Alfred W. Kopf's research while affiliated with CUNY Graduate Center and other places

Publications (380)

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Full-text available
Background: Most studies on dermoscopy of acral lesions were conducted in Asian populations. In this study, we analyzed these features in a predominantly Caucasian population. Objective: Estimate the prevalence of dermoscopic features in acral lesions, and assess their level of agreement between observers. Methods: In this retrospective multic...
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BACKGROUND/OBJECTIVES: Dermoscopy aids in clinical decision-making. However, time pressure is a common reason precluding its use. We evaluated the effect of time on lesion recognition and management decisions utilising clinical and dermoscopic images. METHOD: In all, 100 dermoscopic images were presented to 15 dermatologists with experience in derm...
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JA Stein was supported by the Irwin I. Lubowe Fellowship in Dermatology.
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Author Contributions:Study concept and design: Warycha, Kopf, Cohen, and Polsky. Acquisition of data: Terushkin, Warycha, and Levy. Analysis and interpretation of data: Terushkin, Warycha, Kopf, Cohen, and Polsky. Drafting of the manuscript: Terushkin and Warycha. Critical revision of the manuscript for important intellectual content: Terushkin, Wa...
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Collagen bundles have birefringent properties that cause a rapid randomization of polarized light, explaining why collagen is more conspicuous under polarized dermoscopy.1 Skin lesions with an increased amount of collagen will often reveal shiny, bright white, orthogonal linear streaks, which we have termed “chrysalis structures.” These structures...
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Nodular melanoma (NM) may be biologically aggressive compared with the more common superficial spreading melanoma (SSM), with recent data suggesting underlying genetic differences between these 2 subtypes. To better define the clinical behavior of NMs, the authors compared their clinical and histopathologic features to those of SSMs at their instit...
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Studies have demonstrated differences in colors and dermoscopic structures observed with polarized dermoscopes (PDs) and nonpolarized dermoscopes (NPDs). The objective was to evaluate whether diagnosis and diagnostic confidence changes when viewing dermoscopic images from NPDs and PDs. A total of 100 dermatologists participated in the study. Twenty...
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20001 Background: The high recurrence and mortality rates associated with NM are generally attributed to its advanced thickness at presentation; nevertheless, we and others have recently reported that NM may have distinct biologic characteristics independent of thickness. Here, we examine the differences in clinical behavior of NM compared to SSM a...
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To determine the utility of the current diameter criterion of larger than 6 mm of the ABCDE acronym for the early diagnosis of cutaneous melanoma. Cohort study. Dermatology hospital-based clinics and community practice offices. Patients A total of 1323 patients undergoing skin biopsies of 1657 pigmented lesions suggestive of melanoma. The maximum l...
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To evaluate the performance of dermoscopists in diagnosing small pigmented skin lesions (diameter </= 6 mm) compared with an automatic multispectral computer-vision system. Blinded comparison study. Dermatologic hospital-based clinics and private practice offices. Patients From a computerized skin imaging database of 990 small (</= 6-mm) pigmented...
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The presence of multiple blue-grey dots (MBGD) is widely used by clinicians to decide if a pigmented lesion should be removed, but only little is known about their significance. To evaluate the significance of MBGD for the dermoscopic diagnosis of melanoma. In part 1 we retrospectively evaluated 340 pigmented lesions for the presence and morphologi...
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The article by Saida et al1 on the significance of dermoscopic patterns in detecting malignant melanoma is of great importance to us. Based on the results of this large multicenter study conducted in Japan, the authors reported that 2 dermoscopic patterns, the parallel ridge pattern and irregular diffuse pigmentation pattern, were highly specific f...
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The color, architecture, symmetry, and homogeneity (CASH) algorithm for dermoscopy includes a feature not used in prior algorithms, namely, architecture. Architectural order/disorder is derived from current concepts regarding the biology of benign versus malignant melanocytic neoplasms. We sought to evaluate the accuracy of the CASH algorithm. A to...
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"Fat fingers" are thick digitate linear, curvilinear, branched, or oval/circular dermoscopic structures typically seen in seborrheic keratoses where they represent the gyri of their cerebriform surfaces. Their recognition is very useful in the diagnosis of these lesions, especially when the classic features (eg, milia, comedo-like openings) are abs...
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Dermoscopy (also known as epiluminescence microscopy, dermatoscopy, amplified surface microscopy) is an in-vivo method that has been reported to be a useful tool for the early recognition of melanoma and the differential diagnosis of pigmented lesions of the skin [1, 2]. Its use increases diagnostic accuracy between 5 and 30% over clinical visual i...
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Background/aims: Differentiation between early (Breslow thickness less than 1 mm) malignant melanoma (MM) and atypical melanocytic nevus (AMN) remains a challenge even to trained clinicians. The purpose of this study is to determine the feasibility of reliable discrimination between early MM and AMN with noninvasive, objective, automatic machine vi...
