32 results on '"Fabio Castagnetti"'
Search Results
2. Characteristics and management of skin cancers in very elderly patients: A real‐world challenge for clinicians
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Michela Lai, Riccardo Pampena, Marica Mirra, Margherita Raucci, Elisa Benati, Stefania Borsari, Mara Lombardi, Maria Banzi, Fabio Castagnetti, Tamara Palmieri, Simonetta Piana, Dafne Ramundo, Giovanni Pellacani, and Caterina Longo
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Aged, 80 and over ,Male ,Skin Neoplasms ,skin cancer ,Dermatology ,elderly ,older patients ,Biochemistry ,Cohort Studies ,Keratosis, Actinic ,ageism ,Carcinoma, Squamous Cell ,Humans ,Female ,Melanoma ,Molecular Biology ,Aged - Abstract
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 tumours in nonagenarian and centenarian patients. The aim of our study was to describe epidemiology, clinical-pathological features and treatment strategies of skin cancers in a cohort of patients aged ≧95 years. A total of 116 patients ≧95 years of age presented for the evaluation of 225 skin lesions (mean of 1.94 lesions per patient). The mean age was 97.4 years, 57.8% were women. Most patients had an ECOG score of 3 (49.3%) or 4 (32%). Lesions were mainly located on the head and neck area (74.2%), upper (7.1%) and lower (6,2%) limbs. The majority of patients presented with non-melanoma skin cancers (183/225; 81.3%), 25/225 (11.1%) had actinic keratosis, 5 (2.2%) melanoma and 2 (0.9%) atypical fibroxanthoma. Forty-eight lesions (21.3%) were treated with surgery, 58 (25.8%) with radiotherapy. The management of 73 lesion (32.4%) was discussed at the multidisciplinary tumour board meeting. One patient died for the progression of a squamous cell carcinoma; 74 patients died for causes unrelated to skin tumours, 36 are still alive after a mean follow-up of 27.27 months. This cohort study confirms that age is not per se a contraindication for treatment of skin cancers in elderly patients. Our results support the importance of a patient-centred care approach that should take into consideration patient's preferences, comorbidities, compliance and possible adverse events.
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- 2022
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3. Reply to Letter to the Editor: A Pure Autologous Dermal Graft and Dermal Flap Pocket in Prepectoral Implant Reconstruction After Skin-Reducing Mastectomy: A One-Stage Autologous Reconstruction Alternative to Acellular Dermal Matrices
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Fabio Castagnetti, Saverio Coiro, Monica Foroni, Giuseppe Falco, Simone Mele, Eugenio Cenini, Ljuba Morando, Evelina Begnini, Giulia Borgonovo, and Guglielmo Ferrari
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Surgery - Published
- 2022
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4. Bifurcate inferior pedicle mammoplasty in large ptotic breast for tumor located at the upper outer quadrant with skin involvement —a novel technique allowing good cosmetic outcome: case report
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Saverio Coiro, Guglielmo Ferrari, Eugenio Cenini, Simone Mele, Giulia Borgonovo, Fabio Castagnetti, and Giuseppe Falco
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Novel technique ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Case Report ,Mammoplasty ,030230 surgery ,medicine.disease ,Radiation therapy ,Oncoplastic Surgery ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,030220 oncology & carcinogenesis ,medicine ,Surgery ,Breast reduction ,Radiology ,skin and connective tissue diseases ,business ,Upper outer quadrant ,Reduction (orthopedic surgery) - Abstract
Breast oncoplastic techniques followed by radiotherapy represent nowadays the standard of care for breast cancer treatment. For tumours located at the upper outer quadrant in patients with large and ptotic breasts, the use of level II breast reduction mammoplasty, allows large quadrantectomies without compromising the breast natural shape and reducing the breast volume to be irradiated. When the skin overlying the tumour in the upper outer quadrant is involved, the removal of the skin during mammoplasty could lead to an extreme reduction of the breast, resulting in a bad outcome. Different strategies have been adopted to avoid a poor cosmetic result including a Z plastic or latissimus dorsi (LD) mini flap. At our institution we developed a new technique utilizing an inferior bifurcated pedicle mammoplasty with the preservation of a skin island for a patient with a residual tumour following chemotherapy involving the skin in the upper outer quadrant of the right breast. The patient did show no complications, with no delay for adjuvant radiotherapy treatment. Our method is a novel technique to treat malignancies in this location for patients with large and ptotic breasts when skin removal is indicated and it may represent an effective strategy to prevent excessive gland reduction, thus avoiding poor cosmetic result.
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- 2020
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5. Clinically unquestionable but histologically deceptive melanomas in acral skin grafts: PRAME confirms its role
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Giacomo Santandrea, Riccardo Valli, Moira Ragazzi, Fabio Castagnetti, Michela Lai, Caterina Longo, and Simonetta Piana
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Skin Neoplasms ,Antigens, Neoplasm ,Humans ,Dermatology ,Skin Transplantation ,Melanoma - Abstract
The aim of this study was to investigate the role of PRAME in reducing the risk of an underestimation of tumour margins, in a consecutive series of acral melanomas recurring on skin grafts.
