Riccardo Pampena

• Doctor of Medicine
• Researcher at Azienda Unità Sanitaria Locale Reggio Emilia

Backgrounds Patients or family members first notice around 50% of primary melanoma lesions. Targeted educational campaigns for non‐medical individuals improve melanoma detection rates, but the most effective initiatives are unclear. Objectives To compare the efficacy of passive versus active intervention for non‐medical individuals in classifying...

Introduction: The diagnosis of fully amelanotic skin tumors is difficult on clinical and dermoscopic examination. Objective: We sought to identify an accurate and user-friendly dermoscopic algorithm to differentiate between benign and malignant pink lesions. Methods: The database of 1 referral center was retrospectively reviewed for images of non-i...

Anorectal melanoma (ARM) is a rare malignancy often associated with a poor prognosis due to its late diagnosis and aggressive biological behavior. This review aims to comprehensively investigate ARM’s diagnosis, management, and treatment, emphasizing its clinical characteristics, laboratory findings, and implications for patient prognosis. A system...

Background Previous work with Reflectance Confocal Microscopy (RCM) imaging has shown high sensitivity and specificity for Basal Cell Carcinoma (BCC), but to date there have been few studies on a UK cohort. Objectives The study hypothesised that RCM could be used prospectively to accurately diagnose BCC in a private UK secondary care, single clini...

Background and Objectives: Amelanotic/hypomelanotic melanomas (AHMs) account for 2–8% of all cutaneous melanomas. Due to their clinical appearance and the lack of specific dermoscopic indicators, AHMs are challenging to diagnose, particularly in thinner cutaneous lesions. The aim of our study was to evaluate the clinicopathological and dermoscopic...

It is well known that adnexal skin tumors can simulate other cutaneous neoplasia and that various types of benign and malignant skin tumors can develop or modify during pregnancy. Here, we report a case of trichoblastoma mimicking a keratoacanthoma arising in a nevus sebaceous during pregnancy. Given its unique clinical and dermoscopic features, th...

Introduction: Although the dermoscopic features of facial lentiginous melanomas (LM), including lentigo maligna and lentigo maligna melanoma, have been extensively studied, the literature about those located on the scalp is scarce. This study aims to describe the dermoscopic features of scalp LM and assess the diagnostic accuracy of dermoscopy to...

Jellyfish are aquatic animals of the phylum Cnidaria found in seas all over the world. They are characterized by the presence of cnidocytes, cells that contain a secretory organelle, the cnidocyst, mainly used for predation and defense purposes. An adult female patient presented to our Unit of Dermatology, for a 10 days-old history of macular-eryth...

Introduction Lynch syndrome (LS) is a rare inherited condition associated with mutations in DNA mismatch repair (MMR) genes. In LS, MLH1 and MSH2 are involved in about 90% of mutation, while MSH6 is involved in 10% of mutations [1,2]. Approximately 2-5% of colon-rectal cancers present underlying LS; at the same time, LS patients have the risk of al...

The current evidence on pediatric melanoma is heterogenous, especially regarding the prognosis of different histological subtypes. We sought to systematically review the evidence on pediatric melanoma, highlighting the major sources of heterogeneity and focusing on available data on single patients. A systematic search was performed from 1948 to Ja...

Effective cancer screening detects early stage tumors, leading to a lower incidence of late-stage disease over time. Dermoscopy is the gold standard for skin cancer diagnosis as diagnostic accuracy is improved compared to naked eye examinations. As melanoma dermoscopic features are often body site specific, awareness of common features according to...

Background: Atypical pigmented facial lesions (aPFLs) often display clinical and dermoscopic equivocal and/or overlapping features, thus causing a challenging and delayed diagnosis and/or inappropriate excisions. No specific registry dedicated to aPFL paired with clinical data is available to date. Methods: The dataset is hosted on a specifically d...

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 pa...

Cutaneous leiomyoma is a benign tumor, mainly composed of smooth muscle cells and arising from the arrector pili muscle of hair follicles. The diagnosis of leiomyomas is of paramount importance, as they can often be associated with underlying malignancies (e.g., renal cell carcinoma, leiomyosarcoma) and specific genetic mutations. We report the cas...

