Abstract:
BACKGROUND:Since the late 1970s clinical criteria for dysplastic melanocytic nevi (DMN) have been proposed and discussed. However, to our knowledge, no rigorous quantitative evaluation of the ability of examiners to agree on the gross morphologic features ascribed to DMN or atypical melanocytic lesions in general has been conducted. OBJECTIVE:The purpose of the study was to determine rates of interclinician agreement for recognizing seven clinical features associated with melanocytic lesions. METHODS:The gross morphologic features of 156 pigmented lesions, judged to be the clinically most atypical, from 156 consecutively examined patients with cutaneous melanoma were analyzed. Independent of the other clinicians' examinations, four physicians (two medical oncologists, one internist-epidemiologist, and one dermatologist-dermatopathologist) recorded seven gross morphologic features of the most atypical pigmented lesion on each patient. For up to 122 patients, the rates of interobserver agreement on recognizing these clinical features were measured by intraclass correlation. RESULTS:Among the clinical features assessed, the examiners noted macular components in 85.7% to 96.3% of lesions, asymmetry in 47.2% to 79.5%, irregular borders in 55.1% to 80.2%, ill-defined borders in 40.1% to 83.9%, and haphazard color in 40.8% to 73.9% of lesions. Despite this range of variance among examiners, there were statistically significant rates of interclinician agreement for the recognition of the latter features. There was less agreement in assessing individual colors within lesions. CONCLUSION:These findings substantiate that certain gross morphologic features routinely used in the clinical evaluation of melanocytic lesions can be recognized with a significant degree of reliability.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Barnhill RL,Roush GC,Ernstoff MS,Kirkwood JMdoi
10.1016/0190-9622(92)70023-9subject
Has Abstractpub_date
1992-02-01 00:00:00pages
185-90issue
2 Pt 1eissn
0190-9622issn
1097-6787pii
0190-9622(92)70023-9journal_volume
26pub_type
杂志文章abstract:BACKGROUND:Increasing incidence and mortality rates from cutaneous melanoma are a major public health concern. As part of a national effort to enhance early detection of melanoma/skin cancer, the American Academy of Dermatology (AAD) has sponsored an annual education and early detection program that couples provision o...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(96)90274-1
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Orthopedic surgical procedures involving the foot and ankle are associated with high rates of infection. The optimal method of preparing the skin and nails for foot and ankle surgery remains unknown. OBJECTIVE:This study was conducted to compare the efficacy of 4 different methods of skin and nail preparati...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jaad.2009.04.045
更新日期:2009-12-01 00:00:00
abstract::Infections with mycobacteria are of importance in the differential diagnosis of skin lesions in immunocompromised patients. We report the case of a human immunodeficency virus (HIV)-infected patient who presented with an annular plaque as cutaneous manifestation of Mycobacterium haemophilum. Improvement of the immunol...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/mjd.2000.102455
更新日期:2000-11-01 00:00:00
abstract::We hereby report a case presenting a rare form of secondary syphilis with an unusual nodular eruption accompanied by pruritus and generalized lymphadenopathy, bearing a striking resemblance to lymphoma. The histologic picture was also misleading and was compatible with lymphocytoma cutis. The diagnosis was eventually ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(87)70280-1
更新日期:1987-11-01 00:00:00
abstract::Our studies of mononuclear leukocyte peripheral blood homogenates demonstrate significantly increased cyclic adenosine monophosphate-specific phosphodiesterase activity in patients with atopic dermatitis who were untreated for 1 week, compared with normal adult nonatopic control subjects. Phosphodiesterase activity is...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(89)70150-x
更新日期:1989-07-01 00:00:00
abstract:UNLABELLED:Revolutionary advances in laser research and technology have led to expanded dermatologic laser applications. With the wide range of lasers now available, a large spectrum of skin conditions in the pediatric population can be successfully treated or, in some cases, completely eradicated. Laser treatment of t...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2003.08.004
更新日期:2004-02-01 00:00:00
abstract::The dynamics of symptomatic toe web infections often involve an ecologic interplay in which an initial dermatophyte infection provides a hospitable niche for subsequent colonization by bacteria. Several studies suggest that exacerbation of a mild dermatophyte infection (dermatophytosis simplex) can arise in the occlus...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(09)80301-0