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- 2022
6. A Pure Autologous Dermal Graft and Dermal Flap Pocket in Prepectoral Implant Reconstruction After Skin-Reducing Mastectomy: A One-Stage Autologous Reconstruction Alternative to Acellular Dermal Matrices
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Fabio Castagnetti, Saverio Coiro, Monica Foroni, Giuseppe Falco, Simone Mele, Eugenio Cenini, Evelina Begnini, Giulia Borgonovo, and Guglielmo Ferrari
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Treatment Outcome ,Esthetics ,Breast Implants ,Mammaplasty ,Humans ,Surgery ,Acellular Dermis ,Breast Neoplasms ,Female ,Breast Implantation ,Mastectomy ,Retrospective Studies - Abstract
Skin-reducing mastectomy (SRM) with subpectoral implant positioning represents a consolidated, oncologically safe and cosmetically effective method for the immediate reconstruction of large and ptotic breasts. Acellular dermal matrix (ADM) has been proposed as a substitute for the pectoralis major muscle in this surgical approach; this technique led to a progressive evolution toward prepectoral reconstructions even in skin-reducing mastectomies. Obese patients with macromastia who are typical candidates for SRM with ADM are at increased risk of complications associated with ADMs. Therefore, we avoided ADMs and developed a novel autologous technique for immediate breast reconstruction in large and ptotic breasts eligible for SRM. Specifically, an autologous dermal graft is harvested from contralateral healthy breast reduction to cover the upper pole of the prepectoral implant.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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- 2021
7. Keeping Volume and Contour When Reconstructing the Enlarged Earlobe After Gauging
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Fabio Castagnetti
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business.industry ,Dermatologic Surgical Procedures ,Ear Deformities, Acquired ,Dermatology ,General Medicine ,Surgical Flaps ,Body Modification, Non-Therapeutic ,Young Adult ,medicine.anatomical_structure ,medicine ,Humans ,Surgery ,Computer vision ,Female ,Artificial intelligence ,Ear, External ,business ,Earlobe ,Geology ,Volume (compression) - Published
- 2020
8. The Bovine Pericardium Matrix in Immediate Implant-Based Breast Reconstruction
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Chiara Bertani, Filomena De Bonis, Monica Foroni, Guglielmo Ferrari, Eugenio Cenini, Giuseppe Falco, and Fabio Castagnetti
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medicine.medical_specialty ,medicine.medical_treatment ,Breast Implants ,Mammaplasty ,Breast Neoplasms ,030230 surgery ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,medicine ,Animals ,Humans ,Acellular Dermis ,Breast Implantation ,Mastectomy ,Retrospective Studies ,business.industry ,Surgical wound ,Capsular contracture ,medicine.disease ,Surgery ,Plastic surgery ,Treatment Outcome ,Seroma ,Cattle ,Implant ,Breast reconstruction ,business ,Pericardium ,Follow-Up Studies - Abstract
Acellular dermal matrices have been introduced to optimize direct-to-implant breast reconstruction. We selected a bovine pericardium noncross-linked matrix. The study consists in the retrospective analysis of 123 patients (141 breasts) who underwent conservative mastectomy and immediate implant-based breast reconstruction with bovine pericardium matrix Veritas® from March 2012 to October 2017. The overall rates of early and late complications, after a median follow-up of 51.84 months, were, respectively, 37.6% and 24.1%. The most noticeable early complications were flap ischemia [n = 39 (27.7%)], hematoma [n = 5 (3.6%)], marginal skin flap necrosis [n = 5 (3.6%)] and dehiscence of the surgical wound [n = 2 (1.4%)]. The most common late complications were rippling [n = 18 (12.7%)] and seroma [n = 4 (2.8%)]. The rate of clinically relevant capsular contracture was low: 12.1% (n = 17) presented grade II and only 2.1%% (n = 3) grade III. Implant substitution became necessary for five patients (3.6%). Early complications occurred more frequently in patients undergoing therapeutic mastectomy (p = 0.031). Patients undergoing preoperative radiotherapy more frequently developed late complications (p = 0.012). A clinically relevant capsular contracture (grade II–III) was found in higher average patients age (p = 0.0019). The left side developed less frequently late complications except for rippling (p = 0.002). Rippling occurred more frequently in patients who sustained a nipple skin-sparing mastectomy (p = 0.035). Our results further support the safety of Veritas® in immediate implant-based breast reconstruction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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- 2020
9. Dramatic progression of a chest wall desmoid-like fibromatosis
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Teresa Di Stefano, Riccardo Valli, Maurizio Zizzo, Fabio Castagnetti, Roberto Borrelli, Filippo Lococo, and Salvatore Bellafiore
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Aged, 80 and over ,medicine.medical_specialty ,business.industry ,Biopsy, Needle ,Fibromatosis ,General Medicine ,chest ,Thoracic Neoplasms ,medicine.disease ,Immunohistochemistry ,Severity of Illness Index ,Fibromatosis, Aggressive ,Rare Diseases ,Treatment Outcome ,Settore MED/21 - CHIRURGIA TORACICA ,Disease Progression ,medicine ,Humans ,Female ,Surgery ,Radiology ,Thoracic Wall ,Tomography, X-Ray Computed ,business ,Follow-Up Studies - Published
- 2019
10. Subcutaneous pigmented clear cell sarcoma as a challenging simulator of melanoma
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Simonetta Piana, Caterina Bombonato, Fabio Castagnetti, Davide Nicoli, Elvira Moscarella, and Caterina Longo
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Fatal outcome ,Skin Neoplasms ,Biopsy ,Dermatology ,Groin ,Clear Cell ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Fatal Outcome ,Subcutaneous Tissue ,Diagnosis ,medicine ,Needle ,Humans ,Melanoma ,business.industry ,Disease progression ,Sarcoma ,medicine.disease ,Immunohistochemistry ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Differential ,Biopsy, Needle ,Diagnosis, Differential ,Disease Progression ,Lymph Node Excision ,Lymph Nodes ,Sarcoma, Clear Cell ,Clear-cell sarcoma ,business ,Subcutaneous tissue - Published
- 2018
11. When Biopsy Alone Is Not Enough for the Diagnosis
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Elisabetta Froio, Elvira Moscarella, Fabio Castagnetti, Simonetta Piana, and Cinzia Ricci
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Male ,Clinicopathologic correlation ,Pathology ,medicine.medical_specialty ,Skin Neoplasms ,Biopsy ,Dermatology ,Histogenesis ,Pathology and Forensic Medicine ,Lesion ,Hemangioma ,Predictive Value of Tests ,Biomarkers, Tumor ,medicine ,Humans ,Diagnostic Errors ,Neovascularization, Pathologic ,integumentary system ,medicine.diagnostic_test ,Merkel cell carcinoma ,business.industry ,Mesenchymal stem cell ,General Medicine ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Carcinoma, Merkel Cell ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
Merkel cell carcinoma (MCC) is an aggressive tumor with an uncertain histogenesis typically arising on sun-damaged skin of the elderly. It has rarely been described in association with other tumors such as epithelial, melanocytic, and mesenchymal, but not vascular neoplasias. However, an exuberant vascular reaction is considered a common phenomenon in neuroendocrine neoplasms, where it can even obscure the proliferating cells and mimic a primary vascular neoplasia. A 47-year-old man was referred for the evaluation of a long-lasting reddish skin tumor located on the right buttock. After 2 punch biopsies, the patient underwent surgical excision of the lesion. Histological examination showed a dermal florid, benign vascular proliferation overlying some large deep coalescent nodules made up of monomorphous round cells with scant cytoplasm and a high mitotic activity. After the appropriate immunohistochemical stainings, a final diagnosis of hemangioma overlying a previously unrecognized MCC was rendered. Whether the angiomatous proliferation should be considered an exuberant reaction to the tumor, induced by an angiogenetic drive, or a true hemangioma is somewhat controversial. The main point is that such a neoplastiform angiomatous proliferation may represent a potential diagnostic pitfall, especially in limited specimens, and that an accurate clinicopathologic correlation is always needed. In our case, even if additional punch biopsies had been performed, the vascular proliferation would dominate the histological picture and an accurate diagnostic conclusion would probably not be reached due to the deep location of the MCC.
