological (but not clinical) stage IA is revised to include T1b N0 M0 (formerly pathologic stage IB); 4) the N category descriptors "microscopic" and "macroscopic" for regional node metastasis are redefined as "clinically occult" and "clinically apparent"; 5) prognostic stage III groupings are based on N category criteria and T category criteria (ie, primary tumor thickness and ulceration) and increased from 3 to 4 subgroups (stages IIIA-IIID); 6) definitions of N subcategories are revised, with the presence of microsatellites, satellites, or in-transit metastases now categorized as N1c, N2c, or N3c based on the number of tumor-involved regional lymph nodes, if any; 7) descriptors are added to each M1 subcategory designation for lactate dehydrogenase (LDH) level (LDH elevation no longer upstages to M1c); and 8) a new M1d designation is added for central nervous system metastases. This evidence-based revision of the AJCC melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials. CA Cancer J Clin 2017;67:472-492. © 2017 American Cancer Society.

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Adjuvant Pembrolizumab versus Placebo in Resected Stage III Melanoma

2018-04-15

Alexander M.M. Eggermont , Christian U. Blank , Mario Mandalà +7 more

The programmed death 1 (PD-1) inhibitor pembrolizumab has been found to prolong progression-free and overall survival among patients with advanced melanoma. We conducted a phase 3 double-blind trial to evaluate … The programmed death 1 (PD-1) inhibitor pembrolizumab has been found to prolong progression-free and overall survival among patients with advanced melanoma. We conducted a phase 3 double-blind trial to evaluate pembrolizumab as adjuvant therapy in patients with resected, high-risk stage III melanoma.Patients with completely resected stage III melanoma were randomly assigned (with stratification according to cancer stage and geographic region) to receive 200 mg of pembrolizumab (514 patients) or placebo (505 patients) intravenously every 3 weeks for a total of 18 doses (approximately 1 year) or until disease recurrence or unacceptable toxic effects occurred. Recurrence-free survival in the overall intention-to-treat population and in the subgroup of patients with cancer that was positive for the PD-1 ligand (PD-L1) were the primary end points. Safety was also evaluated.At a median follow-up of 15 months, pembrolizumab was associated with significantly longer recurrence-free survival than placebo in the overall intention-to-treat population (1-year rate of recurrence-free survival, 75.4% [95% confidence interval {CI}, 71.3 to 78.9] vs. 61.0% [95% CI, 56.5 to 65.1]; hazard ratio for recurrence or death, 0.57; 98.4% CI, 0.43 to 0.74; P<0.001) and in the subgroup of 853 patients with PD-L1-positive tumors (1-year rate of recurrence-free survival, 77.1% [95% CI, 72.7 to 80.9] in the pembrolizumab group and 62.6% [95% CI, 57.7 to 67.0] in the placebo group; hazard ratio, 0.54; 95% CI, 0.42 to 0.69; P<0.001). Adverse events of grades 3 to 5 that were related to the trial regimen were reported in 14.7% of the patients in the pembrolizumab group and in 3.4% of patients in the placebo group. There was one treatment-related death due to myositis in the pembrolizumab group.As adjuvant therapy for high-risk stage III melanoma, 200 mg of pembrolizumab administered every 3 weeks for up to 1 year resulted in significantly longer recurrence-free survival than placebo, with no new toxic effects identified. (Funded by Merck; ClinicalTrials.gov number, NCT02362594 ; EudraCT number, 2014-004944-37 .).

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Man against machine: diagnostic performance of a deep learning convolutional neural network for dermoscopic melanoma recognition in comparison to 58 dermatologists

2018-05-04

Holger A. Haenssle , Christine Fink , Roland Schneiderbauer +7 more

Deep learning convolutional neural networks (CNN) may facilitate melanoma detection, but data comparing a CNN's diagnostic performance to larger groups of dermatologists are lacking.Google's Inception v4 CNN architecture was trained … Deep learning convolutional neural networks (CNN) may facilitate melanoma detection, but data comparing a CNN's diagnostic performance to larger groups of dermatologists are lacking.Google's Inception v4 CNN architecture was trained and validated using dermoscopic images and corresponding diagnoses. In a comparative cross-sectional reader study a 100-image test-set was used (level-I: dermoscopy only; level-II: dermoscopy plus clinical information and images). Main outcome measures were sensitivity, specificity and area under the curve (AUC) of receiver operating characteristics (ROC) for diagnostic classification (dichotomous) of lesions by the CNN versus an international group of 58 dermatologists during level-I or -II of the reader study. Secondary end points included the dermatologists' diagnostic performance in their management decisions and differences in the diagnostic performance of dermatologists during level-I and -II of the reader study. Additionally, the CNN's performance was compared with the top-five algorithms of the 2016 International Symposium on Biomedical Imaging (ISBI) challenge.In level-I dermatologists achieved a mean (±standard deviation) sensitivity and specificity for lesion classification of 86.6% (±9.3%) and 71.3% (±11.2%), respectively. More clinical information (level-II) improved the sensitivity to 88.9% (±9.6%, P = 0.19) and specificity to 75.7% (±11.7%, P < 0.05). The CNN ROC curve revealed a higher specificity of 82.5% when compared with dermatologists in level-I (71.3%, P < 0.01) and level-II (75.7%, P < 0.01) at their sensitivities of 86.6% and 88.9%, respectively. The CNN ROC AUC was greater than the mean ROC area of dermatologists (0.86 versus 0.79, P < 0.01). The CNN scored results close to the top three algorithms of the ISBI 2016 challenge.For the first time we compared a CNN's diagnostic performance with a large international group of 58 dermatologists, including 30 experts. Most dermatologists were outperformed by the CNN. Irrespective of any physicians' experience, they may benefit from assistance by a CNN's image classification.This study was registered at the German Clinical Trial Register (DRKS-Study-ID: DRKS00013570; https://www.drks.de/drks_web/).

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Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)

2019-01-01

Noel Codella , Veronica Rotemberg , Philipp Tschandl +7 more

This work summarizes the results of the largest skin image analysis challenge in the world, hosted by the International Skin Imaging Collaboration (ISIC), a global partnership that has organized the … This work summarizes the results of the largest skin image analysis challenge in the world, hosted by the International Skin Imaging Collaboration (ISIC), a global partnership that has organized the world's largest public repository of dermoscopic images of skin. The challenge was hosted in 2018 at the Medical Image Computing and Computer Assisted Intervention (MICCAI) conference in Granada, Spain. The dataset included over 12,500 images across 3 tasks. 900 users registered for data download, 115 submitted to the lesion segmentation task, 25 submitted to the lesion attribute detection task, and 159 submitted to the disease classification task. Novel evaluation protocols were established, including a new test for segmentation algorithm performance, and a test for algorithm ability to generalize. Results show that top segmentation algorithms still fail on over 10% of images on average, and algorithms with equal performance on test data can have different abilities to generalize. This is an important consideration for agencies regulating the growing set of machine learning tools in the healthcare domain, and sets a new standard for future public challenges in healthcare.

