Background Paget's disease is an intraepidermal adenocarcinoma that is difficult to diagnose clinically as it mimics inflammatory or infectious diseases. As a consequence, it may be clinically misdiagnosed resulting in a delay in appropriate management. Reflectance confocal microscopy allows the visualization of the upper layers of the skin and mucosa at cellular resolution. Paget's disease is characterized histologically by the presence of neoplastic cells scattered throughout all layers of the epidermis in a pattern similar to that also observed in melanoma (and termed Pagetoid spread). Objective In vivo confocal microscopy is an excellent diagnostic tool for detecting Pagetoid spread and for diagnosing melanoma. We therefore hypothesized that it may also assist in the diagnosis of Paget's disease. Methods In this study, we describe the confocal features of nine cases of extramammary Paget's disease and one case of mammary one. Results Large atypical Pagetoid cells were present singly and in clusters in all 10 cases and were readily visualized on ex vivo and in vivo confocal microscopy. The presence of Pagetoid spread and other confocal features, in the appropriate clinical context, is suggestive Paget's disease and should allow distinction from other inflammatory diseases that may appear similar clinically. Conclusion The use of confocal microscopy is likely to facilitate earlier diagnosis of Paget's disease and the instigation of appropriate management with concomitant improvement in clinical outcomes. © 2012 European Academy of Dermatology and Venereology.

Reflectance confocal microscopy for diagnosis of mammary and extramammary Paget's disease / Guitera, P; Scolyer, R. A.; Gill, M.; Akita, H.; Arima, M.; Yokoyama, Y.; Matsunaga, K.; Longo, Caterina; Bassoli, S.; Bencini, P. L.; Giannotti, R.; Pellacani, Giovanni; Alessi Fox, C.; Dalrymple, C.. - In: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY. - ISSN 0926-9959. - 27:1(2013), pp. e24-e29. [10.1111/j.1468-3083.2011.04423.x]

Reflectance confocal microscopy for diagnosis of mammary and extramammary Paget's disease

LONGO, Caterina;PELLACANI, Giovanni;
2013

Abstract

Background Paget's disease is an intraepidermal adenocarcinoma that is difficult to diagnose clinically as it mimics inflammatory or infectious diseases. As a consequence, it may be clinically misdiagnosed resulting in a delay in appropriate management. Reflectance confocal microscopy allows the visualization of the upper layers of the skin and mucosa at cellular resolution. Paget's disease is characterized histologically by the presence of neoplastic cells scattered throughout all layers of the epidermis in a pattern similar to that also observed in melanoma (and termed Pagetoid spread). Objective In vivo confocal microscopy is an excellent diagnostic tool for detecting Pagetoid spread and for diagnosing melanoma. We therefore hypothesized that it may also assist in the diagnosis of Paget's disease. Methods In this study, we describe the confocal features of nine cases of extramammary Paget's disease and one case of mammary one. Results Large atypical Pagetoid cells were present singly and in clusters in all 10 cases and were readily visualized on ex vivo and in vivo confocal microscopy. The presence of Pagetoid spread and other confocal features, in the appropriate clinical context, is suggestive Paget's disease and should allow distinction from other inflammatory diseases that may appear similar clinically. Conclusion The use of confocal microscopy is likely to facilitate earlier diagnosis of Paget's disease and the instigation of appropriate management with concomitant improvement in clinical outcomes. © 2012 European Academy of Dermatology and Venereology.
2013
27
1
e24
e29
Reflectance confocal microscopy for diagnosis of mammary and extramammary Paget's disease / Guitera, P; Scolyer, R. A.; Gill, M.; Akita, H.; Arima, M.; Yokoyama, Y.; Matsunaga, K.; Longo, Caterina; Bassoli, S.; Bencini, P. L.; Giannotti, R.; Pellacani, Giovanni; Alessi Fox, C.; Dalrymple, C.. - In: JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY. - ISSN 0926-9959. - 27:1(2013), pp. e24-e29. [10.1111/j.1468-3083.2011.04423.x]
Guitera, P; Scolyer, R. A.; Gill, M.; Akita, H.; Arima, M.; Yokoyama, Y.; Matsunaga, K.; Longo, Caterina; Bassoli, S.; Bencini, P. L.; Giannotti, R.; Pellacani, Giovanni; Alessi Fox, C.; Dalrymple, C.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1140788
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