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- 2015
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12. Problematic Lesions in Children
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Iris Zalaudek, Vincenzo Piccolo, Stefania Pizzigoni, Giuseppe Argenziano, Caterina Longo, Fabio Castagnetti, Aimilios Lallas, Elvira Moscarella, Moscarella, Elvira, Piccolo, Vincenzo, Argenziano, Giuseppe, Lallas, Aimilio, Longo, Caterina, Castagnetti, Fabio, Pizzigoni, Stefania, and Zalaudek, Iris
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Male ,Pathology ,medicine.medical_specialty ,Skin Neoplasms ,Adolescent ,Adult population ,Dermoscopy ,Epithelioid and Spindle Cell ,Dermatology ,Spitz nevi ,Diagnosis, Differential ,Atypical spitz tumor ,Childhood ,Congenital nevi ,Melanocytic nevi ,Melanoma ,2708 ,Pigmented ,Nevus, Epithelioid and Spindle Cell ,Diagnosis ,Child ,Child, Preschool ,Female ,Humans ,Nevus, Pigmented ,Medicine ,Nevus ,Skin Neoplasm ,Preschool ,skin and connective tissue diseases ,neoplasms ,integumentary system ,business.industry ,medicine.disease ,medicine.anatomical_structure ,Scalp ,Differential ,Differential diagnosis ,business ,Human - Abstract
Melanoma in childhood is rare, and appears more commonly either in association with a preexisting (congenital) nevus, or with spitzoid features than de novo. Thus, problematic melanocytic lesions in children are essentially represented by congenital nevi and Spitz nevi that can be regarded as melanoma precursors and melanoma simulators, respectively. As a consequence, clinical and dermoscopic features of melanoma in children differ from those in an adult population. Herein we describe common clinical and dermoscopic features of problematic lesions in children, focusing on congenital and Spitz/Reed nevi, and including other problematic lesions, such as atypical, blue, acral, and scalp nevi.
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- 2013
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13. Lymph nodes' capsular naevi are associated with high naevus count in melanoma patients: a case-control study
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Francesca Specchio, Simone Ribero, Fabio Castagnetti, Simonetta Piana, Caterina Longo, Giuseppe Argenziano, Aimilios Lallas, Roberto Alfano, Elvira Moscarella, Ribero, Simone, Longo, Caterina, Specchio, Francesca, Piana, Simonetta, Castagnetti, Fabio, Moscarella, Elvira, Lallas, Aimilio, Alfano, Roberto, and Argenziano, Giuseppe
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capsular naevi ,melanoma ,naevus count ,sentinel lymph node ,Oncology ,2708 ,Cancer Research ,Male ,medicine.medical_specialty ,Prognostic factor ,Skin Neoplasms ,genetic structures ,Sentinel lymph node ,Dermatology ,Breslow Thickness ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Medicine ,Humans ,skin and connective tissue diseases ,Melanoma ,Retrospective Studies ,Nevus, Pigmented ,business.industry ,Case-control study ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,030220 oncology & carcinogenesis ,Case-Control Studies ,Female ,Lymph ,Lymph Nodes ,Skin cancer ,business ,Dysplastic Nevus Syndrome ,Follow-Up Studies - Abstract
Capsular naevi (CNs) in lymph nodes (LNs) are relatively common, occurring in 3-22% of patients who undergo LN surgery for melanoma. Naevus count is one of the principal risk factors for melanoma, as well as a prognostic factor in melanoma patients. However, little is known about the occurrence of CN in melanoma patients on the basis of their naevus count. A case-control study was performed, to look at the naevus count differences between CN-positive and CN-negative melanoma patients. Cases (CN positive) were matched for age, sex and Breslow thickness with controls (CN negative). Total naevus count was recorded at diagnosis and compared between the two groups. This study was conducted in a tertiary referral academic centre for skin cancer. Twenty-two positive CN patients were matched with 22 negative CN patients. The mean Breslow thickness was 2.66 mm (range: 0.6-9). Positive CN patients were significantly associated with an increasing naevus count on their skin (P=0.02). Patients with more than 100 naevi reported an odds ratio of 7.78 on having a CN compared with patients with fewer than 50 naevi on their skin (P=0.02). An increased melanocytic migration to LNs might be the reason for the association between CNs and a high number of melanocitic naevi on the skin. This could shed some light on the physiology of melanocytes and could be an easy way to predict patients at greater risk of having CNs.
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- 2017
14. ILDS Newsletter No. 30
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Daniel Wagschal, Simonetta Piana, V. Roberti, Honggang Tu, Matthias Goebeler, Druck Reinhardt Druck Basel, Moira Ragazzi, Axel Patrice Villani, M. Augustin, C. Carrera, S. Puig, Fukumi Furukawa, H. Heigel, P. Spring, M. Curzio, Dennis McGonagle, Ayako Kimura, T.A. Duong, Takahiro Haga, Noriyuki Aoyagi, Luca Borradori, Aimilios Lallas, J. Malvehy, Axel Trautmann, D. Hohl, Elvira Moscarella, Satz Mengensatzproduktion, Sadanori Furudate, Taku Fujimura, Giuseppina Abignano, Francesco Del Galdo, Concepción Castillo-Gallego, Rivka Friedland, Rotem Tal, O. Chosidow, P. Perrier, Giuseppe Argenziano, P. Erba, Sibel Zehra Aydin, Giovanni Pellacani, Nobuo Kanazawa, Tamara Palmieri, Zhi-Hui Tang, P. Wolkenstein, Moshe Lapidoth, Genichi Tojo, Mitsuko Kawano, G. Trevisan, S. Ingen-Housz-Oro, Yumi Kambayashi, Miriam Wittmann, K. Herberger, Mona Amini-Adle, L. Alos, Kouetsu Ogasawara, Heiko Poppe, Caterina Longo, J.C. Simon, T. Kornek, S. Gobbi, I. Alarcon, Hong Bei, Iris Zalaudek, Marco Stieger, Michael P. Horn, Koji Uede, Masumi Okuda, M. Bagot, L. Baudoux, Kayo Kunimoto, C. Beham-Schmid, J. Corneille, M. Wiednig, Alex Zvulunov, E. Sbidian, N. Di Meo, R. Coppola, T. Lopez, Chao Liu, Lidia M. Poppe, Helmut Beltraminelli, V. Panasiti, A. Gatti, Luc Thomas, Stefano Gardini, Dan Ben Amitai, T. Wetzig, M.A. Radtke, E. Aberer, S. Calvieri, V. Devirgiliis, Brigitte Balme, I. Schaefer, P. Hagmann, Laurent Parmentier, T. Gonzalez, M. Averbeck, M.C. Mihm, Helena Marzo-Ortega, Hai-Yan Zeng, M. Kendler, Zoe Spanou, P. Lieto, Zoe Ash, Akira Hashimoto, Fabio Castagnetti, M. Armengot-Carbo, P. Londei, B. Kranzelbinder, L. Valeyrie-Allanore, Setsuya Aiba, A. Naspi, A. Abrego, and Masato Mizuashi
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medicine.medical_specialty ,business.industry ,medicine ,Dermatology ,business - Published
- 2013
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15. Early diagnosis of melanoma: what is the impact of dermoscopy?