Skin lesion analysis toward melanoma detection: A challenge at the 2017 International symposium on biomedical imaging (ISBI), hosted by the international skin imaging collaboration (ISIC)

2018-04-01

Noel Codella , David Gutman , M. Emre Celebi +7 more

This article describes the design, implementation, and results of the latest installment of the dermoscopic image analysis benchmark challenge. The goal is to support research and development of algorithms for … This article describes the design, implementation, and results of the latest installment of the dermoscopic image analysis benchmark challenge. The goal is to support research and development of algorithms for automated diagnosis of melanoma, the most lethal skin cancer. The challenge was divided into 3 tasks: lesion segmentation, feature detection, and disease classification. Participation involved 593 registrations, 81 pre-submissions, 46 finalized submissions (including a 4-page manuscript), and approximately 50 attendees, making this the largest standardized and comparative study in this field to date. While the official challenge duration and ranking of participants has concluded, the dataset snapshots remain available for further research and development.

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International Union against Cancer

1959-10-01

The HAM10000 dataset, a large collection of multi-source dermatoscopic images of common pigmented skin lesions

2018-08-14

Philipp Tschandl , Cliff Rosendahl , Harald Kittler

Training of neural networks for automated diagnosis of pigmented skin lesions is hampered by the small size and lack of diversity of available datasets of dermatoscopic images. We tackle this … Training of neural networks for automated diagnosis of pigmented skin lesions is hampered by the small size and lack of diversity of available datasets of dermatoscopic images. We tackle this problem by releasing the HAM10000 ("Human Against Machine with 10000 training images") dataset. We collected dermatoscopic images from different populations acquired and stored by different modalities. Given this diversity we had to apply different acquisition and cleaning methods and developed semi-automatic workflows utilizing specifically trained neural networks. The final dataset consists of 10015 dermatoscopic images which are released as a training set for academic machine learning purposes and are publicly available through the ISIC archive. This benchmark dataset can be used for machine learning and for comparisons with human experts. Cases include a representative collection of all important diagnostic categories in the realm of pigmented lesions. More than 50% of lesions have been confirmed by pathology, while the ground truth for the rest of the cases was either follow-up, expert consensus, or confirmation by in-vivo confocal microscopy.

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Global Burden of Cutaneous Melanoma in 2020 and Projections to 2040

2022-03-30

Melina Arnold , Deependra Singh , Mathieu Laversanne +7 more

Despite many cases being preventable, cutaneous melanoma remains the most serious skin cancer worldwide. Understanding the scale and profile of the disease is vital to concentrate and reinforce global prevention … Despite many cases being preventable, cutaneous melanoma remains the most serious skin cancer worldwide. Understanding the scale and profile of the disease is vital to concentrate and reinforce global prevention efforts.

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Melanoma

2006-07-06

Arlo J. Miller , Martín C. Mihm

This review summarizes the molecular and genetic lesions underlying the progression from benign nevus to malignant melanoma. This review summarizes the molecular and genetic lesions underlying the progression from benign nevus to malignant melanoma.

Germline BRCA1 Mutations and a Basal Epithelial Phenotype in Breast Cancer

2003-09-30

William D. Foulkes

A basal epithelial phenotype is found in not more than 15% of all invasive breast cancers. Microarray studies have shown that this phenotype is associated with breast cancers that express … A basal epithelial phenotype is found in not more than 15% of all invasive breast cancers. Microarray studies have shown that this phenotype is associated with breast cancers that express neither estrogen receptor (ER) nor erbB-2 (HER2/neu) (i.e., ER/erbB-2-negative tumors). The ER/erbB-2- negative phenotype is also found in breast cancers occurring in BRCA1 mutation carriers (i.e., BRCA1-related breast cancers). We tested the hypothesis that BRCA1-related breast cancers are more likely than non-BRCA1/ 2-related breast cancer to express a basal epithelial phenotype. Among 292 breast cancer specimens previously analyzed for ER, erbB-2, p53, and germline mutations in BRCA1 and BRCA2, we identified 76 that did not overexpress ER or erbB-2. Of the 72 specimens with sufficient material for testing, 40 expressed stratified epithelial cytokeratin 5 and/or 6 (5/6). In univariate analysis, the expression of cytokeratin 5/6 was statistically significantly associated with BRCA1-related breast cancers (odds ratio = 9.0, 95% confidence interval = 1.9 to 43; P =.002, two-sided Fisher's exact test). Thus, germline BRCA1 mutations appear to be associated with a distinctive breast cancer phenotype.

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How Will Emerging Treatments for PD-1&#x2013;Refractory Melanoma Shape the Delivery of Care?

2025-06-26

| Default Digital Object Group

Fostering trust and interpretability in skin cancer classification: a hybrid framework of deep learning and machine learning with explainable AI

2025-06-25

Anindita Roy , Abdullah Al Maruf , Rayhanul Islam Sony +3 more | Journal of Ambient Intelligence and Humanized Computing

intraosseous Melanoma in Maxillary Bone

2025-06-24

E.F. Roginsky , Anthony K. Mills , MPH | International Journal of Oral and Maxillofacial Surgery

Skin Cancer Cell Detection using Image Processing

2025-06-24

Taskin Sabit , Faiza Tasnim , Sadia Afrin Sara +2 more | International Journal of Pioneering Technology and Engineering

Early diagnosis and precise detection of skin cancer represent a global health priority since this disease remains highly dangerous while being among the most frequent ones. This research investigates the … Early diagnosis and precise detection of skin cancer represent a global health priority since this disease remains highly dangerous while being among the most frequent ones. This research investigates the effectiveness of deep learning techniques, specifically Convolutional Neural Networks (CNN) and the VGG16 architecture, for skin cancer detection and classification. The study works with images from the International Skin Imaging Collaboration (ISIC) while employing resizing and augmentation preprocessing to boost its model performance. We evaluate the proposed model using precision, recall, and F1-score metrics to ensure accurate classification. The proposed CNN model achieved 87% validation accuracy, outperforming the VGG16 model, which attained 65% accuracy. Experimental results highlight the potential of AI-driven models in improving diagnostic accuracy, demonstrating their significance in medical image analysis and early skin cancer detection.

