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Keywords = cherry angiomas

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27 pages, 5721 KiB  
Article
Cutaneous Changes Beyond Psoriasis: The Impact of Biologic Therapies on Angiomas and Solar Lentigines
by Florin Ciprian Bujoreanu, Diana Sabina Radaschin, Ana Fulga, Laura Bujoreanu Bezman, Carmen Tiutiuca, Mihaela Crăescu, Carmen Pantiș, Elena Niculet, Alina Pleșea Condratovici and Alin Laurențiu Tatu
Medicina 2025, 61(4), 565; https://doi.org/10.3390/medicina61040565 - 22 Mar 2025
Viewed by 874
Abstract
Background and Objectives: Psoriasis is a chronic inflammatory skin disease, and biologic therapies have revolutionized treatment by targeting key cytokine pathways. While these therapies effectively control psoriatic lesions, their impact on other cutaneous structures, such as cherry angiomas and solar lentigines, remains [...] Read more.
Background and Objectives: Psoriasis is a chronic inflammatory skin disease, and biologic therapies have revolutionized treatment by targeting key cytokine pathways. While these therapies effectively control psoriatic lesions, their impact on other cutaneous structures, such as cherry angiomas and solar lentigines, remains unclear. Angiomas are benign vascular proliferations influenced by systemic inflammation and hormonal factors, whereas solar lentigines are UV-induced pigmentary lesions associated with aging and sun exposure. This study aimed to assess the impact of biologic therapies on the development of these lesions in psoriasis patients. Materials and Methods: This retrospective observational study was conducted over a five-year period (2019–2024) at a tertiary dermatological center in Southeastern Europe. Clinical and demographic data, including treatment history, were extracted from medical records, while digital dermoscopy was used to assess lesion progression. Statistical analyses evaluated associations among biologic therapy classes, systemic inflammation, and cutaneous lesion development. Results: Angioma prevalence was significantly higher among postmenopausal women and those with osteoporosis, suggesting a hormonal influence on vascular proliferation. Patients with psoriatic arthritis had a greater angioma burden, reinforcing the role of chronic inflammation in angiogenesis. IL-23 inhibitors were linked to increased angioma formation compared to TNF-α inhibitors, while methotrexate and UVB therapy appeared to have a protective effect. Solar lentigines were more frequent in postmenopausal women and in patients with systemic inflammatory conditions. In contrast, smoking and moderate alcohol consumption were associated with lower lesion counts. Conclusions: Our findings suggest that biologic therapies, particularly IL-23 inhibitors, may contribute to angiogenesis and pigmentary changes in psoriasis patients, highlighting the influence of systemic inflammation on vascular and melanocytic activity. Additionally, TNF-α inhibitors and NSAIDs were associated with an increased prevalence of solar lentigines, while methotrexate and UVB therapy appeared to have a protective effect. Given these associations, further research is needed to elucidate the underlying mechanisms and refine treatment strategies to optimize dermatologic care for psoriasis patients. Full article
(This article belongs to the Special Issue Psoriasis: Pathogenesis and Therapy)
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13 pages, 4566 KiB  
Review
Reflectance Confocal Microscopy and Dermoscopy for the Diagnosis of Solitary Hypopigmented Pink Lesions: A Narrative Review
by Luca Ambrosio, Anna Pogorzelska-Antkowiak, Chiara Retrosi, Giovanni Di Lella, Marco Spadafora, Iris Zalaudek, Caterina Longo, Giovanni Pellacani and Claudio Conforti
Cancers 2024, 16(17), 2972; https://doi.org/10.3390/cancers16172972 - 26 Aug 2024
Viewed by 1585
Abstract
Diagnosing solitary pink skin lesions poses a significant challenge due to the scarcity of specific clinical and dermoscopic criteria. Several benign lesions, such as cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus, often exhibit similar clinical and dermoscopic [...] Read more.