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Confidence is an important factor in decision making and may influence patient care. To evaluate whether short-training-based dermoscopy increases confidence in the diagnosis of skin lesions. After a 1-hour course on dermoscopy, 20 pairs of clinical and dermoscopic images of lesions were presented to 19 dermatology residents with little or no dermo...
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BACKGROUND: Confidence is an important factor in decision making and may influence patient care. OBJECTIVES: To evaluate whether short-training-based dermoscopy increases confidence in the diagnosis of skin lesions. METHODS AND MATERIALS: After a 1-hour course on dermoscopy, 20 pairs of clinical and dermoscopic images of lesions were presented to 1...
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In a pilot study, the three-point checklist of dermoscopy has been shown to represent a valid and reproducible tool with high sensitivity for the diagnosis of skin cancer in the hands of a small group of nonexperts. To re-evaluate these preliminary results in a large number of observers independently from their profession and expertise in dermoscop...
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In replyWe thank Drs Weinstock and Cohn for their comments on our article. The ABCDs of melanoma were developed by our group in 1985 when we perceived a significant problem.1 It was fairly easy to diagnose melanoma when it was in an advanced state. However, the diagnosis of early melanoma was much more problematic. Therefore, the reason that the AB...
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The public health impact of malignant melanoma continues to increase. It has been estimated that 59 580 newly diagnosed cases of invasive melanoma and an additional 46 170 cases of in situ melanoma will occur in the United States in 2005.1 Currently, 1 in 62 people in the United States will develop invasive melanoma during their lifetime (up from 1...
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To assess current practices of US dermatologists regarding the diagnosis, treatment, and management of melanoma in situ (MIS). Survey. A total of 1200 dermatologists randomly selected from the American Board of Medical Specialists Directory of Board Certified Medical Specialists. Results based on 597 questionnaires returned. The overall response ra...
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Large congenital melanocytic naevi (LCMN), which develop in utero and are present in approximately one in 20,000 newborns, are associated with markedly increased risks of cutaneous melanoma, leptomeningeal melanoma and neurocutaneous melanocytosis (NCM). This study examined clinical characteristics associated with melanoma and NCM among patients wi...
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Atypical mole syndrome is a sporadic or an inherited condition with an increased risk of melanoma. Germline mutations in the CDKN2A, ARF, CDK4 and somatic mutations in the PTEN and BRAF genes have been associated with melanoma. In this study, we evaluated genes associated with familial and sporadic melanoma for mutations in 28 probands with the aty...
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Dermoscopy is an in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented lesions of the skin. It has been shown to increase diagnostic accuracy over clinical visual inspection in the hands of experienced physicians. This article is a review of the principles of dermoscopy as well as recent technologi...
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The incidence of cutaneous melanoma has increased over the past several decades, making its early diagnosis a continuing public health priority. The ABCD (Asymmetry, Border irregularity, Color variegation, Diameter >6 mm) acronym for the appraisal of cutaneous pigmented lesions was devised in 1985 and has been widely adopted but requires reexaminat...
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The rising incidence of cutaneous malignant melanoma has been observed in the past decades. Currently, there is no cure for metastatic melanoma; only early diagnosis followed by prompt excision of cutaneous lesions ensures a good prognosis. The clinical ABCD rule is created as a framework for differentiating melanomas from benign pigmented skin les...
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Many factors have been identified as important determinants that increase the risk of malignant melanoma (MM) developing. Patients with classic atypical mole syndrome (CAMS) have multiple such factors and are known to be at high risk for MMs developing.Objective We sought to evaluate the risk for newly diagnosed MMs developing in patients with CAMS...
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The principal objective of screening individuals at risk for melanoma is detection of cutaneous melanoma during the curable stages of its early evolution. Unaided visual inspection of the skin is often suboptimal at diagnosing melanoma. Improving the diagnostic accuracy for melanoma remains an area of active research. These research efforts have fo...
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There is a need for better standardization of the dermoscopic terminology in assessing pigmented skin lesions. The virtual Consensus Net Meeting on Dermoscopy was organized to investigate reproducibility and validity of the various features and diagnostic algorithms. Dermoscopic images of 108 lesions were evaluated via the Internet by 40 experience...
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Pigmented basal cell carcinoma (BCC) can masquerade as malignant melanoma, especially in dark-skinned patients. We present a rare case of pigmented BCC located in an old burn scar in a 74-year-old Hispanic woman, and we demonstrate the potential value of dermatoscopy as a diagnostic tool in cases of pigmented lesions. Although clinically simulating...
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To describe morphological features of seborrheic keratosis as seen by dermoscopy and to investigate their prevalence. Prospective cohort study using macrophotography and dermoscopy for the documentation of seborrheic keratosis. Seborrheic keratoses were prospectively collected in 2 sites: a private practice in Plantation, Fla (site 1), and the Depa...