Importance: Previous systematic reviews and meta-analyses have concluded that given data paucity, a comparison of reflectance confocal microscopy (RCM) with dermoscopy is complex. They recommend comparative prospective studies in a real-world setting of suspect lesions. Objective: To test the hypothesis that RCM reduces unnecessary lesion excisi...

The increase life expectancy led to an expected increase in skin cancer incidence in older patients. Their treatment can require a complex decision‐making process. Limited data are available on characteristics, management and outcome of skin tumors in nonagenarian and centenarian patients. The aim of our study was to describe epidemiology, clinical...

Aim of this study was to systematically review the literature to assess efficacy and safety of stereotactic radiotherapy (SRT) in combination with immunotherapy for the treatment of melanoma brain metastases (MBM). The literature was searched using PubMed, Scopus, and Embase. Studies comparing SRT plus immunotherapy versus SRT or immunotherapy alon...

Introduction: Nevus-associated melanoma (NAM) accounts for almost one third of all cutaneous melanomas; it is often associated with younger age, trunk location and lower Breslow’s thickness compared to de novo melanoma (DNM). Objectives: To define the prevalence of NAM in a tertiary referral Center in Italy and to analyze its distribution accordin...

Cutaneous adnexal tumors (ATs) encompass a variegated group of hamartomas and benign or malignant tumors, originating from the hair follicle, sebaceous, eccrine or apocrine glands that may simulate other cutaneous neoplasms. This study aims to provide a comprehensive overview of the spectrum of clinical and dermoscopic features of ATs, to better de...

Breast cancer-associated genes 1 and 2 (BRCA1 and BRCA2) are tumor suppressor genes encoding a large protein that is involved in many essential biological processes. BRCA mutated patients show an increased risk to develop several malignancies, including cutaneous malignancies, although inconsistently across multiple studies. We carried out an obser...

Background: In Italy, comprehensive national studies, about mortality rates for cutaneous melanoma, are missing. The aim of this study was to analyze the trend of cutaneous melanoma mortality in Italy from 1982 to 2016. Methods: Data on death certificates were obtained from Italian National Institute of Statistics (ISTAT: Istituto nazionale di S...

PRAME (PReferentially expressed Antigen in MElanoma), a cancer testis antigen expressed in low levels in gonadal, endometrial, and adrenal gland tissues, has been recently considered a valuable tool in the differential diagnosis between benign and malignant melanocytic lesions. The aim of the current study is to perform PRAME immunostaining on a la...

Pemphigus vulgaris (PV) belongs to the group of autoimmune blistering diseases. PV can affect not only mucous membranes, but also the skin and it is characterized by serum IgG autoantibodies against desmoglein 1 and 3, two major components of desmosomes. The introduction of glucocorticoids improved dramatically the prognosis of patients affected by...

Background: Basal cell carcinoma can simulate melanoma and specific dermoscopic criteria have not yet been defined in a large cohort. Objective: To identify dermoscopic "trump" characteristics for differential diagnosis, identify cluster groups and assess the clinical impact of this study's findings. Methods: Retrospective, multicentric compar...

During the Italian first wave of the COVID-19 pandemic, social restrictions and bad news daily spread by mass media inevitably had a great influence on the mental state of the population. To assess how much the COVID-19 outbreak impacted the psychologic state of patients referring to our Skin Cancer Unit from March 9th to May 31st, 2020, we submitt...

BACKGROUND/OBJECTIVES: Non-invasive skin imaging features of main skin inflammatory and autoimmune diseases have been reported, although a comprehensive review of their correlation with histopathologic features is currently lacking. Therefore, the aim of this paper was to review the correlation of dermoscopic, reflectance confocal microscopy (RCM)...

In-vivo reflectance confocal microscopy (RCM) is a non-invasive diagnostic tool representing an adds-on to clinical and dermoscopic exam to enhance the diagnosis of melanoma.¹ Several diagnostic algorithm have been validated for the diagnosis of the most frequent melanoma subtypes.¹ However, melanoma encompasses a wide range of distinct histologica...

The continuous improvement of life expectancy of patients with chronic lymphocytic leukemia (CLL) has resulted in increased risk of second primary malignancy that potentially may affect survival and quality of life of CLL patients. We performed a systematic review to assess the risk and the clinical‐pathological features and prognosis of cutaneous...

