Navegando por Palavras-chave "Dermatoscopia"
Agora exibindo 1 - 4 de 4
Resultados por página
Opções de Ordenação
- ItemSomente MetadadadosAvaliação dos padrões dermatoscópicos das lesões melanocíticas nas áreas de transição entre a pele glabra e não-glabra(Universidade Federal de São Paulo (UNIFESP), 2019-12-18) Junco, Fernanda Braga [UNIFESP]; Hirata, Sergio Henrique [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the dermatoscopic patterns of melanocytic lesions in the transition zone between glabrous and non-glabrous skin. Methods: Retrospective study in which 82 cases of melanocytic lesions in the transition zone between glabrous and non-glabrous skin were selected, all of them evaluated in the dermatoscopy outpatient clinic of the Federal University of São Paulo - São Paulo School of Medicine (Universidade Federal de São Paulo - Escola Paulista de Medicina), between 1999 to 2018. The dermatoscopic pattern of each lesion was evaluated by two dermatologists with experience in dermatoscopy. The dermatoscopic pattern, the anatomical location in the palmoplantar region and the location on the Wallace line were studied. All variables were correlated with the chi-square test. Results: 82 melanocytic lesions in the palmoplantar transition zone were studied, in which 77 cases were benign melanocytic lesions in the transition zone between glabrous and non-glabrous skin and five were melanomas. All dermatoscopic patterns were grouped into single patterns and combined patterns. The frequency of single dermatoscopic patterns, in descending order, was: parallel grooves (22/77), grid (9/77), fibrillar (7/77), net (5/77), pod (3/77), globular (2/77), parallel crests (2/77). 27 lesions presented combined patterns (27/77) that are described in descending order: reticulate/parallel grooves (10/77), grid/parallel grooves (7/77), fibrillar/globular (2/77), grid/reticulate (2/77), pod/parallel grooves (2/77), globular/homogeneous (2/77), globular/parallel grooves (1/77), homogeneous/parallel grooves (1/77) and parallel crests/multicomponent (1/77). An anatomopathological exam was done in 17 of all 77 benign melanocytic lesions. The results, in descending order, were: lentiginous compound melanocytic nevi (8/17), compound melanocytic nevi (2/17), junctional melanocytic nevi (2/17), lentiginous junctional melanocytic nevi (2/17), lentiginous melanocytic nevus (2/17) and lentigo simplex (1/17). The other 60 cases that were not excised presented benign dermoscopic features and are in dermatoscopic follow-up. We analyzed the frequency of single and combined dermatoscopic patterns regarding the different locations of the palmoplantar region: fingers (14/77), toes (17/77), heel (19/77), lateral of the feet (14/77) and medial of the feet (13/77). We also evaluated the dermatoscopic patterns distribution in respect to the Wallace line: superior, exactly in the line’s center and inferior. There was no correlation between the combined dermatoscopic pattern and its palmoplantar anatomical location or the location of the transition nevus in the Wallace line. There was no correlation between the dermoscopic patterns and individuals age. Conclusions: The dermatoscopic pattern that was more present in the transition one between the glabrous and non-glabrous skin is the parallel grooves, followed by the reticular transition/parallel grooves pattern. The combined pattern was found in 35% of all lesions (27/77) and the transition dermatoscopic pattern was found in 12 of these combined pattern lesions (12/27). There was no correlation between the single and combined patterns with the anatomical location of the lesions in the different plantar areas or the location on the Wallace line.
- ItemAcesso aberto (Open Access)Características clínico-epidemiológicas e dermatoscópicas dos melanomas do couro cabeludo: estudo observacional multicêntrico(Universidade Federal de São Paulo, 2022-04-05) Pereira, Amanda Regio [UNIFESP]; Hirata, Sergio Henrique [UNIFESP]; Guitera, Pascale; http://lattes.cnpq.br/2040826097718565; http://lattes.cnpq.br/3948704483698892Objetivos: Analisar os aspectos clínicos e epidemiológicos dos melanomas do couro cabeludo, com ênfase na cobertura capilar, correlacionando-a com fatores prognósticos; descrever as características dermatoscópicas dos melanomas do couro cabeludo e determinar a acurácia diagnóstica da dermatoscopia para diferenciá-los de lesões pigmentadas benignas. Métodos: Melanomas primários do couro cabeludo diagnosticados ao longo de duas décadas em quatro centros de referência na Austrália e Itália foram incluídos retrospectivamente. Com base na documentação fotográfica, as lesões foram classificadas quanto à cobertura capilar e visibilidade por dois investigadores e correlacionadas com alguns fatores prognósticos (espessura de Breslow, índice mitótico e ulceração). Para a análise dermatoscópica, foram incluídos melanomas lentiginosos (lentigo maligno e lentigo maligno melanoma); como grupo controle, lesões pigmentadas benignas (lentigo solar, queratose actínica, queratose seborreica, queratose liquenoide) com confirmação histopatológica. As características dermatoscópicas foram analisadas por um examinador experiente e cego para o diagnóstico histopatológico. Dois examinadores experientes forneceram diagnósticos presuntivos para cada lesão, permitindo o cálculo da sensibilidade, especificidade, curva ROC e concordância inter-observadores. Regressão logística foi utilizada para a construção de um modelo preditivo de malignidade. Resultados: Para a análise clínico-epidemiológica foram incluídos 113 melanomas do couro cabeludo. A maioria destes localizavam-se em áreas de fácil visualização ao exame clínico (49% em couro cabeludo calvo; 15% na linha de implantação capilar). Demais melanomas (36%) foram considerados cobertos por cabelos, revelando mais frequentemente