Oral Mucosal Melanoma: Case Reports and Literature Review

2025-06-24

A. González-Jiménez , Veronica Barreto , N. Vieira Sebe +7 more | International Journal of Oral and Maxillofacial Surgery

Rapid Tumour Regression in Advanced Cutaneous Squamous Cell Carcinoma Following Cemiplimab: A Case Report

2025-06-24

A. Onafowokan , A. Yusuf , C. Fowell +3 more | International Journal of Oral and Maxillofacial Surgery

A Computer Aided Diagnostic Tool for Automatic Psoriasis Segmentation and feature extraction from Dermoscopic images

2025-06-23

Charu Bolia | INTERANTIONAL JOURNAL OF SCIENTIFIC RESEARCH IN ENGINEERING AND MANAGEMENT

Background: Psoriasis is a skin disease condition that prevails with red scaly surface along with roughness and requires accurate and precise lesion localization. The subjective methods require more expertize and … Background: Psoriasis is a skin disease condition that prevails with red scaly surface along with roughness and requires accurate and precise lesion localization. The subjective methods require more expertize and dermatologist intervention. The time consuming process leads to motivate development of automated tools for detecting psoriasis lesion along with its characteristics which will help in treatment process. Objective: The study presents the deep learning methodology for detection of psoriasis lesion present in dermoscopic images. Methods: A Grad-CAM is applied to highlight discriminative lesion regions from pre-trained classification models. A pseudo ground truth mask is generated with attention maps in order to train U-net segmentation. The attention maps are post-processed to generate pseudo ground truth masks, which are then used to train a U Net segmentation model to detect psoriatic part. The approach eradicates the dependence on pixel-level annotations, aiding scalable lesion mapping. Result: The proposed methodology is applied on dermoscopic psoriasis images obtained from benchmark Dermnet database. The dice coefficient obtained as 95.6. The method accurately localizes and detects the characteristic of psoriasis for further calculate Psoriasis Area Severity Index score. Our approach suggests the potential to help dermatologist as well as patients to detect psoriasis and provide treatment accordingly. Key Words: Psoriasis, Grad-CAM, Lesion, Dice-coefficient

Atypical Spitz Tumor (Spitz Melanocytoma) With Lymph Node Metastasis and Long-Term Clinical Follow-Up

2025-06-23

Schaida Schirwani , Jeff Theaker , Lucy Side +1 more | American Journal of Dermatopathology

Abstract: Spitz tumors are clinically and histologically challenging because of their close histologic resemblance to melanomas. Differentiating metastatic atypical Spitz tumors from melanoma has been a controversial issue for many … Abstract: Spitz tumors are clinically and histologically challenging because of their close histologic resemblance to melanomas. Differentiating metastatic atypical Spitz tumors from melanoma has been a controversial issue for many decades. Diagnosis relies on expert pathologist review and a host of immunohistochemical and genomic testing including gene fusions in ALK, ROS, and NTRK, which has been informative in diagnosing and classifying these challenging lesions. Evidence suggest that atypical Spitz tumors associated with regional lymph node metastasis have good prognosis and do not spread to internal organs, however, cases of childhood melanomas (often with TERT mutations) can occur, often with a fatal outcome. Therefore, making a conclusive diagnosis is crucial when treating patients. In this study, we report a girl diagnosed with atypical Spitz tumor with lymph node metastasis at the age of 10 years. She has shown no recurrence after 20 years of follow-up. The formalin-fixed, paraffin-embedded tissue was retrospectively analyzed by next-generation sequencing and additional immunohistochemistry. PRAME immunohistochemistry was negative, as were ALK and ROS. No BRAF or TERT mutations were identified. No pathogenic or likely pathogenic variant was identified on testing lymphocyte DNA for familial malignant melanoma, including CDKN2A, CDK4, and BAP1 and a panel of 79 genes associated with childhood solid tumors.

A cross-sectional retrospective review of store-and-forward teledermatology in New Mexico

2025-06-23

Tharani Murali , Jose L. Cortez , Nicole L. Bolick +3 more | Archives of Dermatological Research

Transforming Aesthetic Dermatology: The Role of Artificial Intelligence in Skin Health

2025-06-22

Xiang Chen , Zongmei Zhou , Hui Ding +2 more | Dermatology and Therapy

Artificial intelligence (AI) has profoundly impacted various medical fields, including dermatology, which is to a large extent an image-based discipline. Initially applied in general dermatology, AI has expanded into aesthetic … Artificial intelligence (AI) has profoundly impacted various medical fields, including dermatology, which is to a large extent an image-based discipline. Initially applied in general dermatology, AI has expanded into aesthetic dermatology, where it assists in integrating objective approaches with the aesthetic judgment of dermatologists. This review explores the role of AI in aesthetic dermatology, focusing on skin condition assessment, diagnosis, treatment optimization, and patient education, as well as the challenges and future directions in this evolving field.

A COMPREHENSIVE REVIEW ON MACHINE LEARNING AND DEEP LEARNING TECHNIQUES FOR FUNGAL SKIN DISEASES

2025-06-21

| IJARCCE

Prognostic value of C-reactive protein in patients with melanoma: a meta-analysis

2025-06-20

Xin Xing , Zhixiang Fang | Annals of Medicine

C-reactive protein (CRP) has been widely investigated for its prognostic value for melanoma, however, findings remained different. Consequently, this meta-analysis was performed for identifying its precise role in forecasting melanoma … C-reactive protein (CRP) has been widely investigated for its prognostic value for melanoma, however, findings remained different. Consequently, this meta-analysis was performed for identifying its precise role in forecasting melanoma prognosis. We searched PubMed, Web of Science, Embase and Cochrane Library till 25 January 2025, and computed combined hazard ratios (HRs) and 95% confidence intervals (CIs) for estimating CRP's effect on forecasting overall survival (OS) and progression-free survival (PFS) of melanoma. Nineteen studies consisting of 4634 cases were enrolled into the present work. As suggested by our data, higher CRP showed remarkable relation to dismal OS (HR = 2.26, 95% CI = 1.89-2.71, p < 0.001) and inferior PFS (HR = 1.84, 95% CI = 1.13-2.98, p = 0.014) of melanoma patients. Subgroup analyses indicated that CRP had consistent prognostic significance of OS among various subgroups (all p < 0.05). The findings were verified to be reliable by publication bias and sensitivity analyses. High CRP remarkably predicts dismal OS and PFS of melanoma cases, which is the promising biomarker used to forecast melanoma prognosis in clinical practice.