Background It is well known that the number of nevi varies with age. However, there are a few data in the literature concerning total nevus count at different ages. The aim of this study was to assess and compare the total nevus count among different age groups. Methods The total nevus count was assessed in consecutive patients belonging to nine a...

Background: Dermoscopy and Reflectance Confocal Microscopy (RCM) features of scalp melanoma according to lesion location and histopathology have not been fully investigated. Objectives: To reveal dermoscopic and RCM features of scalp melanoma according to lesion location and histopathology. Methods: We retrospectively retrieved images of suspi...

Incidence of melanoma has been increasing in both sexes in the last decades. Advanced melanoma has always been one of the deadliest cancer worldwide due to his high metastatic capacity. In the last ten years, progresses in the knowledge of the molecular mechanisms involved in the melanoma development and progression, and in immune-response against...

BACKGROUND: Digital dermoscopy follow-up (DDF) is useful in improving melanoma recognition, catching early changes over time, although benign nevi can also show changes. Reflectance confocal microscopy (RCM) improves melanoma diagnostic accuracy and decreases the number of unnecessary resections. OBJECTIVES: To evaluate dynamic dermoscopic and RCM...

We herein report a case of accelerated nodulosis (AN) in a patient under treatment with tocilizumab (TCZ), an anti‐IL6 receptor antibody. Dermoscopy might be a useful tool prompting the early recognition of AN, whose final diagnosis however depends on clinical–pathological correlation.

Background Infiltrative basal cell carcinoma (BCC) has a higher risk for post-surgical recurrence as compared to the most common low-aggressive superficial and nodular BCC. Independent diagnostic criteria for infiltrative BCC diagnosis have not been still defined. Improving the pre-surgical recognition of infiltrative BCC might significantly reduce...

Background: Hyperhidrosis is a disorder of excessive sweating severely impacting on patient's quality of life (Qol). Several studies have been published about oral oxybutynin, but no studies focused on the achievement of complete clinical and Qol response. Objectives: the aim of this study was to report our real-life experience with oral oxybuty...

Snakebites in Europe are mostly due to bites from Viperidae species of the genus Vipera. This represents a neglected public health hazard with poorly defined incidence, morbidity and mortality. In Europe, fourteen species of “true vipers” (subfamily Viperinae) are present, eleven of which belong to the genus Vipera. Amongst these, the main medicall...

Background In‐vivo reflectance confocal microscopy (RCM) increases diagnostic accuracy for melanoma diagnosis when combined with dermoscopy. In patients with multiple atypical nevi a comparative dermoscopic approach improves melanoma recognition and saves unnecessary excision. The performance of a comparative approach combining dermoscopy and RCM h...

Background Amelanotic and hypomelanotic melanoma (AHM) has a higher risk of delayed diagnosis and a significant lower 5‐year melanoma‐specific survival compared to pigmented melanoma. Our aim was the evaluation of the clinicopathological/dermoscopic features of amelanotic melanoma (AM) and hypomelanotic melanoma (HM). Methods All participants had...

In Reply The use of dermatoscopy in clinical practice has changed the way of diagnosing melanomas and skin cancer in general by allowing a real-time view of specific structures that are well correlated with histopathologic substrates. Although diagnostic dermatoscopic criteria have been extensively evaluated and validated for usual melanoma subtype...

Recently 5‐fluorouracil 0.5% / salicylic acid 10% (5‐FU/SA) topical solution has been included in the National Italian portfolio for lesion‐directed treatment of grade I/II actinic keratosis (AKs) located on the face or scalp. To describe the utility of dermoscopy and RCM in treatment response monitoring of a series of AKs treated with 5‐FU/SA as l...

Background There is lack of studies on the diagnostic accuracy of dermatoscopy and reflectance confocal microscopy (RCM) for dark pigmented lesions. Objective To assess the diagnostic accuracy of dermatoscopy plus confocal microscopy for melanoma diagnosis of dark pigmented lesions in real life. Methods Prospective analysis of difficult dark lesi...

Regression within cutaneous melanoma has been previously described as a spontaneous or therapy-induced phenomenon, driven by the activation of the immune system. However, simultaneous development of regression in both melanoma and multiple melanocytic nevi is an extremely rare event, having been reported only twice in the literature .