afinamento capilar (63%) do que densa cobertura capilar (37%). Melanomas de couros cabeludos com densa cobertura capilar foram mais frequentemente invasivos (81%) e com maior espessura de Breslow (mediana ± intervalo interquartil) (0,8 ± 1,3mm) do que melanomas de couros cabeludos calvos ou com afinamento capilar (43%; 0 ± 0,6mm), P=0,004. Entretanto, quando considerados apenas os casos invasivos (n=55), a espessura de Breslow e índice mitóticos não revelaram diferenças estatisticamente significativas entre áreas cobertas e áreas de fácil visibilidade. Para a análise dermatoscópica, foram incluídos 56 melanomas lentiginosos e 44 controles. Múltiplas características previamente descritas tanto para melanomas faciais quanto extrafaciais foram frequentemente identificadas em ambos os grupos. A sensibilidade dos examinadores para diagnosticar melanoma do couro cabeludo (IC95%) foi 76,8% (63,6-87,0) e 78,6% (65,6-88,4); especificidade de 54,5% (38,9-69,6) e 56.8% (41,0-71,7); e concordância razoável (coeficiente Kappa 0,248). Na regressão logística multivariada, as variáveis mais fortemente preditoras de malignidade foram: (OR, IC95%) heterogeneidade de cores (15,43, 1,48-160,3); linhas pigmentadas em distribuição reticular (14,96, 1,68-132,9); aumento da densidade da trama vascular (3,45, 1,09-10,92); e círculos acinzentados perifoliculares (2,89, 0,96-8,67). O modelo preditivo atingiu 85,7% (73,8-93,6) em sensibilidade, 61,4% (45,5-75,6) em especificidade e 81,5 (73,0-90,0) de área sob a curva para discriminar lesões benignas e malignas. Um fluxograma foi proposto visando melhorar a performance diagnóstica da dermatoscopia. Conclusão: A maioria dos melanomas do couro cabeludo são detectados em áreas de fácil visualização, que também são mais propensas ao fotodano crônico. Aqueles cobertos por cabelos, apesar de raros, são mais frequentemente invasivos. Padrões dermatoscópicos de melanomas faciais e extrafaciais podem ser identificados no couro cabeludo, com considerável sobreposição com lesões pigmentadas benignas, correlacionando-se com baixa especificidade e concordância inter-observadores à dermatoscopia.
- ItemAcesso aberto (Open Access)Diagnóstico do tumor glômico pela dermatoscopia do leito e da matriz ungueal(Sociedade Brasileira de Dermatologia, 2010-04-01) Maehara, Laura de Sena Nogueira [UNIFESP]; Ohe, Eugenia Maria Damasio [UNIFESP]; Enokihara, Mauro Yoshiaki [UNIFESP]; Michalany, Nilceo Schwery [UNIFESP]; Yamada, Sergio [UNIFESP]; Hirata, Sergio Henrique [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Surgery is the best treatment for glomus tumors. Sometimes this can be a challenging procedure because, despite being a well-defined tumor, its visualization can be difficult. The use of nail bed and matrix dermoscopy facilitates the diagnosis and aids in the localization and demarcation of the tumor. It is a simple and low-cost procedure that does not involve additional risks to the patient who will undergo surgery.
- ItemAcesso aberto (Open Access)Teledermatoscopia das lesões cutâneas pigmentadas(Universidade Federal de São Paulo (UNIFESP), 2009-07-29) Ishioka, Priscila [UNIFESP]; Almeida, Fernando Augusto de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: To evaluate agreement in diagnosis of pigmented skin lesions through presential or remote dermoscopic examination. To analyze diagnosis agreement of teledermoscopy and presential dermoscopic examination regarding pathological findings. To verify accuracy, sensibility and specificity of teledermoscopy in detection of malignant pigmented lesions. Methods: A total of 64 pigmented skin lesions were submitted to clinical and dermoscopic examinations performed presentially by two examiners experienced in dermoscopy, at the Dermoscopy Outpatient’s Clinic, Department of Dermatology, Universidade Federal de São Paulo (UNIFESP), in 2005. Two years later, the digital clinical and dermoscopic images of these cases were re-examined by the same specialists through transmission of images and clinical data via web. Agreement between presential diagnosis and telediagnosis was assessed by the Kappa (κ) statistic calculation and its respective 95% confidence interval (95% CI). Through this calculation, the agreement between presential presumptive diagnoses and telediagnoses with pathological findings was analyzed. Sensitivity, specificity and accuracy of two diagnostic modalities were obtained using the pathological examination as the gold standard. The respective 95% confidence interval (95% CI) was calculated for each diagnostic measurement. Results: Good diagnostic agreement was observed between presential examination and teledermoscopy, with a Kappa value of 0.698 (95% CI - [0.575; 0.821]). Good agreement was also found between conventional examination and teledermoscopy, and the pathological findings (gold standard) had Kappa values of 0.728 (95% CI - [0.608; 0.848]) and 0.656 (95% CI - [0.526; 0.785]), respectively. Accuracy of 84%, sensitivity of 93% and specificity of 78% were observed in detecting malignant pigmented lesions by remote dermoscopic examination. Two false negative cases were observed through teledermoscopy. There was no statistically significant difference in sensitivity, specificity and accuracy of both diagnostic methods. Conclusions: Remote dermoscopic examination by means of digital image transmission and of clinical data provided diagnostic accuracy, sensitivity and specificity comparable to conventional examination. Teledermoscopy proved to be an efficient and reliable method to detect malignant lesions, representing an important tool to screen pigmented lesions. The good diagnostic agreement between assessment via web and conventional examination highlights the applicability of teledermoscopy as a specialized assistance tool in regions that are difficult to reach or lack health resources.