Deep Learning-based Hybrid ResNet50 and AlexNet Model for Skin Cancer Classification

2025-06-20

| International journal of intelligent engineering and systems

ASO Visual Abstract: Isolated Limb Infusion or Perfusion as First-Line Versus Second-Line Therapy for In-Transit Metastatic Melanoma

2025-06-20

Michelle M. Dugan , Aleena Boby , Helana Ghali +6 more | Annals of Surgical Oncology

Clinical characteristics and prognostic factors in patients with malignant melanoma: A Chinese prospective cohort study

2025-06-20

Long Tang , Yiyao Wang , Haike Lei +7 more | World Journal of Clinical Oncology

Melanoma is a highly malignant tumor that has an extremely poor prognosis. It is the primary cause of death among cutaneous malignancies, accounting for 75% of such fatalities; approximately 325000 … Melanoma is a highly malignant tumor that has an extremely poor prognosis. It is the primary cause of death among cutaneous malignancies, accounting for 75% of such fatalities; approximately 325000 new cases and 57000 deaths were reported worldwide in 2020. The main modalities for melanoma treatment include surgery, immunotherapy, targeted therapy, high-dose interferon, antitumor angiogenesis, chemotherapy, and radiotherapy. Due to China's special national conditions, the main pathological types and therapeutic effects are greatly different from those in Europe and the United States, so more studies are needed to determine the curative effects of such treatments in the Chinese population. To explore their clinical characteristics, prognostic influencing factors and real-world data to provide a reference basis for further diagnosis and treatment. We collected pathological data from patients diagnosed with malignant melanoma in our hospital in recent years. Univariate analysis was conducted using the log-rank test, while multivariate analysis was performed with the Cox proportional hazard regression model. The survival rate was calculated using the Kaplan-Meier method. The male-to-female patient ratio was 1.04: 1. Among the clinical classifications, melanoma of the limb accounted for 47.56% of cases, followed by melanoma of the skin (18.18%) and mucosal melanoma (18.05%). The 5-year survival rates for stage I-II, stage III, and stage IV patients were 54.65%, 37.88%, and 28.58%, respectively. Univariate analysis revealed that age, tumor stage, treatment mode, platelet count at the first visit, and lactate dehydrogenase (LDH) level were significantly related to patient survival. Patients with high LDH and high platelet counts exhibited significantly lower survival rates at 1 year, 3 years, and 5 years. Multivariate analysis demonstrated that tumor stage, chemotherapy, interferon therapy, and LDH level were independent risk factors affecting patient survival and prognosis. Compared to the mortality rates of patients who did not receive chemotherapy or interferon therapy, those of patients who received chemotherapy and interferon therapy were 30.0% and 44.5% lower, respectively. Additionally, patients with elevated LDH levels were 2.27 times more likely to die than patients with normal LDH levels. Melanoma is highly malignant, and its prognosis is influenced by numerous factors, resulting in an overall poor prognosis. This study identified several factors that impact patient prognosis, providing a foundation for individualized comprehensive treatment.

Modified Le-Net Model with Multiple Image Features for Skin Cancer Detection

2025-06-19

Vishal Kumar I B , H S Vimala , J Shreyas | Cancer Investigation

Computer-based technologies significantly improve melanoma and non-melanoma skin cancer detection by providing non-invasive, cost-effective, and rapid diagnostic solutions. In this context, the study proposes a novel Deep Learning (DL)-based skin … Computer-based technologies significantly improve melanoma and non-melanoma skin cancer detection by providing non-invasive, cost-effective, and rapid diagnostic solutions. In this context, the study proposes a novel Deep Learning (DL)-based skin cancer detection approach that leverages an advanced segmentation technique called Improved DeepJoint Segmentation (IDJS). This method is designed to enhance the accuracy and precision of the detection process. Initially, the proposed Modified LeNet (MLeNet)-based model applies a Gaussian filter during preprocessing to reduce speckle noise in the input skin images effectively. Following this, the preprocessed images undergo the IDJS segmentation process, which effectively partitions the cancerous regions with high accuracy. Subsequently, three types of features are extracted from the segmented images and they are Multi-Texton Histogram (MTH)-based features, Improved Pyramid Histogram of Oriented Gradient (IPHOG)-based features, and Median Binary Pattern (MBP). These extracted features serve as the input to the MLeNet model for the final skin cancer detection. The datasets used in this work are the HAM10000 dataset and the ISIC 2019 dataset. With a positive metric value of 0.952, the MLeNet model outperforms the traditional models, with LeNet achieving the highest score of 0.932.

Corrigendum to “Prognostic Model for Patient Survival in Primary Anorectal Mucosal Melanoma: Stage at Presentation Determines Relevance of Histopathologic Features” [Modern Pathology 33 (2020) 496–513]

2025-06-19

Priyadharsini Nagarajan , Jin Piao , Jing Ning +7 more | Modern Pathology

Molecular landscape of acral melanoma: an integrative review

2025-06-19

J. Castillo , Wagner Silva , Denise Barcelos +1 more | Surgical and Experimental Pathology

Abstract Melanoma is an aggressive malignant neoplasm and a significant public health concern due to its high mortality rate. The acral subtype—which includes acral lentiginous and subungual melanomas—exhibits distinct and … Abstract Melanoma is an aggressive malignant neoplasm and a significant public health concern due to its high mortality rate. The acral subtype—which includes acral lentiginous and subungual melanomas—exhibits distinct and complex features that differentiate it from other melanoma subtypes. Understanding its molecular profile is essential for the development of personalized therapeutic strategies. An integrative literature review enables the synthesis and critical analysis of findings from multiple studies, and within the context of acral melanoma molecular biology, it offers a foundation for generating new hypotheses and therapeutic approaches. This study employed an integrative literature review, characterized by an exploratory and descriptive methodology focused on the molecular biology of acral melanoma. Articles were collected from the MEDLINE and EMBASE databases, restricted to publications in journals ranked B2 or higher in the Qualis classification system, covering the period from January 2014 to December 2023. Defined inclusion and exclusion criteria were applied, and the methodological quality of the 38 selected articles was validated. Regarding genomic alterations, driver mutations in BRAF and NRAS were observed at lower frequencies compared to other cutaneous melanoma types. The review also addressed genetic progression, emphasizing the role of signaling pathways and chromosomal instability, including events such as focal amplifications and structural rearrangements.