In 2009, snakebites were included in the list of the World Health Organization (WHO) neglected diseases. Dermatological literature lacks current and up to date articles about snakebites and their management, despite the fact that dermatologists, especially from rural hospitals, can be called into the emergency room to consult the management of susp...

Background Nevus‐associated melanoma (NAM) has been regarded as a distinct biological entity from de‐novo melanoma (DNM); however, static dermoscopy often fails in differentiating these entities. Digital dermoscopic monitoring allows to identify dynamic changes occurring during follow‐up; this may improve diagnostic accuracy and potentially our kno...

Background Melanocytic lesions with eccentric hyperpigmentation (EH), even though without other dermatoscopic features of melanoma, are often excised. Objective Aiming to understand if the EH in a pigmented lesion is an accurate criterion of malignancy, we evaluated the capability of two evaluators, with different expertise, to correctly diagnose...

Both dermoscopy and in‐vivo reflectance confocal microscopy (RCM) demonstrated high levels of diagnostic accuracy for basal cell carcinoma (BCC) diagnosis.1,2 Although specific dermoscopic criteria have been described, BCC may simulate other benign and malignant cutaneous tumors, with melanoma representing one of the most common differential diagno...

Importance The clinical and dermoscopic features of the vast majority of uncommon variants of cutaneous melanoma have been rarely reported, leading to difficulty in making accurate diagnoses. Objective To define the main clinical and dermoscopic features of the most frequently reported but uncommon histologic variants of cutaneous melanoma. Evide...

Nevus-associated melanoma (NAM) is defined on histopathological basis by the coexistence of melanoma and nevus components. Melanomas developing on pre-existing congenital or acquired nevi are usually of the superficial spreading subtype and harbor the BRAFV600E mutation. NAM accounts for almost one-third of melanoma cases As compared to de novo mel...

Background: Metastasis from cutaneous squamous cell carcinoma (cSCC) mainly involve the regional nodal basin, with an incidence ranging from 2%-4% until 15% in case of high-risk tumors. When dealing with high-risk cSCC, ultrasound examination is recommended every 3- 4 months during follow up. We aimed to determine the role of US examination in the...

Background: Imiquimod 3.75% cream (Zyclara® Meda, Stockholm, Sweden) is a new field-directed therapy for actinic keratosis (AK). Objectives: The aim is to evaluate efficacy and the morphologic dynamic changes induced by this treatment by means of dermatoscopy and reflectance confocal microscopy (RCM) of imiquimod 3.75% cream for the treatment of...

New drugs have been recently approved as adjuvant therapies for melanoma. In this Bayesian network meta‐analysis, we aimed to assess the best therapeutic option in terms of Recurrence Free Survival (RFS), Overall Survival (OS) and adverse events (AEs). PubMed, Embase, Cochrane library and the American Society of Clinical Oncology databases were sea...

Background: The head and neck are considered one single anatomical unit. No data on clinical, dermoscopic and confocal aspects of neck melanoma are currently available. Objectives: To identify clinical, dermoscopic and confocal diagnostic features of neck melanomas. Methods: Consecutive malignant (cases) and benign (controls) melanocytic skin...

Ex-vivo fluorescence confocal microscopy (FCM) is an emerging technique that demonstrates high levels of accuracy in diagnosis and margins assessment in dermatologic surgery. Recently, a new device (digital ex-vivo FCM) has been developed combining reflectance and fluorescence modalities, to provide an image that mimics conventional hematoxylin and...

Background: Conplete surgical excision is the preferred biopsy type for suspicious melanocytic lesions. However, partial biopsy is sometimes used in special situations. Previous studies have explored the effect of partial biopsy of a primary melanoma on patient outcome with controversial results. Objective: We performed a meta-analysis on the in...

Background: No large studies have defined the best treatment of actinic cheilitis. Methods: We conducted a systematic review to define the best therapies for actinic cheilitis in clinical response and recurrences. Results: We first identified 444 papers, and 49 were finally considered, including 789 patients and 843 treated areas. The followin...

Background Pink skin tumors are difficult to differentiate, clinically and dermoscopically. In previous studies, mainly focused on pigmented lesions, pattern analysis provided the best sensitivity and specificity values, as compared to other algorithms. These findings suggest that the global dermoscopic appearance, based on the evaluation of preval...