Diagnosing solitary pink skin lesions poses a significant challenge due to the scarcity of specific clinical and dermoscopic criteria. Several benign lesions, such as cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus, often exhibit similar clinical and dermoscopic features. This similarity extends to some malignant lesions, including basal cell carcinoma, actinic keratosis, and amelanotic melanoma, making differentiation difficult. Recent studies highlight the enhanced diagnostic accuracy of reflectance confocal microscopy (RCM), which offers increased sensitivity and specificity compared to dermoscopy alone for diagnosing skin cancer. This study aims to summarize the application of dermoscopy and RCM in distinguishing between benign and malignant pinkish–reddish skin lesions. The integration of RCM with traditional dermoscopic techniques improves the ability to accurately identify and differentiate these lesions. However, it is crucial to note that for any suspicious lesions, a final diagnosis must be confirmed through surgical excision and histopathological evaluation. This comprehensive approach ensures accurate diagnosis and appropriate treatment, highlighting the importance of combining advanced imaging techniques in clinical practice. Full article
(This article belongs to the Special Issue Dermoscopy in Skin Cancer)
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17 pages, 3455 KiB  
Article
Color Analysis of Merkel Cell Carcinoma: A Comparative Study with Cherry Angiomas, Hemangiomas, Basal Cell Carcinomas, and Squamous Cell Carcinomas
by Dimitra Koumaki, Georgios Manios, Marios Papadakis, Aikaterini Doxastaki, Georgios Vasileiou Zacharopoulos, Alexander Katoulis and Andreas Manios
Diagnostics 2024, 14(2), 230; https://doi.org/10.3390/diagnostics14020230 - 22 Jan 2024
Cited by 1 | Viewed by 5830
Abstract
Merkel cell carcinoma (MCC) is recognized as one of the most malignant skin tumors. Its rarity might explain the limited exploration of digital color studies in this area. The objective of this study was to delineate color alterations in MCCs compared to benign [...] Read more.
Merkel cell carcinoma (MCC) is recognized as one of the most malignant skin tumors. Its rarity might explain the limited exploration of digital color studies in this area. The objective of this study was to delineate color alterations in MCCs compared to benign lesions resembling MCC, such as cherry angiomas and hemangiomas, along with other non-melanoma skin cancer lesions like basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), utilizing computer-aided digital color analysis. This was a retrospective study where clinical images of the color of the lesion and adjacent normal skin from 11 patients with primary MCC, 11 patients with cherry angiomas, 12 patients with hemangiomas, and 12 patients with BCC/SCC (totaling 46 patients) were analyzed using the RGB (red, green, and blue) and the CIE Lab color system. The Lab color system aided in estimating the Individual Typology Angle (ITA) change in the skin, and these results are documented in this study. It was demonstrated that the estimation of color components can assist in the differential diagnosis of these types of lesions because there were significant differences in color parameters between MCC and other categories of skin lesions such as hemangiomas, common skin carcinomas, and cherry hemangiomas. Significant differences in values were observed in the blue color of RGB (p = 0.003) and the b* parameter of Lab color (p < 0.0001) of MCC versus cherry angiomas. Similarly, the mean a* value of Merkel cell carcinoma (MCC) compared to basal cell carcinoma and squamous cell carcinoma showed a statistically significant difference (p < 0.0001). Larger prospective studies are warranted to further validate the clinical application of these findings. Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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18 pages, 15758 KiB  
Article
Clinical, Dermoscopic, Ultrasonographic, and Histopathologic Correlations in Kaposi’s Sarcoma Lesions and Their Differential Diagnoses: A Single-Center Prospective Study
by Athanasia Tourlaki, Gianluca Nazzaro, Yiran Wei, Stefano Buffon, Maria A. Mattioli, Angelo V. Marzano and Lucia Brambilla
J. Clin. Med. 2023, 12(1), 278; https://doi.org/10.3390/jcm12010278 - 29 Dec 2022
Cited by 12 | Viewed by 3642
Abstract
(1) Background: Kaposi’s sarcoma (KS) is an angioproliferative neoplasm typically appearing as angiomatous patches, plaques, and/or nodules on the skin. Dermoscopy and ultrasonography have been suggested as an aid in the diagnosis of KS, but there is little evidence in the literature, especially [...] Read more.