更新日期:1993-05-01 00:00:00
abstract::Neutrophilic dermatoses are a heterogeneous group of inflammatory skin disorders that present with unique clinical features but are unified by the presence of a sterile, predominantly neutrophilic infiltrate on histopathology. The morphology of cutaneous lesions associated with these disorders is heterogeneous, which ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2017.11.064
更新日期:2018-12-01 00:00:00
abstract::Dialogues in Dermatology, a monthly audio program from the American Academy of Dermatology, contains discussions between dermatologists on timely dermatologic topics. Commentaries from the Dialogues Editor-in-Chief, Warren R. Heymann, MD, are provided after each discussion as a topic summary. These highlights are prov...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2004.03.012
更新日期:2004-07-01 00:00:00
abstract::The number of physicians who provide ambulatory care for patients with skin diseases is rapidly increasing. Current and proposed changes in health care financing may limit direct access to dermatologists. We provide recent data on volume of visits for cutaneous diagnoses, including the types of medical practitioners w...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(93)70243-m
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:While progress has been made in defining the clinical and histopathologic features of high-risk cutaneous squamous cell carcinoma (HRcSCC), optimal staging guidelines remain elusive. OBJECTIVE:We seek to guide clinical practice regarding nodal staging options for patients with HRcSCC via review of evolving ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2018.09.006
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Hereditary polymorphic light eruption (HPLE) occurs unique ly in the American Indian and Inuit and exhibits autosomal dominant transmission. Because the cutaneous expression of HPLE resembles that of polymorphic light eruption (PLE) and because many non-Indians in the United States have American Indian herit...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(96)80060-0
更新日期:1996-04-01 00:00:00
abstract::The antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the occurrence of arterial and/or venous thromboembolic events and obstetric complications in the setting of circulating antiphospholipid antibodies. Dermatologic manifestations are commonly seen in APS with almost half of the patients exhi...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2006.11.033
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Many patients who give a history of a dermatitis reaction to jewelry or metal contact with skin are negative to metals on standard patch testing. Some may be showing false-negative reactions. OBJECTIVE:Our purpose was to determine whether patients with a history of jewelry reactions but whose standard patch...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/mjd.2000.107235
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Isotretinoin is a very effective drug for treating severe recalcitrant nodular acne. A new micronized formulation of isotretinoin has been shown to be clinically equivalent to standard isotretinoin with improved bioavailability and minimal food effect. The safety profile of the micronized formulation has not...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mjd.2001.115966
更新日期:2001-08-01 00:00:00
abstract::In 2002, the National Rosacea Society assembled an expert committee to develop the first standard classification of rosacea. This original classification was intended to be updated as scientific knowledge and clinical experience increased. Over the last 15 years, significant new insights into rosacea's pathogenesis an...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2017.08.037
更新日期:2018-01-01 00:00:00
abstract::Erythematous papulonodules that resembled a malignant lymphoma developed in a 62-year-old man. Further examination revealed that he had primary myelofibrosis with cutaneous extramedullary hematopoiesis. All three marrow elements (myeloid, erythroid, and megakaryocytic series) were present in the skin lesions. Although...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/0190-9622(90)70046-k
更新日期:1990-02-01 00:00:00
abstract::Immunopathology continues to be important in diagnostic dermatopathology. Immunopathology is an invaluable tool for assessing the tissue of origin or direction of differentiation of cells. In some cases this can result in a more precise diagnosis. This article reviews the role of immunopathology in determining the bio...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(96)80106-x