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Giuseppe Argenziano, Vito Di Lernia, Fabio Castagnetti, Caterina Longo, Giuseppe Albertini, Giovanni Pellacani, Cinzia Ricci, Iris Zalaudek, Simonetta Piana, and Barbara De Pace
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Dermatoscopy ,medicine.medical_specialty ,medicine.diagnostic_test ,Practice patterns ,business.industry ,Mortality rate ,Melanoma ,MEDLINE ,Dermatology ,General Medicine ,medicine.disease ,medicine ,business ,Melanoma diagnosis - Abstract
There are three possible explanations for the improved melanoma recognition when a clinician uses dermoscopy: first, the presence of early dermoscopy signs that become visible in melanoma much before the appearance of the classical clinical features; second, an increased attitude of clinicians to check more closely clinically banal-looking lesions; and third, an improved attitude of clinicians to monitor their patients. In this review, the light and the dark sides of melanoma screening are briefly discussed, including the need to find better strategies to decrease the number of unnecessary excision of benign lesions on one hand, and to finally decrease melanoma mortality rates on the other.
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- 2012
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16. Bilateral breast reconstruction with DIEP flaps: 4 years’ experience
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Igor Stupka, Ivan Justan, P Hyza, Fabio Castagnetti, Pavel Novák, Nicola Monni, Lubos Drazan, and Jiri Vesely
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Adult ,medicine.medical_specialty ,Esthetics ,Mammaplasty ,medicine.medical_treatment ,Breast Neoplasms ,Surgical Flaps ,Postoperative Complications ,DIEP flap ,Humans ,Medicine ,Bilateral Prophylactic Mastectomy ,Rectus abdominis muscle ,Mastectomy ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Prophylactic Mastectomy ,Middle Aged ,Surgery ,Treatment Outcome ,Patient Satisfaction ,Quality of Life ,Feasibility Studies ,Female ,business ,Breast reconstruction - Abstract
Summary Bilateral prophylactic mastectomy without reconstruction is not accepted by the majority of patients. Successful reconstruction is therefore a mandatory condition for prophylactic mastectomy. Of the many options for autologous breast reconstruction, the deep inferior epigastric perforator (DIEP) flap best meets requirements for bilateral reconstruction in selected patients. The goal of this study is to verify the feasibility of the procedure in our conditions and to find out how it is accepted by patients. We present 55 consecutive patients who were scheduled for bilateral DIEP flap reconstruction during a 4-year period. We reviewed medical charts, performed clinical assessments and processed anonymous questionnaires. There were 77 immediate and 33 delayed breast reconstructions. There was 100% flap survival and no microanastomoses revisions. In 11 patients (10%) the surgeon preferred to convert the DIEP into a mini transverse rectus abdominis muscle (miniTRAM) flap in order to provide adequate blood supply. Complications: revision for haematoma under the flap in four patients (7.2%), excessive blood loss in four patients (7.2%) and partial mastectomy skin flap necrosis in 10 immediate breast reconstructions (12.9%). Patients' evaluation of the aesthetic result was good or excellent in 96.2% of cases. In 33.9% of patients the postoperative quality of life was considered unchanged and 50.9% of them it even improved. The DIEP flap is recommended for bilateral breast reconstruction. Occasional conversion into a miniTRAM flap can increase the total flap survival rate. Bilateral prophylactic mastectomy and DIEP flap reconstruction are very well accepted by patients.
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- 2008
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17. Ex Vivo Fluorescence Microscopy
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Stefano Gardini, Caterina Longo, Moira Ragazzi, Giuseppe Argenziano, Giovanni Pellacani, Fabio Castagnetti, and Simonetta Piana
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Pathology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,medicine.disease ,law.invention ,Surgical pathology ,Breast cancer ,Confocal microscopy ,law ,medicine ,Mohs surgery ,Fluorescence microscope ,Basal cell carcinoma ,Skin cancer ,business ,Ex vivo - Abstract
Ex vivo fluorescence confocal microscopy (FCM) is a novel imaging technique that can be applied on freshly excised tumors for rapid bedside pathology for Mohs surgery and in general pathology. The first clinical application of FCM was on skin cancers such as basal cell carcinoma, for which it has demonstrated high sensitivity and specificity for margin assessment. Later, FCM was applied on freshly excised specimens in general pathology and in particular on breast cancer samples. Preliminary studies highlighted the potential applicability of this fascinating new tool to characterize the tumor and obtain a rapid detection of residual tumor in surgical margins.
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- 2016
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18. Ultrasound-Guided Percutaneous Catheter Drainage of Large Breast Abscesses in Lactating Women: How to Preserve Breastfeeding Safely
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Nicola Rocco, Monica Foroni, Rita Vacondio, Fabio Castagnetti, Daniele Bordoni, Vanessa Marchesi, Giuseppe Falco, Valentina Iotti, Luigi Marano, and Guglielmo Ferrari
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Adult ,medicine.medical_specialty ,Percutaneous ,Cost-Benefit Analysis ,ultrasound-guided drainage ,Breastfeeding ,Mastitis ,Pediatrics ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Breast Diseases ,0302 clinical medicine ,breast abscess ,breastfeeding preservation ,Abscess ,Breast Feeding ,Drainage ,Female ,Humans ,Infant ,Infant, Newborn ,Italy ,Lactation ,Prospective Studies ,Treatment Outcome ,Ultrasonography, Interventional ,Maternity and Midwifery ,medicine ,Seldinger technique ,Ultrasonography ,Pregnancy ,Interventional ,business.industry ,Health Policy ,Obstetrics and Gynecology ,medicine.disease ,Newborn ,Surgery ,030220 oncology & carcinogenesis ,business ,Surgical incision ,Breast feeding - Abstract
Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation.34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess. A pigtail catheter was inserted into the fluid collection using the Seldinger technique under US guide and connected to a three stop way to allow drainage and irrigation of the cavity until its resolution.All procedures have been found safe and well tolerated. No recurrence was observed and breastfeeding was never interrupted.The described technique allows to avoid surgery and to preserve breastfeeding in well-selected patients with a safe, well-tolerated and cost-effective procedure.