(1) Background: Kaposi’s sarcoma (KS) is an angioproliferative neoplasm typically appearing as angiomatous patches, plaques, and/or nodules on the skin. Dermoscopy and ultrasonography have been suggested as an aid in the diagnosis of KS, but there is little evidence in the literature, especially regarding its possible differential diagnoses. Our aim is to describe and compare the clinical, dermoscopic, and ultrasonographic features of KS and KS-like lesions. (2) Methods: we conducted a prospective study on 25 consecutive patients who were first referred to our tertiary care center from January to May 2021 for a possible KS. (3) Results: 41 cutaneous lesions were examined by means of dermoscopy, Doppler ultrasonography, and pathology, 32 of which were KS-related, while the remaining 9 were lesions with clinical resemblance to KS. On dermoscopy, a purplish-red pigmentation, scaly surface, and the collarette sign were the most common features among KS lesions (81.3%, 46.9%, and 28.1%, respectively). On US, all 9 KS plaques and 21 KS nodules presented a hypoechoic image. Dermoscopic and Doppler ultrasonographic findings of KS-like lesions, such as cherry angioma, venous lake, glomus tumor, pyogenic granuloma, and angiosarcoma were also analyzed. (4) Conclusions: dermoscopy and Doppler ultrasonography can be useful to better assess the features of KS lesions and in diagnosing equivocal KS-like lesions. Full article
(This article belongs to the Special Issue Update on Skin Cancers: Non-invasive Diagnostic Tools and Treatment)
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7 pages, 1550 KiB  
Article
Clinicopathological and Dermoscopic Baselines in Patients with Lynch Syndrome
by Giovanni Paolino, Riccardo Pampena, Matteo Riccardo Di Nicola and Santo Raffaele Mercuri
Cancers 2023, 15(1), 114; https://doi.org/10.3390/cancers15010114 - 24 Dec 2022
Cited by 1 | Viewed by 5791
Abstract
Despite the fact that Lynch Syndrome (LS) patients may also develop extra-colonic malignancies, research evaluating the association between LS and skin cancers is currently very limited. We performed a monocentric clinical and dermoscopic study involving 42 LS patients which referred to the Dermatology [...] Read more.
Despite the fact that Lynch Syndrome (LS) patients may also develop extra-colonic malignancies, research evaluating the association between LS and skin cancers is currently very limited. We performed a monocentric clinical and dermoscopic study involving 42 LS patients which referred to the Dermatology Unit for cutaneous screenings. In total, 22 patients showed a mutation in MLH1 and 17 patients a MSH2 mutation. Out of the entire cohort, 83% of LS patients showed brown hairs and 78% brown eyes, and the most frequent phototypes were III and II (respectively, 71.5% and 21%). A positive medical history for an internal malignancy was present in 36% of patients, with colon cancer as the most frequent malignancy in 60% of cases. A total of 853 cutaneous lesions have been analyzed: 47% of patients showed a total number of nevi > 10. The main observed dermoscopic features were a uniform reticular pattern (77% of patients), a mixed pattern (9% of patients) and a uniform dermal pattern (14% of patients). Eruptive cherry angiomas were present in 24% of cases, eruptive seborrheic keratosis in 26% and viral warts in 7% of cases; basal cell carcinoma was detected in 7% of cases. We have not found specific associations with specific skin manifestations, and the clinical and dermoscopic appearance of the pigmented lesions reflected the features present in the general population. To date, there are currently no guidelines for skin screening in LS patients. According to our study, there is insufficient evidence to ensure increased surveillance in LS patients; further studies with larger samples of patients are needed to better investigate dermatological and dermoscopic features in LS carriers. Full article
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