DermoMamba: a cross-scale Mamba-based model with guide fusion loss for skin lesion segmentation in dermoscopy images

2025-06-19

Nguyễn Văn Hoàng , Dinh-Hieu Nguyen , Thi-Thao Tran +1 more | Pattern Analysis and Applications

ASO Author Reflections: Novel 2D Histopathological Markers for the Risk Stratification of Sentinel Node Metastasis in the Era of Adjuvant Systemic Therapy for Primary Cutaneous Melanoma

2025-06-19

Sophie E Orme , Marc Moncrieff , Gerald Saldanha | Annals of Surgical Oncology

Influence of sentinel lymph node biopsy on the prognosis of acral melanoma patients

2025-06-18

Thiago Francischetto , Ana Clara Falcão , André Rhodes Neves +7 more | Anais Brasileiros de Dermatologia

An evaluation of Nivolumab and ipilimumab for the treatment of resectable stage III melanoma

2025-06-18

Alistair McCombe , Alexander C.J. van Akkooi | Expert Review of Anticancer Therapy

Twenty years ago, surgery was the centerpiece of treatment for cutaneous melanoma, including for resectable stage III and IV patients. The arrival of effective systemic therapies in the early 2010s … Twenty years ago, surgery was the centerpiece of treatment for cutaneous melanoma, including for resectable stage III and IV patients. The arrival of effective systemic therapies in the early 2010s has led to the abandonment of less effective traditional chemotherapeutic agents, a reduction in surgical excision margins, and a smaller set of indications for lymph node dissection. A more recent shift has been from adjuvant to neo-adjuvant immunotherapy for resectable macroscopic stage III melanoma. The speed at which the field is progressing, and the frequency of important publications on the topic, mean that regular review articles are useful to the scientific and wider community to keep abreast of this rapidly changing environment. PubMed and Cochrane databases were used to perform the literature search. We have contextualized the emergence of ipilimumab and nivolumab in the adjuvant and neo-adjuvant treatment of resectable stage III melanoma with discussion of pivotal studies, and how they influence the current guidelines. The future is looking brighter for patients with Stage III melanoma. The pendulum has swung away from radical surgery, and toward less invasive procedures and bespoke systemic treatment options based on tumor characteristics, patient factors, and response to neo-adjuvant therapy.

Geriatric nursing competence and training needs among dermatology nurses: A cross-sectional study

2025-06-18

Jinlian Feng , Yuling Zhong , Xueyu He +4 more | Journal of Nursing Education and Practice

Objective: To investigate the current status of geriatric nursing competence among dermatology nurses and analyze its potential related factors. Methods: A cross-sectional quantitative study was conducted with 550 dermatology nurses … Objective: To investigate the current status of geriatric nursing competence among dermatology nurses and analyze its potential related factors. Methods: A cross-sectional quantitative study was conducted with 550 dermatology nurses from 20 medical institutions in China. Data were collected using a questionnaire containing sociodemographic variables and the Geriatric Nursing Competency Assessment Scale for Clinical Nurses, which includes primary, secondary, and tertiary dimensions. Multivariate linear regression was used for analysis. Results: The overall mean score for geriatric nursing competence among dermatology nurses was 2.36 &plusmn; 0.90. Among the three primary dimensions, &ldquo;professional competence&rdquo; received the highest score (2.46 &plusmn; 0.89). Of the ten secondary dimensions, &ldquo;critical thinking&rdquo; achieved the highest score (2.48 &plusmn; 0.96), while &ldquo;research and innovation&rdquo; received the lowest score (2.15 &plusmn; 1.05). Experience in caring for elderly patients, the duration of geriatric nursing training, and the presence of patients aged &plusmn; 60 years were the main factors related to geriatric nursing competence. The level of the healthcare institution, educational background, work experience, and the degree of specialization in geriatric nursing training were statistically significant factors influencing dermatology nurses&#39; competence.&nbsp; Conclusions: The geriatric nursing competence of dermatology nurses is moderate. There is an urgent need to strengthen research development and promote professional growth.

Association between Obesity and Melanoma Risk in an Asian Population: A Nationwide Cohort Study

2025-06-18

Hye Yeon Koo , Kyungdo Han , Ji‐Hye Park +5 more | Cancer Research and Treatment

Previous studies from mostly Western populations have suggested possible associations between obesity and melanoma risk. This study aimed to investigate associations between obesity status and melanoma using a nationwide cohort … Previous studies from mostly Western populations have suggested possible associations between obesity and melanoma risk. This study aimed to investigate associations between obesity status and melanoma using a nationwide cohort of Koreans. 4,441,403 adults who received a national health examination in 2012 were included from the Korean National Health Insurance Service database, and followed until December 31, 2022. Obesity status was defined based on the body mass index at the baseline health examination. Cox proportional hazards analyses were performed to evaluate associations between obesity status and incident melanoma, with adjustment for confounders. Stratified analyses were performed by sex and menopausal status (in women). Overall, melanoma risk increased according to obesity status (p for trend=0.024); adjusted hazard ratios (95% confidence intervals) for melanoma risk were 0.766 (0.438-1.340) in underweight; 1.292 (1.072-1.557) in overweight; 1.202 (1.002-1.442) in obesity; and 1.191 (0.798-1.778) in severe obesity compared to normal weight (reference). In stratified analyses, similar trends to those of the overall study population were observed among men and premenopausal women (p for trend=0.052 in men and 0.036 in premenopausal women). Among premenopausal women, the risk of melanoma increased linearly with obesity status. Meanwhile, among postmenopausal women, melanoma risk showed no significant difference or trend according to obesity status. Overweight and obesity were associated with increased risk of melanoma in a population-based cohort of Koreans. Obese individuals, especially men and premenopausal women, may require more thorough prevention and screening strategies for melanoma.

Bridging clinic to home: domestic devices in dermatological diagnostics and treatments

2025-06-18

Diala Haykal , Frédéric Flament | Frontiers in Digital Health

The integration of diagnostic and therapeutic tools into home-used devices has significantly transformed dermatology, making advanced skincare technologies more accessible to the public. Home-based diagnostic devices empower individuals to monitor, … The integration of diagnostic and therapeutic tools into home-used devices has significantly transformed dermatology, making advanced skincare technologies more accessible to the public. Home-based diagnostic devices empower individuals to monitor, assess, and track skin conditions in real time, promoting earlier interventions and personalized skincare. Therapeutic devices, on the other hand, enable users to actively treat cosmetic and dermatological concerns, offering greater autonomy in managing skin health outside the clinical setting. These technologies, often inspired by clinical-grade equipment, promise enhanced patient engagement but also raise critical questions regarding safety, efficacy, and regulatory oversight. Importantly, the regulatory status of these devices, particularly for diagnostic tools, varies significantly across regions, affecting standards for quality, permitted energy outputs, and intended uses. This commentary separately explores the opportunities and challenges posed by home-used diagnostic and therapeutic devices, evaluates their roles in cosmetic dermatology, and highlights key insights from the literature to contextualize their growing influence on personalized skincare.