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- 2016
19. Overexpansion technique in burn scar management
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Cristiano Dominici, Edoardo Caleffi, Francesca Mazzeo, Donatello Di Mascio, and Fabio Castagnetti
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Tissue Expansion ,Economic shortage ,Thigh ,Critical Care and Intensive Care Medicine ,Surgical Flaps ,Cicatrix ,medicine ,Humans ,Child ,Patient compliance ,Burn scar ,business.industry ,Tissue Expansion Devices ,Skin Transplantation ,General Medicine ,Middle Aged ,Trunk ,Surgery ,medicine.anatomical_structure ,Patient Satisfaction ,Emergency Medicine ,Female ,Body region ,Implant ,Burns ,business ,Volume (compression) - Abstract
Overexpansion techniques are useful in overcoming a shortage of donor site for expansion: the aim of the authors was to verify whether this technique should be chosen instead of serial expansions for creation of wider and more malleable flaps for reconstruction. From 1993 to May 2005 we have overexpanded 59 patients with burn scars. The patients always underwent reconstruction at least 2 years after complete healing. Almost any body region capable of expansion has been overexpanded. The technique is illustrated here in the reconstruction of scalp, neck, trunk and thigh. Tissue expander original volume ranged from 450 to 800 cc: the silicon implant shape was both round and rectangular. Mean overinflation was 3.6 times beyond the stated vendor's maximum volume. The principle ratios were performed in the trunk (4.375) and in the lower extremities (4.125). The largest volume instilled in a single tissue expander was 3500 cc. Overall expansion length was on average 172.6 days (range: 101–248). All patients were compliant with inflation once a week. The reconstructions were planned as the expansion of a transposition or an advancement flap. All patients had completion of their reconstruction with satisfactory resolution of their problem: complications occurred in three of all hyperinflated prostheses. Tissue overexpansion, if carefully planned and conducted, allows the completion of reconstruction in one-stage. Instead of serial expansions, it enhances patient compliance and reduces cost.
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- 2006
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20. Tubed Flap Interpolation in Reconstruction of Helical and Ear Lobe Defects
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Fabio Castagnetti and Donatello Di Mascio
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Adult ,Male ,medicine.medical_specialty ,Motorcycle accident ,Adolescent ,Dermatology ,Surgical Flaps ,medicine ,Humans ,Tube (container) ,Ear, External ,business.industry ,Ear Deformities, Acquired ,Anatomy ,General Medicine ,Plastic Surgery Procedures ,medicine.disease ,Dog bite ,Surgery ,Bridge (graph theory) ,Treatment Outcome ,Tube length ,Ear lobe ,Wounds and Injuries ,Female ,business - Abstract
Background. A useful reconstructive tool, as a delayed method, for marginal defects of the ear of more than 2.5 cm wide with no deficit of the cartilaginous frame and low scapha involvement, consists of tubed flaps raised from neighboring areas. The patients treated with this technique sustained a dog bite in three cases, a human bite in one case, a motorcycle accident in one case, and finally, a burn trauma in two cases. Objective. Three different cases of acquired marginal defects, namely ascending superior helix, descending helix, and cauda elicis with lobule involvement, are shown. Methods. In the helix reconstruction, the tube width has not to be more than 15 mm, and the tube length has to be 1 cm longer than the defect. There was no conditioning of the flaps. No pedicle bridge was interposed along the major tube. The interval between two divisions was on average approximately 5 weeks. Results. Seven patients were treated with this technique: In all cases, we had no infections or skin necrosis. To avoid a shrinkage of the tube, a correct ratio between flap dimensions and helical defect has to be estimated. Conclusion. Although it is considered an old technique and it is a multistage reconstructive sequence, this procedure could be the first preference in cases of marginal defects more than 2.5 cm wide. This is because it restores naturally the anatomy of the helix.
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- 2004
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21. Double V-Y Advancement Flap in the Management of Lower Lip Reconstruction
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Fabio Castagnetti, Giovanni Bianco, Franco Papadia, Alessio Baccarani, and A. Bocchi
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Treatment outcome ,Lower lip ,Surgical Flaps ,Surgery ,V-y advancement ,stomatognathic diseases ,Plastic surgery ,Treatment Outcome ,Lip cancer ,Lip Neoplasms ,Carcinoma, Squamous Cell ,medicine ,Humans ,Female ,Vermilion ,Surgical treatment ,business ,Aged - Abstract
A new method for lower lip reconstruction is proposed. It is based on a double cutaneous and mucous V-Y advancement flap and is suggested for the surgical treatment of lip cancer confined between the skin and the vermilion with a horizontal spread. Sixteen patients were treated from 1996 to 2001 with this technique and the results were satisfactory both from the functional and the aesthetic standpoints.
- Published
- 2003
- Full Text
- View/download PDF
22. Dermoscopy in the diagnosis and management of basal cell carcinoma
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Zoe Apalla, Dafne Ramundo, Aimilios Lallas, Fabio Castagnetti, Iris Zalaudek, Elvira Moscarella, Caterina Longo, Dimitrios Ioannides, Tamara Palmieri, Giuseppe Argenziano, Lallas, Aimilio, Apalla, Zoe, Ioannides, Dimitrio, Argenziano, Giuseppe, Castagnetti, Fabio, Moscarella, Elvira, Longo, Caterina, Palmieri, Tamara, Ramundo, Dafne, and Zalaudek, Iris
- Subjects
medicine.medical_specialty ,Pathology ,nonsurgical treatments ,Cancer Research ,Skin Neoplasms ,animal structures ,diagnosis ,Early detection ,dermatoscopy ,basal cell carcinoma ,dermoscopy ,pigmentation ,subtype ,ulceration ,Oncology ,Medicine (all) ,medicine ,Humans ,Basal cell carcinoma ,skin and connective tissue diseases ,neoplasms ,Dermatoscopy ,medicine.diagnostic_test ,integumentary system ,business.industry ,fungi ,nonsurgical treatment ,Disease Management ,General Medicine ,medicine.disease ,Dermatology ,Tumor Subtype ,diagnosi ,Carcinoma, Basal Cell ,business - Abstract
The dermoscopic findings of basal cell carcinoma (BCC) were first described more than a decade ago and the list of BCC-related criteria has been several times updated and enriched. Today, the dermatoscope is considered the key tool for the diagnosis of BCC, since it allows its early detection and enables its discrimination from other pigmented and nonpigmented skin tumors. The dermoscopic pattern of BCC results from several combinations of well-known BCC criteria, depending on several factors, including histopathologic subtype, location, gender, age and pigmentary trait. In addition, recent evidence highlighted that dermoscopy is also useful in the management of BCC, since it provides information on the tumor subtype, the presence of pigmentation or ulceration and the response to nonablative treatments.