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Full-text available
Overexpression of the oncogene HDM2 is observed in a substantial proportion of melanomas, including noninvasive and thin lesions, suggesting that HDM2 overexpression may be an early event in melanocyte transformation. To determine the role of HDM2 in the clinical progression of melanoma, we examined whether its expression was associated with patien...
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There is no consensus concerning management of Spitz nevi. This study was carried out to ascertain how dermatologists manage Spitz nevi. A questionnaire was sent to 997 fellows of the American Academy of Dermatology, 284 pediatric dermatologists, and 27 directors of pigmented-lesion clinics. The results are based on the 381 questionnaires returned....
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BACKGROUND The proliferation marker MIB-1, which recognizes the Ki-67 antigen, provides independent prognostic information in several tumor types. Its utility in melanoma has been evaluated mostly in studies of thick primary tumors. Its usefulness in thinner lesions has not been assessed adequately.METHODSA well characterized cohort of 137 patients...
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Opinions concerning the significance of dysplastic nevi and their management vary among dermatologists. The purpose of this study was to assess how fellows of the American Academy of Dermatology (AAD) perceive and manage dysplastic nevi. Questionnaires were sent to 1216 fellows of the AAD; 456 questionnaires were returned. Almost all respondents (9...
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Dermoscopy is a simple to use in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented skin lesions. It has been shown to increase diagnostic accuracy over clinical visual inspection in the hands of an experienced physician. This paper is a review of the principles of Dermoscopy as well as recent tech...
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The public has long been instructed to wear protective clothing against ultraviolet (UV) damage. Our purpose was to determine the UV protection factor (UPF) of two cotton fabrics used in the manufacture of summer T-shirts and to explore methods that could improve the UPF of these fabrics. Each of the two types of white cotton fabrics (cotton T-shir...
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The incidence and mortality rates of melanoma have risen for many decades in the United States. Increased exposure to ultraviolet (UV) radiation is generally considered to be responsible. Sunburns, a measure of excess sun exposure, have been identified as a risk factor for the development of melanoma. Because sunburns are primarily due to UVB (280-...
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Several dermoscopic features have been identified as characteristic for melanoma; however, the reliability of these criteria in differentiating early melanomas from atypical moles has yet to be determined. The authors found the following dermoscopic features to be useful (i.e., highly specific) in differentiating early melanoma from atypical moles:...
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Differentiation of melanoma from melanocytic nevi is difficult even for skin cancer specialists. This motivates interest in computer-assisted analysis of lesion images. Our purpose was to offer fully automatic differentiation of melanoma from dysplastic and other melanocytic nevi through multispectral digital dermoscopy. At 4 clinical centers, imag...
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The purpose of this study was to assess the precision of automatic computerized measurement of parameters that may be useful in the differentiation of malignant melanoma from benign pigmented skin lesions, and also to determine the feasibility of quantitative monitoring of skin lesions over time. Ten independent sequences of images were acquired wi...
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To determine the risk for developing malignant melanoma and neurocutaneous melanocytosis (NCM) in patients with large congenital melanocytic nevi. Follow-up data suitable for calculations were available on 160 patients in the New York University Registry of Large Congenital Melanocytic Nevi who had been free of known melanomas or NCM when entered i...
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To describe the relevant morphologic features and to create a simple diagnostic method for pigmented basal cell carcinoma (BCC) using in vivo cutaneous surface microscopy (ie, dermoscopy, dermatoscopy, or oil epiluminescence microscopy). Pigmented skin lesions were photographed in vivo using immersion oil (surface microscopy). All pigmented skin le...
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Thickness is known to be an important survival prognosticator for cutaneous melanoma, but controversy exists as to whether Clark level of invasion retains prognostic significance once thickness has been accounted for. A recent proposal to eliminate Clark level from the staging system for melanoma of the American Joint Committee on Cancer (AJCC) pro...
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This is the first reported case of a melanoma in a psoriatic plaque. The clinical, dermoscopic, and histologic features of this case are detailed. A review of the risk of melanoma among patients treated with psoralen-ultraviolet A is presented.
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The case of a 2-mm Spitz nevus is reported. We comment on the case and describe the skin-surface microscopy features.
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Laboratory tests and imaging studies are often ordered for asymptomatic patients with malignant melanomas (MMs) in an effort to detect subclinical metastatic disease. However, their sensitivity and specificity for detecting cryptic metastases are not well established. A review of the literature on laboratory tests and imaging studies for MM metasta...
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The risk of the occurrence of malignant melanoma (MM) in medium-sized (1.5 to 19.9 cm in diameter) congenital melanocytic nevi (CMN) is the subject of controversy. Universally accepted recommendations regarding the management of such lesions have not been made. Our purpose was to assess the risk of MM arising in medium-sized CMN. The study included...
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One of the most difficult problems in the in vivo diagnosis of cutaneous tumors is the differentiation clinically between early malignant melanoma (MM) and atypical (dysplastic) melanocytic nevi (AMNs) because these lesions share clinical features. High-quality digital imaging systems and store-and-forward technology have the potential for use in a...