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Articles by A. A Marghoob
Total Records ( 2 ) for A. A Marghoob
  A Rishpon , N Kim , A Scope , L Porges , M. C Oliviero , R. P Braun , A. A Marghoob , C. A Fox and H. S. Rabinovitz
 

Objective  To identify criteria for the diagnosis of squamous cell carcinoma (SCC) and actinic keratosis (AK) by in vivo reflectance confocal microscopy (RCM).

Design  Prospective RCM imaging of lesions suspected clinically and/or dermoscopically to be SCC or AK, followed by RCM assessment of the biopsy-proven SCCs and AKs.

Setting  Private skin cancer clinic, Plantation, Florida.

Patients  A total of 38 lesions in 24 patients were assessed, including 7 AKs, 25 SCCs in situ, 3 invasive SCCs, and 3 keratoacanthomas.

Interventions  Prior to undergoing biopsy, all lesions were assessed by RCM.

Results  Mosaic RCM images at the stratum corneum level revealed scale in 29 SCCs (95%) and in all 7 AKs. Polygonal nucleated cells at the stratum corneum were seen in 3 SCCs (10%) and 1 AK (14%). All 38 cases displayed an atypical honeycomb and/or a disarranged pattern of the spinous-granular layer of the epidermis; round nucleated cells were seen in the spinous-granular layer in 20 SCCs (65%) and 1 AK (14%). Round blood vessels in the superficial dermis were seen in 28 SCCs (90%) and 5 AKs (72%).

Conclusions  An increasing frequency of abnormal RCM features can be observed across the spectrum of keratinocytic neoplasias. The presence of an atypical honeycomb or a disarranged pattern of the spinous-granular layer, round nucleated cells at the spinous-granular layer, and round blood vessels traversing through the dermal papilla are the key RCM features of SCC.

  G Pellacani , M Vinceti , S Bassoli , R Braun , S Gonzalez , P Guitera , C Longo , A. A Marghoob , S. W Menzies , S Puig , A Scope , S Seidenari and J. Malvehy
 

Objective  To test the interobserver and intraobserver reproducibility of the standard terminology for description and diagnosis of melanocytic lesions in in vivo confocal microscopy.

Design  A dedicated Web platform was developed to train the participants and to allow independent distant evaluations of confocal images via the Internet.

Setting  Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.

Participants  The study population was composed of 15 melanomas, 30 nevi, and 5 Spitz/Reed nevi. Six expert centers were invited to participate at the study.

Intervention  Evaluation of 36 features in 345 confocal microscopic images from melanocytic lesions.

Main Outcome Measure  Interobserved and intraobserved agreement, by calculating the Cohen statistics measure for each descriptor.

Results  High overall levels of reproducibility were shown for most of the evaluated features. In both the training and test sets there was a parallel trend of decreasing values as deeper anatomic skin levels were evaluated. All of the features, except 1, used for melanoma diagnosis, including roundish pagetoid cells, nonedged papillae, atypical cells in basal layer, cerebriform clusters, and nucleated cells infiltrating dermal papillae, showed high overall levels of reproducibility. However, less-than-ideal reproducibility was obtained for some descriptors, such as grainy appearance of the epidermis, junctional thickening, mild atypia in basal layer, plump bright cells, small bright cells, and reticulated fibers in the dermis.

Conclusion  The standard consensus confocal terminology useful for the evaluation of melanocytic lesions was reproducibly recognized by independent observers.

 
 
 
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