- Published
- 2015
23. Oncological safety of breast cancer patients undergoing free-flap reconstruction and lipofilling
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Daniele Bordoni, Giuseppe Falco, G. Pons, C. Liuzza, Fabio Castagnetti, and J. Masia
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Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Mammaplasty ,Breast Neoplasms ,Free flap ,Free Tissue Flaps ,Breast cancer ,medicine ,Fat grafting ,Humans ,Mastectomy ,Retrospective Studies ,business.industry ,Hazard ratio ,Carcinoma, Ductal, Breast ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Carcinoma, Lobular ,Carcinoma, Intraductal, Noninfiltrating ,Treatment Outcome ,Oncology ,Adipose Tissue ,Case-Control Studies ,Free flap reconstruction ,Female ,Neoplasm Recurrence, Local ,Breast reconstruction ,business ,Free flap surgery - Abstract
Background: Autologous fat grafting is a widely accepted approach for breast reconstruction after mastectomy but its oncological safety has not been established. This study aimed to compare recurrence in patients who underwent fat-grafting procedures after autologous breast reconstruction and those who did not. Patients and methods: We retrospectively reviewed 207 consecutive patients, who underwent mastectomy and reconstruction using free flap surgery. We divide them in two groups: a study group of patients who underwent fat grafting procedure and a control group of patients who did not. Outcome regarding local and regional recurrence was compared between the two groups. Particularly, we studied recurrences from primary surgery to baseline (first lipofilling) and from baseline to most recent follow-up. Results: Median follow-up was 60 months from surgery to baseline and 29 months from baseline to most recent follow-up. The overall observational period after mastectomy in the control group was 120 months. Local recurrence was observed in 6 patients from the study group, respectively 3 in the first observational period and 3 after the fat grafting procedure. The control group, as the study one, presented a total of 6 recurrences (p ¼ 0.555; Hazard Ratio free flap and lipo vs only free flap: ¼ 0.66; 95% CI 0.16e2.66). Conclusions: We found no significant differences in recurrence between patients who underwent fat grafting and those who did not. These encouraging findings support previous results but larger series of patients are required to confirm long-term oncological safety in these procedures.
- Published
- 2014
24. Breast conserving treatment for ductal carcinoma in situ in the elderly: can radiation therapy be avoided? Our experience
- Author
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Gianni Antonio Della Corte, Bruno Amato, Eugenio Cenini, Vincenzo Sabatino, Guglielmo Ferrari, Fabio Castagnetti, Maria Giulia Sommella, Daniele Bordoni, Giuseppe Falco, Nicola Rocco, E. Procaccini, Antonello Accurso, and Rita Compagna
- Subjects
Risk ,medicine.medical_specialty ,Antineoplastic Agents, Hormonal ,medicine.medical_treatment ,Breast Neoplasms ,Disease ,Mastectomy, Segmental ,Breast cancer ,medicine ,Breast-conserving surgery ,Humans ,skin and connective tissue diseases ,Aged ,Retrospective Studies ,Aged, 80 and over ,Adjuvant tamoxifen ,business.industry ,Ductal carcinoma in situ ,General Medicine ,Ductal carcinoma ,medicine.disease ,Breast conserving treatment ,Surgery ,Radiation therapy ,Tamoxifen ,Carcinoma, Intraductal, Noninfiltrating ,Treatment Outcome ,Chemotherapy, Adjuvant ,Personal choice ,Female ,Radiotherapy, Adjuvant ,Neoplasm Recurrence, Local ,business - Abstract
Introduction : Ductal Carcinoma In Situ (DCIS) is a heterogeneous, pre-malignant disease accounting for 15–20% of all new breast cancers. If appropriately managed, DCIS has a small chance of impacting on patient life expectancy. Despite the possibility of a further recurrence or of a development in an invasive form, we are unable to select treatment of choice especially in the elderly. In particularly we risk an overtreatment of women at low risk of progression to invasive breast cancer. The aim of this study was to retrospectively evaluate the outcome of elderly patients affected by DCIS not undergoing Radiation Therapy (RT) after Breast Conserving Surgery (BCS). Material and methods : We reviewed our prospectively-maintained database from 1998 to 2013, selecting all women over 65 years old diagnosed with DCIS who did not receive RT for personal choice. We considered two groups, according to the risk of local recurrence (Low Risk (Group 1) vs. High Risk (Group 2)). Results : We identified 44 cases of DCIS treated with surgery alone or with surgery followed by adjuvant tamoxifen. 24 patients presented low risk of local recurrence (Group 1) and 20 had characteristics associated to high risk of local recurrence (Group 2). At a median follow-up of 66.3 months, no local recurrences have been described in group 1. No patients presented distant metastases, while 4 patients died for other causes. At a median follow-up of 72 months we observed 5 local recurrences in the second group ( p Conclusion : Our results suggest that radiation therapy can be safely avoided in a selected group of elderly patients affected by DCIS.