Research on melanoma depth of invasion prediction method

2025-06-18

Zhao Caifeng , V.M. Dubovoi | Optoelectronic Information-Power Technologies

Melanoma, a highly malignant skin tumor, relies on its Depth of Invasion (DoI) as a critical metric for assessing tumor malignancy, predicting patient prognosis, and guiding treatment strategies. Traditional DoI … Melanoma, a highly malignant skin tumor, relies on its Depth of Invasion (DoI) as a critical metric for assessing tumor malignancy, predicting patient prognosis, and guiding treatment strategies. Traditional DoI measurement methods are manual, time-consuming, and prone to errors due to complex tissue morphologies and the need for fine annotations. This study introduces a novel Convolutional Neural Network (CNN)-based framework that integrates image patch classification with morphological processing to achieve high-precision DoI prediction under coarse annotations. The approach comprises four modules: pathology tissue differentiation using Otsu thresholding and morphological operations, lesion and epidermal region identification via EfficientNetB0 classification, and DoI measurement through least-squares boundary fitting. Experimental results on a melanoma dataset demonstrate a Mean Absolute Error (MAE) of 0.503 mm and a Root Mean Square Error (RMSE) of 0.169 mm, significantly outperforming traditional segmentation networks such as UNet and Attention-UNet. This method provides a robust and efficient solution for automated melanoma diagnosis, with substantial potential for clinical translation.

AdaBoost-NEAT: A Novel Machine Learning Approach for Accurate Skin Disease Classification with Multi-Feature Integration

2025-06-18

K. Sri Rama Krishna , V. Selvi | International Journal of Computational and Experimental Science and Engineering

Accurate and early diagnosis of dermatological conditions remains a critical challenge in healthcare, with misdiagnosis leading to severe patient outcomes. This study introduces a novel framework for skin disease classification … Accurate and early diagnosis of dermatological conditions remains a critical challenge in healthcare, with misdiagnosis leading to severe patient outcomes. This study introduces a novel framework for skin disease classification by integrating evolutionary computation, ensemble learning, and multi-modal feature analysis. We propose a hybrid Neuro Evolution of Augmenting Topologies (NEAT) architecture, enhanced through AdaBoost optimization, to evolve neural network topologies dynamically while prioritizing discriminative feature combinations. Our methodology leverages multi-modal feature fusion, combining texture, color, and deep spectral descriptors to capture clinically relevant patterns across dermatological imaging data. Experiments conducted on benchmark datasets, including the ISIC archive and HAM10000, demonstrate the superiority of our approach over state-of-the-art models. The proposed system achieves 98.7% classification accuracy (placeholder value—replace with actual result), outperforming conventional SVM (92.1%), KNN (89.6%), and baseline NEAT (95.3%) through rigorous cross-validation. Further analysis reveals significant improvements in sensitivity (97.2%) and specificity (99.1%), addressing critical gaps in minority class identification. By unifying evolutionary neural architectures with adaptive boosting and multi-scale feature engineering, this work advances automated dermatological diagnosis, offering a clinically interpretable tool for distinguishing malignant, inflammatory, and infectious skin conditions. Comparative ablation studies validate the synergistic impact of fused feature representations and ensemble evolutionary learning, positioning the framework as a transformative solution for intelligent dermatology decision support systems.

Epiderma Shield: CNN-Based Classification of Skin Diseases

2025-06-18

Adarsh Gupta | International Journal for Research in Applied Science and Engineering Technology

Skin diseases are a medical condition that affects the skin. The cause of these diseases might be a virus, infection, bacteria, allergy, etc. These diseases cause itchiness, rashes, inflammation, or … Skin diseases are a medical condition that affects the skin. The cause of these diseases might be a virus, infection, bacteria, allergy, etc. These diseases cause itchiness, rashes, inflammation, or skin changes. To recognize and differentiate these skin conditions, we have some traditional methods like blood testing and skin scraping and some modern technology too, like lasers and microscopes, but the problem is either they are less accurate or very expensive. To overcome these, we can introduce AI in the health sector, which makes tasks very easy and cheap. The introduction of a deep learning model integrated with image preprocessing in computer vision provides remote access ith the ability to detect various skin-related diseases at early stages.

Skin Lesion Classification Using Deep Learning

2025-06-18

Yash Pande | International Journal for Research in Applied Science and Engineering Technology

Skin lesion is one of the most common types of cancer globally, and early recognition is essential for a better prognosis for patients. In this paper, we built a machine … Skin lesion is one of the most common types of cancer globally, and early recognition is essential for a better prognosis for patients. In this paper, we built a machine learning-based image classification system to classify dermoscopic skin lesion images into a range of diseases. We adopted the publicly available HAM10000 dataset and preprocessed it for model optimization and the prevention of overfitting, including image resizing, normalization, and data augmentation. We also investigated class distribution to see the data imbalance and give a hint for model training. To demonstrate the classification ability, we conducted the experiment with four models, including SVM, CNN, VGG16, and ResNet50.The SVM achieved an accuracy of approximately 80%, while the CNN improved this to 92%. The VGG16 model further increased the accuracy to 94%. ResNet50 outperformed all other models, achieving the highest accuracy of 95%. Our results demonstrate that deep learning models, particularly ResNet50 and VGG16, are highly effective in skin lesion classification and have significant potential for supporting early skin cancer diagnosis and aiding healthcare professionals in clinical decision-making

Immunohistochemistry and Ancillary Studies in Diagnostic Dermatopathology

2025-06-17

| Cambridge University Press eBooks

Immunohistochemistry and ancillary studies play a crucial role in diagnostic pathology. Yet, few books cover their practicality in diagnostic dermatopathology. This book provides a practical guide to the application of … Immunohistochemistry and ancillary studies play a crucial role in diagnostic pathology. Yet, few books cover their practicality in diagnostic dermatopathology. This book provides a practical guide to the application of rapid and cost-effective immunohistochemistry, as well as ancillary studies including immunofluorescence and molecular studies. With a focus on practicality and bridging knowledge gaps, the book covers helpful diagnostic stains and pertinent ancillary studies, organized by lines of differentiation. Each chapter includes a synopsis of antibodies, immunohistochemical panels, summary tables outlining staining patterns, and case studies. Now in its second edition, this book covers entities based on lineage, including epithelial, adnexal, melanocytic, lymphoid, and soft tissue, and discusses the role of molecular studies in the diagnosis of cutaneous neoplasms and soft tissue lesions. This comprehensive volume is an essential resource for pathologists, dermatopathologists, and residents in pathology and dermatology.