Background The association of clinical and dermoscopic features with BRAF mutational status has been poorly analysed in multiple primary melanomas (MPM). Objective. To investigate if concordance of BRAF mutational status is associated with dermoscopic similarity in multiple melanomas of the same patient. Methods Dermoscopic images and correspondin...

Background In‐vivo reflectance confocal microscopy significantly improves melanoma diagnosis as compared to clinical/dermoscopic examination alone. Several confocal criteria have been described allowing to differentiate melanoma from nevi; by combining different criteria three pure confocal scores (Pellacani 2005, Segura 2009 and Pellacani 2012) an...

Basal cell carcinoma (BCC) represents one of the best indications for the use of in‐vivo reflectance confocal microscopy (RCM). High levels of diagnostic accuracy is reached with the combined use of dermoscopy and RCM for BCC diagnosis that is based on a set of distinct confocal features. Furthermore, new handled devices allowed to speed‐up the con...

Adnexal tumors represent one of the most troublesome differential diagnosis when dealing with skin lesions with clinical and dermoscopic criteria suggestive for basal cell carcinoma (BCC). Among these, benign follicular tumors, and in particular trichoblastoma and trichoepithelioma, deserve a special mention as BCC mimickers. These are benign tumor...

Over the years, other modified versions of the traditional Mohs surgery have been applied including the perimeter technique (PT). In detail, in our study, the surgical specimen is labeled for margin counting and a further layer including the lesions’ bottom is analysed. This article is protected by copyright. All rights reserved.

Melanomas and nevi displaying regression features can be difficult to differentiate. To describe reflectance confocal microscopy features in benign and malignant pigmented skin lesions characterized by regression features in dermoscopy. Methods: Observational retrospective study. Inclusion criteria were presence of dermoscopic features of regressio...

Background Frozen histological sections are currently used for intra‐operative margin assessment during Mohs surgery. Fluorescence confocal microscopy (FCM) is a new tool, which offers a promising and faster alternative to frozen histology. Objective The aim of the present study is to prospectively evaluate in a clinical setting, the accuracy of F...

Melanoma skin metastases may occur as satellitosis and in transit metastases as a consequence of intralymphatic tumor spread, or distant metastases, due to hematogenous dissemination.¹ High-risk patients must be therefore accurately monitored by means of clinical and instrumental examination. Surgical resection of the lesions remains the preferred...

Background Sclerosing nevus with pseudomelanomatous features (SNPFs) is a clinical and pathologic entity that mimics melanoma both clinically and histologically. The lesion is a melanocytic nevus, histologically characterized by fibrosis and a pseudomelanomatous proliferation. It is typically seen in young to middle‐aged individuals, mainly on the...

Pandeya et al. report that nevus-associated melanoma is associated with a specific phenotype, namely, young age, high number of nevi, non-brown eye color and slight dermal elastosis. Potential implications regarding differences between nevus-associated melanomas and de novo melanomas are discussed.

Primary cutaneous lymphomas are a heterogeneous group that includes 2 main groups of primary T- and B-cell lymphomas, which can involve the skin with distinct variability in clinical presentation, histopathology, immunophenotypes, molecular signature, and prognosis. The authors describe the most frequent clinical forms of cutaneous lymphomas and th...

原位黑色素瘤(MIS)是被称为黑色素瘤的皮肤肿瘤的极早期阶段。近几十年来,黑色素瘤的发病率以每年2.6% 的速度增长,而MIS是造成这一增长的主要诊断物。识别MIS非常重要,因为在这一阶段(被称为表皮内阶段),癌细胞没有机会扩散到体内任何部位。由于从良性(无害)色素病变(比如正常胎块)中区分MIS非常具有挑战性,因此意大利雷焦艾米利亚的研究人员开展了本研究,考虑通过两种无创(即无需任何手术)方式来诊断皮肤癌,分别被称为反射共焦显微镜(RCM)和皮肤镜,看看能否利用它们来检测表皮内黑色素瘤。皮肤镜是一种价格低廉的方法,已在全球范围内应用20年之久:医生会使用一种被称为皮血管镜的手持设备来观察放大十倍左右的皮肤,以观看肉眼无法看到的东西。RCM是最近兴起的一种技术,但不太容易获得,可创建某部分皮...