- Published
- 2014
25. Fluorescence confocal microscopy for pathologists
- Author
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Monica Foroni, Giovanni Pellacani, Giorgio Gardini, Moira Ragazzi, Fabio Castagnetti, Simonetta Piana, Caterina Longo, and Guglielmo Ferrari
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Fluorescence confocal microscopy ,Confocal ,Cytodiagnosis ,H&E stain ,Breast Neoplasms ,Biology ,Fluorescence ,Pathology and Forensic Medicine ,law.invention ,Surgical pathology ,chemistry.chemical_compound ,Clinical ,Confocal microscopy ,law ,Endomicroscopy ,medicine ,Humans ,Breast ,Thyroid Neoplasms ,Thyroid ,Frozen section procedure ,Microscopy ,Microscopy, Confocal ,Pathology, Clinical ,Colorectum ,Lymph node ,Colorectal Neoplasms ,Female ,Lymphatic Metastasis ,Microscopy, Fluorescence ,Acridine orange ,Histology ,chemistry - Abstract
Confocal microscopy is a non-invasive method of optical imaging that may provide microscopic images of untreated tissue that correspond almost perfectly to hematoxylin- and eosin-stained slides. Nowadays, following two confocal imaging systems are available: (1) reflectance confocal microscopy, based on the natural differences in refractive indices of subcellular structures within the tissues; (2) fluorescence confocal microscopy, based on the use of fluorochromes, such as acridine orange, to increase the contrast epithelium-stroma. In clinical practice to date, confocal microscopy has been used with the goal of obviating the need for excision biopsies, thereby reducing the need for pathological examination. The aim of our study was to test fluorescence confocal microscopy on different types of surgical specimens, specifically breast, lymph node, thyroid, and colon. The confocal images were correlated to the corresponding histological sections in order to provide a morphologic parallel and to highlight current limitations and possible applications of this technology for surgical pathology practice. As a result, neoplastic tissues were easily distinguishable from normal structures and reactive processes such as fibrosis; the use of fluorescence enhanced contrast and image quality in confocal microscopy without compromising final histologic evaluation. Finally, the fluorescence confocal microscopy images of the adipose tissue were as accurate as those of conventional histology and were devoid of the frozen-section-related artefacts that can compromise intraoperative evaluation. Despite some limitations mainly related to black/white images, which require training in imaging interpretation, this study confirms that fluorescence confocal microscopy may represent an alternative to frozen sections in the assessment of margin status in selected settings or when the conservation of the specimen is crucial. This is the first study to employ fluorescent confocal microscopy on surgical specimens other than the skin and to evaluate the diagnostic capability of this technology from pathologists' viewpoint.
- Published
- 2014
26. Morphologic grading and treatment of facial actinic keratosis
- Author
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Elvira Moscarella, Caterina Longo, Giuseppe Argenziano, Fabio Castagnetti, Enrico Zendri, Giovanni Pellacani, Iris Zalaudek, Aimilios Lallas, Simonetta Piana, Zalaudek, Iri, Piana, Simonetta, Moscarella, Elvira, Longo, Caterina, Zendri, Enrico, Castagnetti, Fabio, Pellacani, Giovanni, Lallas, Aimilio, and Argenziano, Giuseppe
- Subjects
Reflectance confocal microscopy ,medicine.medical_specialty ,Actinic ,Keratosis ,Dermoscopy ,Dermatology ,Humans ,Microscopy, Confocal ,Facial Dermatoses ,Facial Neoplasms ,Keratosis, Actinic ,Precancerous Conditions ,medicine ,Facial Dermatose ,Microscopy ,Confocal ,2708 ,Grading (tumors) ,Facial neoplasm ,Subclinical infection ,business.industry ,Actinic keratosis ,Actinic keratoses ,medicine.disease ,Facial Neoplasm ,Field cancerization ,business ,Human - Abstract
Actinic keratoses (AKs) represent the earliest stage in the development of squamous cell carcinoma (SCC) and represent important biomarkers for individuals at risk for development of invasive SCC. Based on clinical morphology, AK can be subdivided into three different grades, which correspond to specific dermatoscopic, reflectance confocal microscopic, and histopathologic substrates. Given the risk for potential progression toward invasive SCC, AK should be treated at the earliest stage. A wide range of minimal destructive or topical therapies is available for the treatment of AK. The choice of treatment depends on the number, size, clinical grading, duration, and location of lesions, patient's compliance, general health conditions, and cosmetic outcome. Treatment can be divided into lesion-directed and field-directed therapies. Lesion-directed treatment focuses on the treatment of single lesions, whereas field-directed treatment aims to eliminate both clinically visible and subclinical lesions within the field of actinic damage (concept of field cancerization). Noninvasive techniques such as dermoscopy and reflectance confocal microscopy can be helpful in identifying AK potentially progressing toward SCC, as well as in the selection of the adequate treatment and monitoring of the treatment outcome.
- Published
- 2014
27. Atypical Spitz tumours and sentinel lymph node biopsy: A systematic review
- Author
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Elvira Moscarella, Zoe Apalla, Caterina Longo, Simonetta Piana, Aimilios Lallas, Fabio Castagnetti, Harald Kittler, Athanassios Kyrgidis, Iris Zalaudek, Gerardo Ferrara, Giuseppe Argenziano, Lallas, Aimilio, Kyrgidis, Athanassio, Ferrara, Gerardo, Kittler, Harald, Apalla, Zoe, Castagnetti, Fabio, Longo, Caterina, Moscarella, Elvira, Piana, Simonetta, Zalaudek, Iri, and Argenziano, Giuseppe
- Subjects
Pathology ,medicine.medical_specialty ,Skin Neoplasms ,Prognosi ,Sentinel lymph node ,Predictive Value of Test ,Epithelioid and Spindle Cell ,Humans ,Lymph Nodes ,Lymphatic Metastasis ,Nevus, Epithelioid and Spindle Cell ,Patient Selection ,Predictive Value of Tests ,Prognosis ,Risk Factors ,Sentinel Lymph Node Biopsy ,Biopsy ,medicine ,Nevus ,In patient ,Skin Neoplasm ,medicine.diagnostic_test ,business.industry ,Risk Factor ,Melanoma ,Lymph Node ,Lymphatic Metastasi ,medicine.disease ,Oncology ,Predictive value of tests ,Lymph ,business ,Human ,Paediatric population - Abstract
Sentinel lymph node biopsy has been proposed as a diagnostic method for estimation of the malignant potential of atypical Spitz tumours. However, although cell deposits are commonly detected in the sentinel lymph nodes of patients with atypical Spitz tumours, their prognosis is substantially better than that of patients with melanoma and positive sentinel lymph node biopsies. We did a systematic review of published reports to assess the role of sentinel lymph node biopsy as a prognostic method in the management of atypical Spitz tumours. The results of our analysis did not show any prognostic benefit of sentinel lymph node biopsy; having a positive sentinel lymph node does not seem to predict a poorer outcome for patients with atypical Spitz tumours. These findings indicate that, especially in the paediatric population, it might be prudent initially to use complete excision with clear margins and careful clinical follow-up in patients with atypical Spitz tumours.