Dermoscopic evaluation of normal canine skin with a handheld dermoscope

2025-06-17

Rachael Loek , David Gardiner , George A. Moore +2 more | Veterinary Dermatology

Abstract Background Dermoscopy is a noninvasive diagnostic tool that provides a magnified view of skin structures. While dermoscopy is described for certain canine dermatological diseases, large‐scale studies evaluating normal skin … Abstract Background Dermoscopy is a noninvasive diagnostic tool that provides a magnified view of skin structures. While dermoscopy is described for certain canine dermatological diseases, large‐scale studies evaluating normal skin are lacking. Hypothesis/Objective This study aimed to correlate dermoscopic findings with histopathological results in healthy canine skin to enhance understanding of dermoscopic microanatomy and pigmentation patterns. Animals Healthy, adult, shelter dogs ( n = 121). Materials and Methods After general anaesthesia for prescheduled sterilisation procedures, four regions on each dog were assessed using a handheld dermoscope followed by collecting a biopsy for histopathological investigation. Dermoscopic assessment included skin colour and pattern, presence of scale and blood vessel number. Dermoscopic findings were correlated with histopathological characteristics. Results Dermoscopy identified grey as the most common skin colour, diffuse as the primary pattern, most commonly mild scale and primarily absent blood vessels. Dermoscopy correlation with histopathological results identified moderate scale as more likely to have hyperkeratosis, and no significant correlation between visualised blood vessels and number of endothelial cells. Furthermore, the dermoscopic colour brown was more likely to have melanin within each epidermal layer, while white was less likely to have melanin within each layer. Despite the lack of gross and dermoscopic inflammation, such as erythema, 53 of 484 sites had histopathological evidence of inflammation, with primarily mild mastocytic and eosinophilic superficial dermatitis. Conclusions and Clinical Relevance Dermoscopy can identify characteristics in canine skin that correlate with histopathological results, yet mild inflammation may remain undetected. This correlation better establishes baselines for future studies utilising dermoscopy when assessing dermatological diseases.

Dermoscopic Features and Their Association With Breslow Thickness of Facial Lentigo Maligna in Koreans: A Multi‐Center Retrospective Study

2025-06-17

Jae Sung Lee , Ji Su Lee , Jun Young Kim +3 more | The Journal of Dermatology

ABSTRACT Background Owing to the rarity of lentigo maligna (LM) and lentigo maligna melanoma (LMM) in East Asians, their dermoscopic features are underreported. The prognosis and management of LM and … ABSTRACT Background Owing to the rarity of lentigo maligna (LM) and lentigo maligna melanoma (LMM) in East Asians, their dermoscopic features are underreported. The prognosis and management of LM and LMM depend on the Breslow thickness (BT). However, the association between BT and the dermoscopic features of LMM is largely unknown. Objectives To report the dermoscopic features of LM/LMM in Koreans and analyze the association between BT and dermoscopic findings of LMM. Methods This retrospective study included 46 patients with facial LM/LMM (32 patients had ≤ 1 mm BT and 14 had > 1 mm) collected from three tertiary hospitals in Korea. The frequency of each dermoscopic feature of LM/LMM was assessed according to the BT. Logistic regression analysis was performed to investigate the association between certain dermoscopic patterns and BT in patients with LM/LMM. Results Observed dermoscopic patterns in Korean patients with LM/LMM included asymmetrical pigmented follicular openings (100%), asymmetry of the overall shape (97.8%), annular–granular pattern (95.7%), dark rhomboids (95.7%), blotches (78.3%), polychromy (45.7%), blue–white veil (41.3%), thin brown network (36.4%), regression structures (19.6%), and fingerprint pattern (8.7%). Milky‐red areas (32.6%), red rhomboids (26.1%), linear vessels (21.7%), arborizing vessels (8.7%), dotted vessels (2.2%), and hairpin vessels (2.2%) were also observed. Multivariable logistic regression revealed that a blue–white veil (odds ratio [OR], 42.895; 95% confidence interval [CI], 1.878–979.565), red rhomboids (OR, 13.666; 95% CI, 1.070–174.552), and linear vessels (OR, 18.823; 95% CI, 1.357–261.107) were significantly associated with LMM with a BT of > 1 mm. The predictive model (range: 0–7) had a reliable diagnostic value (area under the curve = 0.964). Conclusions This study provides an in‐depth analysis of the dermoscopic features of LM/LMM in East Asian patients. Preoperative dermoscopy, which provides BT information, may help determine the appropriate management of LMM.

Can MUM1 Be a Useful Marker for Differentiating Malignant Melanoma From Benign Nevi?

2025-06-17

Masatomo Doi , Junki Koike , Motohiro Chosokabe +1 more | American Journal of Dermatopathology

Abstract: Reliable markers are needed to help differentiate malignant melanoma (MM) from benign melanocytic nevi (BMN). MUM1 (multiple myeloma oncogene 1)/IRF4, a transcription factor expressed in tumors such as MM, … Abstract: Reliable markers are needed to help differentiate malignant melanoma (MM) from benign melanocytic nevi (BMN). MUM1 (multiple myeloma oncogene 1)/IRF4, a transcription factor expressed in tumors such as MM, may be a potential diagnostic marker. This study evaluated MUM1 expression in MM and BMN using the Allred scoring system. This retrospective, single-center study included patients diagnosed with MM or BMN through excision biopsy at St. Marianna University Hospital between January 1, 2019 and December 31, 2021. Immunohistochemical staining for MUM1, S-100, HMB45, and Melan A was performed on paraffin sections. Two certified pathologists, masked to the diagnoses, independently evaluated the staining. MUM1 expression was scored using the Allred system, including the proportion score (PS), intensity score (IS), and total score (TS). This study included 32 patients with MM and 36 patients with BMN. S-100 was positive in all patients with MM, and HMB45 and MelanA were positive for 94% of patients with MM. MUM1 staining was positive in 97% of patients with MM and 100% of patients with BMN. The most common PS was 5, observed in 72% of patients with MM and in 50% of patients with BMN. An IS of 2 was the most frequent in 59.4% of the patients with MM and 66.7% of the patients with BMN. A TS of 7 was the most common in 62.5% of the patients with MM and 55.6% of the patients with BMN. No significant differences in the PS, IS, or TS were observed. These findings suggest that although MUM1 is a sensitive marker, it is not reliable for distinguishing MM from BMN.

