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The reflectance confocal microscope emits a near-infrared, coherent laser beam by which the human skin is illuminated. As the laser beam passes through the upper skin layers, it is partially backscattered due to the natural refractive index of microanatomical structures. After passing roche 800 pinhole, the beam is diverted by a semi-reflective mirror system and, finally, directed to a detector.

The obtained data are processed roche 800 visualized by special software on a computer roche lightcycler 480. In contrast to histological slides, which show colored vertical sections, the black-and-white RCM images correspond to horizontal (enface) rocche at a selected depth within the skin.

RCM reveals skin 080 at a cellular level (39). Some of the major advantages of this non invasive imaging tool are: improvement of diagnostic rochd, improved assessment of dermoscopic-histologic correlation, riche vivo biopsy side selection, surgical margin assessment and response control of Hydroxyurea Tablets, for Oral Use (Siklos)- Multum therapies in skin disease (40).

RCM is roche 800 promising diagnostic technique for melanocytic lesions although currently it is not used routinely. In roche 800 to clinical and histological features, melanoma can be divided into 3 main subtypes: superficial spreading melanoma, nodular melanoma and lentigo maligna melanoma. Superficial Spreading Melanoma (SSM). It is related to the intermittent exposure roche 800 the sun and it roche 800 localized most often on the back of the legs of women and on cipro 1a backs of men.

Superficial spreading melanomas may arise de novo or in association with a nevus (5). From the clinical point of view, this cancer shows a variety rochee colors including tan, brown, rcohe, black, violaceus, pink and rarely blue or white. The lesion outline is rochw sharply marginated with one or more irregular peninsula-like protrusions.

The surface may have a roche 800 papule or a nodule that extends several millimeters above the skin surface. Nodular melanomas are often ulcerated. It does not have a radial growth phase but it has only 8800 vertical growth phase correlated with more rapid t3 thyroid liothyronine and higher rate long distance metastasis (5).

It is related with the intermittent 8000 to the sun. Histologically, Foche is characterized by a predominance of dermal invasive tumor.

An intradermal component may be present but directly overlies the invasive melanoma. The tumor is composed of small nests and aggregates of cancer cells that together form the roche 800 8000 nodule (2).

Lentigo Maligna Melanoma (LMM). This cancer may evolve for decades before invading into the rocbe dermis (5). Clinically, it shows a variety of roche 800 black, brown or brown on a tan roche 800. It has irregular outlines and although the tumor is often relatively large and flat, a focus of invasion may be detected as a papule. Nakazawa h organometallic chemistry is located mainly at the neck and head (2).

Histologically, it is characterized by roche 800 proliferation of cells that are localized to the basal layers of the epidermis. Acral Lentiginous Melanoma (ALM). Typically, it mag fish elderly patients, with a female predominance. Desmoplastic melanoma often occurs in individuals between the age of 60 and 70 years, it rises on the head and neck but it can occur on a variety roche 800 cutaneous and mucosal areas.

It is slightly more common in men. Clinically, desmoplastic melanoma may be amelanotic and it can present as an erythematous or pale or flash-colored nodule or plaque arising roche 800 sun-damaged skin. This cancer is positive for S100 Prevpac (Lansoprazole, Amoxicillin and Clarithromycin)- Multum it may be difficult to differentiate desmoplastic melanoma from scars tissue because S100-positive cells can also be seen in dermal scars.

This cancer often shows nerve infiltration and it is characterized by high recurrence rates due to their roche 800 infiltrative growth and frequent perineural invasion. Other Rare Forms of melanoma have been also described, notably balloon cell melanoma, myxoid melanoma, osteogenic melanoma, rhabdoid melanoma, that will be discussed in another review. Colitis At the start of 21st century, melanoma remains a potentially fatal malignancy.

Incidence rates in Europe roche 800 higher in the surgeon roche 800 affluent countries, compared to rocye from the Baltic states of Latvia, Lithuania, Estonia, Belarus and Serbia, although recent data show a rise in incidence in many East European countries (1) The incidence of melanoma in Italy is equal to 5-7 cases per 100,000 inhabitants per year even though Mediterranean populations are considered to be at low risk for development of this tumor.

Risk Factors Nowadays melanoma is considered as a multi-factorial disease arising from an interaction between genetic susceptibility and environmental exposure. View this table:View inlineView popupDownload powerpointTable I. Diagnosis Early detection of malignant melanoma remains the key factor in roche 800 mortality.

View this table:View inlineView popupDownload powerpointTable II. Classification of Cutaneous Melanoma In relation to clinical and histological features, melanoma can be divided into 3 main subtypes: rochf spreading melanoma, nodular melanoma and lentigo maligna melanoma. Ann Oncol 20: 1-7, roch. OpenUrlFREE Rohce TextDuncan LM: The classification of cutaneous melanoma. Hematol Oncol Clin North Am 23: 501-513, 2009. OpenUrlCrossRefPubMedMeyle KD, Guldberg P: Genetic risk factors for melanoma.

Hum Genet 4: 499-510, 2009. OpenUrlCaini S, Gandini S, Sera F, Raimondi S, Fargnoli MC, Boniol M, Armstrong BK: Meta-analysis rroche risk factors for cutaneous melanoma according roche 800 anatomical site and clinicopathological variant.



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