- Published
- 2014
28. Inserting ex vivo fluorescence confocal microscopy perioperatively in mohs micrographic surgery expedites bedside assessment of excision margins in recurrent basal cell carcinoma
- Author
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Giuseppe Argenziano, Elvira Moscarella, Moira Ragazzi, Caterina Longo, Aimilios Lallas, Fabio Castagnetti, Stefano Gardini, Iris Zalaudek, Giovanni Pellacani, Simonetta Piana, Tamara Palmieri, Longo, Caterina, Ragazzi, Moira, Castagnetti, Fabio, Gardini, Stefano, Palmieri, Tamara, Lallas, Aimilio, Moscarella, Elvira, Piana, Simonetta, Pellacani, Giovanni, Zalaudek, Iri, Argenziano, Giuseppe, Longo, C, Ragazzi, M, Castagnetti, F, Gardini, S, Palmieri, T, Lallas, A, Moscarella, E, Piana, S, Pellacani, G, and Zalaudek, I
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Neoplasm, Residual ,Skin Neoplasms ,Point-of-Care System ,medicine.medical_treatment ,Point-of-Care Systems ,Basal Cell ,Dermatology ,Biology ,Micrographic surgery ,Fluorescence ,law.invention ,Excision margins ,Basal cell carcinoma ,Confocal microscope ,Aged, 80 and over ,Carcinoma, Basal Cell ,Humans ,Microscopy, Confocal ,Mohs Surgery ,Neoplasm Recurrence, Local ,Radiotherapy, Intensity-Modulated ,Confocal microscopy ,law ,Intensity-Modulated ,Mohs surgery ,medicine ,80 and over ,Recurrent basal cell carcinoma ,Aged ,Microscopy ,Radiotherapy ,Carcinoma ,medicine.disease ,Radiation therapy ,Neoplasm Recurrence ,Local ,Confocal ,Residual ,Neoplasm ,Ex vivo ,Human - Abstract
Mohs micrographic surgery can be employed in recurrent basal cell carcinoma, although it is a time-consuming technique. Recently, ex vivo fluorescence confocal microscopy (FCM) has been employed to obtain a fast assessment of tumor margins at the bedside. In our case we successfully employed ex vivo FCM to assess the tumor margins and we treated the persistent tumor with intensity-modulated radiation therapy. Our case demonstrates that a multidisciplinary approach is very efficient in managing complex and recurrent tumors and highlights the benefits of FCM as a new technique that can be used in the surgical theater to speed up the entire procedure.
- Published
- 2013
29. Primary vein grafting in treatment of ring avulsion injuries: a 5-year prospective study
- Author
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P Hyza, Igor Stupka, Raul Ranno, Fabio Castagnetti, Lubos Drazan, and Jiri Vesely
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,medicine.medical_treatment ,Veins ,Avulsion ,Grip strength ,Amputation, Traumatic ,Finger Injuries ,medicine ,Humans ,Prospective Studies ,Vein ,Survival rate ,business.industry ,Middle Aged ,Surgery ,Plastic surgery ,medicine.anatomical_structure ,Amputation ,Replantation ,Female ,business ,Artery - Abstract
Out of 262 hands with total finger amputations treated by replantation of finger/fingers from January 2001 until January 2006, there were only 6 cases of type III ring avulsion injuries, all of which were replanted. Radical resection of the damaged part of the artery with primary vein grafting was used in each case; only 1 artery and 2 veins were anastomosed for each finger. The survival rate was 100%. Mean total active motion was 195 degrees (ranging from 175 degrees to 220 degrees ). Mean 2-point discrimination was 8.6 mm static (ranging from 4 to 11 mm) and 6.2 mm moving (ranging from 3 to 9 mm), and mean grip strength was 37.4 kg. We believe that liberal resection of the "zone of contusion" of vessels and primary vein grafting for arterial repair can improve the overall survival rate of replantation in type III ring avulsion injuries, and replantation can be attempted in majority of the cases; good hand function can be expected.
- Published
- 2007
30. Keeping Extra Skin for Nipple-Areola Reconstruction during Mastectomy
- Author
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Lubos Drazan and Fabio Castagnetti
- Subjects
Areola reconstruction ,medicine.medical_specialty ,business.industry ,Mammaplasty ,medicine.medical_treatment ,Surgery ,Nipples ,medicine ,Humans ,Female ,business ,Mastectomy ,Skin - Published
- 2007
- Full Text
- View/download PDF
31. Double V-Y Advancement Flap in the Management of Lower Lip Reconstruction.
- Author
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Antonio Bocchi, Alessio Baccarani, Giovanni Bianco, Fabio Castagnetti, and Franco Papadia
- Published
- 2003
- Full Text
- View/download PDF
32. Otoplasty: Anterior Abrasion of Ear Cartilage with Dermabrader
- Author
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Stefano Baldassarre, Donatello Di Mascio, and Fabio Castagnetti
- Subjects
Adult ,Male ,medicine.medical_specialty ,Antihelix ,Adolescent ,Esthetics ,medicine.medical_treatment ,Abrasion (medical) ,Ear Cartilage ,Suture (anatomy) ,medicine ,Humans ,Child ,business.industry ,Dermabrasion ,Suture Techniques ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Plastic surgery ,medicine.anatomical_structure ,Italy ,Patient Satisfaction ,Child, Preschool ,Otologic Surgical Procedures ,Female ,business ,Otoplasty ,Follow-Up Studies - Abstract
The international literature describes many different techniques for correcting prominent ears. Some of these techniques use weakening of the anterior surface in an “open or close” way. Others use suturing of the unfold antihelix. Still others suture the concha with mastoid, and some combine several of these procedures. There is thus no most widely accepted single method. Since 1993, the senior author has used the described technique on a group of 40 patients (35 bilateral and 5 monolateral cases). Before 1993, the senior author always used an “open” technique, but the anterior cartilage was weakened by the partial parallel incision procedure. In the current study, the surgical approach for cases with a normal or moderately deep concha consisted of open anterior otoplasty with cartilage abrasion by an electric burr alone. If the concha was severely hypertrophied, concha–mastoid suturing was combined with otoabrasion, as previously described. The follow-up period was a minimum of 16 months and a maximum of 8 years. Complications were rare and rapidly resolved. The outcome was successful whether the burr alone or a combined method was used. The authors believe that anterior abrasion of ear cartilage is a useful, simple technique that is not too time consuming by which an immediate postoperative aesthetic improvement is reached. It also is more precise and safe than the partial parallel incision procedure.
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