ASO Visual Abstract: Validation of Invasive Area for Predicting Sentinel Node Status and Survival in Primary Cutaneous Melanoma

2025-06-17

Sophie E Orme , Mark Bamford , Marie O'Riordan +7 more | Annals of Surgical Oncology

Welch Allyn Connex Monitor, Accessories

2025-06-16

| Biomedical Safety & Standards

FFTL-Net: A network for the classification of skin diseases based on feature fusion and transfer learning

2025-06-16

Xiaowei Song , Y. Mei , Zhilei Zhao +5 more | Machine Learning Science and Technology

Abstract The objective is to address the issues of data imbalance, overfitting, and inadequate generalisation ability in skin disease datasets and recognition models. The proposed model for the classification of … Abstract The objective is to address the issues of data imbalance, overfitting, and inadequate generalisation ability in skin disease datasets and recognition models. The proposed model for the classification of skin diseases is based on the fusion of features and the utilisation of transfer learning. The model's architecture is predicated on a dense connection network that serves as its fundamental framework, with LBP and HOG features incorporated as supplementary inputs. Subsequently, a feature fusion module integrated with an attention mechanism is employed to extract and combine features. Finally, the Softmax-loss function of category equilibrium and the domain adaptive strategy based on the maximum mean difference are established. The integration of prior knowledge into the deep network is a critical step in addressing the challenges of overfitting and data imbalance in skin disease classification. The FFTL-Net achieved AUC value of 98.16% on the ISIC 2018 dataset and 98.31% on the ISIC 2019 dataset. This represents an improvement of 1.25% and 0.33% compared to the second-ranked algorithm, respectively. The experimental results demonstrate the efficacy of the model in addressing the data imbalance issue in skin disease datasets, with prediction accuracies of at least 93% being achieved for BCC and other rare samples. The model demonstrates superior recognition accuracy, augmented generalisation capability, and an absence of indications of overfitting.

Comparative analysis of clinical, morphological and prognostic parameters of non-metastatic skin melanoma

2025-06-16

Kirill Silakov , O. E. Abramova , E. V. Shako +7 more | Research and Practical Medicine Journal

Modern understanding of melanoma carcinogenesis and progression highlights the importance of identifying risk factors and prognosis at early stages. Purpose of the study. Analysis of clinical characteristics in patients with … Modern understanding of melanoma carcinogenesis and progression highlights the importance of identifying risk factors and prognosis at early stages. Purpose of the study. Analysis of clinical characteristics in patients with skin melanoma. Patients and methods. A retrospective analysis of the medical records of 142 patients with skin melanoma has been carried out. Data on age, gender, tumor localization, disease stage according to the American Joint Committee on Cancer (8th ed., 2017), histological types according to the WHO classification (2022), as well as treatment methods and disease outcomes have been analyzed. Results. Among the studied patients with skin melanoma, women predominated – 78 cases (54.9 %), men – 64 cases (45.1 %). The average age of patients was 63 ± 5.6 years, ranging from 29 to 88 years. Melanoma was most frequently diagnosed at advanced stages: stages IIIA–IIID were detected in 53 patients (37.3 %), stages IIA–IIC – in 40 (28.2 %), and stages 0 and IA–IB – in 16 (11.3 %) and 33 (23.2 %) patients, respectively. The predominant histological types were nodular melanoma (48.6 %) and superficially spreading melanoma (38.7 %). The most common tumor localizations were the skin of the lower extremities (32.3 %) and the back (30.9 %). In 23 patients (16.2 %) with disease progression, metastases were detected in the brain, lymph nodes, liver, lungs, and bones. Conclusions. The carried-out analysis can help clarify the clinical and morphological features of skin melanoma and improve diagnostic and therapeutic approaches.

ASSESSMENT OF PATTERN OF SKIN DISEASES AMONG PATIENTS ATTENDING OUT-PATIENT DERMATOLOGY CLINIC

2025-06-16

B. Jyothsna , P Latha , Shabin Taj | Journal of Population Therapeutics and Clinical Pharmacology

Early diagnosis and delayed treatment of anorectal melanoma in a 19-year-old female: A case report

2025-06-14

Yousef Saffaf , Hazem Arab , Ahmed Aldolly +2 more | International Journal of Surgery Case Reports

Skin Cancer Detection using Harmonic Brown Bear Optimization enabled Transfer Learning

2025-06-14

M. Manickavasagam , Vaddadi Vasudha Rani , Uttam Kumar Giri +1 more | Computational Biology and Chemistry

ASO Visual Abstract: Association of Weight-Bearing Activity and Prognosis of Plantar Melanoma—An Unanticipated Perspective

2025-06-14

Jina Kim , Dong‐Youn Lee , Goo‐Hyun Mun +1 more | Annals of Surgical Oncology

Japanese Dermatological Association Guidelines: Clinical Questions of Guidelines for Melanoma 2025

2025-06-13

Satoshi Fukushima , Takamichi Ito , Jun Asai +7 more | The Journal of Dermatology

ABSTRACT Advancements in melanoma management have underscored the need for periodic guideline updates every few years to reflect current clinical practices. Previous versions of melanoma clinical practice guidelines in Japan … ABSTRACT Advancements in melanoma management have underscored the need for periodic guideline updates every few years to reflect current clinical practices. Previous versions of melanoma clinical practice guidelines in Japan have primarily aimed to reflect global standards of care. This focus on international benchmarks was largely attributed to the scarcity of high‐quality evidence from East Asia, necessitating reliance on Western references. Recent findings indicate differences in melanoma subtypes and drug efficacy between Western and East Asian populations. Therefore, efforts were made to incorporate data from East Asia in this revision, aiming to develop guidelines that better reflect the region's unique characteristics. This revision was commissioned by the Japanese Dermatological Association (JDA) and Japanese Skin Cancer Society (JSCS) and was undertaken by a committee comprising experts across relevant fields who meticulously reviewed and systematized a wide range of literature on melanoma to develop comprehensive, evidence‐based guidelines. Literature searches were conducted by the Japan Medical Library Association. The recommendation statements were determined using the GRADE Grid approach. The guideline was developed in accordance with the Minds Clinical Practice Guideline Creation Manual 2020, ver. 3.0. Twelve clinical questions (CQs) were established, and corresponding recommendation statements were provided for each CQ. For several CQs, the inclusion of data from East Asia resulted in recommendations that differed from those in Western guidelines. Considering that the biology of melanoma has been increasingly recognized to vary by subtype and ethnicity, guidelines should be developed independently for each region based on evidence specific to the melanoma characteristics of that region. We firmly believe that this JDA clinical guideline for melanoma will contribute to improving melanoma management in East Asia.