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Sturge-Weber syndrome (SWS) is characterized by port-wine stains (PWS) affecting the face, eyes, and central nervous system. Pulsed dye laser (PDL) is the standard treatment for PWS. Unfortunately, recurrence is frequent because of reformation and reperfusion of blood vessels. OBJECTIVE:We sought to assess ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jaad.2014.10.011
更新日期:2015-01-01 00:00:00
abstract::Although sclerotherapy is an established procedure to treat ectatic veins, a wide disparity remains in the reported rates of success, especially for larger varicose veins. This article reviews the venous anatomy of the lower extremity and outlines the indications for sclerotherapy. The historical basis for treatment t...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(98)70506-7
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Patients with rosacea have increased amounts of cathelicidin and protease activity but their usefulness as disease biomarkers is unclear. OBJECTIVE:We sought to evaluate the effect of doxycycline treatment on cathelicidin expression, protease activity, and clinical response in rosacea. METHODS:In all, 170 ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jaad.2016.01.023
更新日期:2016-06-01 00:00:00
abstract::The Patient Protection and Affordable Care Act will have substantial effects on the US health care system. Physicians hold varied opinions regarding the overall merits or drawbacks of the health system reform law, but it is critical that we understand its components and the implications for our practices and our patie...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2010.07.020
更新日期:2010-10-01 00:00:00
abstract::A 9-year-old girl with systemic lupus erythematosus developed bullous eruption. Histopathologic examination showed subepidermal blistering and immunoglobulins (IgG, IgM, IgA) and complement components (C1q, C3) deposited linearly at the basement membrane zone. IgG in this patient's serum bound to the dermal side of 1 ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(98)70472-4
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:The use of cutaneous resurfacing lasers to treat rhytides is widely accepted. Several carbon dioxide lasers, many using fundamentally different technologies, are available. OBJECTIVE:The purpose of this study was to compare the results obtained and side effects after treating rhytides with 3 different carbo...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0190-9622(98)70002-7
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Drug cutaneous reaction and isolated cases of parotitis induced by terbinafine have been reported. OBSERVATION:We report a case of drug reaction with eosinophilia and systemic symptoms induced by terbinafine associated with a severe sialadenitis and a complete sicca syndrome. Evolution was protracted with a...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2004.06.023
更新日期:2004-11-01 00:00:00
abstract::An intensely pruritic dermatosis that occurred in a woman during the third trimester of pregnancy is described. The clinical manifestations included red follicular papules symmetrically distributed on the skin of the forearms, abdomen, thighs, and legs. The histopathologic findings were not specific. However, immunopa...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(88)70059-6
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:The incidence of cutaneous nontuberculous mycobacteria (NTM) infections is increasing. These infections are a diagnostic and therapeutic challenge. OBJECTIVE:We investigated the clinical features, diagnosis, and management of cutaneous NTM infections. METHODS:A retrospective case series studied 78 patients...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2019.04.022
更新日期:2019-09-01 00:00:00
abstract::The immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome (IPEX) is a rare disorder caused by mutations of the FOXP3 gene. The FOXP3 gene encodes a DNA-binding protein of the forkhead/winged-helix family and is the central controller of the development of CD4+CD25+ regulatory T cells. CD4+CD25+ regu...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2005.08.047
更新日期:2006-07-01 00:00:00
abstract::An acute localized, purulent skin lesion developed on the right knee of an 8-year-old girl and was subsequently diagnosed as a primary cutaneous Nocardia brasiliensis infection. It was soon accompanied by intense lymphangitis and regional adenopathy. The patient had a history of a minor abrasion contaminated by soil a...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(90)70232-7
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Giant angiofibromas in patients with tuberous sclerosis complex (TSC) are rare. OBJECTIVE:We sought to report two patients who had TSC with unusually large and disfiguring facial angiofibromas and to identify underlying histopathologic changes that may possibly explain the clinical features. METHODS:We per...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2012.03.021
更新日期:2012-12-01 00:00:00