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Dermatopathology: Practical & Conceptual January - March 2006
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5. New Heights: An assist to the next (10th) edition of “Lever’s”
Renata A. Joffe, M.D.
Content
Introduction
1. Small plaque parapsoriasis
2. Dysplastic nevus
3. Solar keratosis
4. Inverted follicular keratosis/trichilemmoma
5. Discoid lupus erythematosus vs. systemic lupus erythematosus
6. Lentigo maligna
7. Atopic dermatitis
8. Sebaceous adenoma
9. Muir-Torre syndrome
10. Bowen’s disease
11. Follicular mucinosis/alopecia mucinosa
12. Granuloma faciale and erythema elevatum diutinum
13. Follicular degeneration syndrome
14. Eccrine papillary adenoma
15. Degos’ disease
16. Dermatofibroma
17. Proliferating tricholemmal cyst
18. Erythema multiforme (dermal and epidermal types)
19. Lichen sclerosus et atrophicus vs. morphea
20. Malignant melanoma (classification)
21. Malignant melanoma—ABCD’s
22. Malignant melanoma—wide/deep excision
23. Sentinel node biopsy for melanoma
24. Malignant melanoma: nontumorigenic compartment of primary malignant melanoma (radial growth phase), tumorigenic compartment of primary malignant melanoma (vertical growth phase)
25. Minimal deviation melanoma
26. Nevoid melanoma
27. Malignant melanoma—in infancy and childhood
28. Malignant blue nevus
29. MELTUMP and SAMPUS
30. Bulge activation hypothesis
Conclusion
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6. Lentigo maligna
Quotation from the 9th edition of Lever's:
"It is controversial whether lentigo maligna should be regarded as a form of melanoma in situ in all cases, or whether some cases should be regarded as precursor lesions (lentigo maligna) of in situ melanoma (melanoma in situ, lentigo maligna type). It has been suggested that the risk of progression from lentigo maligna to invasive lentigo maligna melanoma may be about 5%, although some cases may progress rapidly."
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA): None.
Statements contrary by ABA:
"During the past 30 years, however, histopathologists have avoided making specific diagnoses of malignant melanoma in situ by utilizing a variety of nondiagnostic, euphemistic descriptions for it such as melanotic freckle of Hutchinson, melanosis circumscripta precancerosa of Dubreuilh, active junctional nevus, lentigo maligna, atypical melanocytic hyperplasia, melanocytic dysplasia, and melanocytic intraepithelial neoplasia. Each of these terms evades a specific diagnosis of malignant melanoma in situ, a diagnosis than can, and should, be made clinically and histopathologically if reliable criteria are used."
Dubow BE, Ackerman AB. Ideas in pathology. Malignant melanoma
in situ
: the evolution of a concept.
Mod Pathol.
1990 Nov;3(6):734-744.
Other works of ABA in which the ideas contrary are expressed:
1. Exploding Myths: Melanocytic Neoplasms (video). Available at: www.derm101.com, 2005.
2. Ackerman AB. Mythology and numerology in the sphere of melanoma.
Dermatopathology: Practical & Conceptual
6(3): 251-256, 2000.
3. Ackerman AB. Melanoma in situ and matters that transcend it.
Hum Pathol
. 29(1): 4-5, 1998.
4. Ackerman AB. Correspondence. To the Editor: Melanoma
in situ. Hum Pathol.
29(11):1328-1329, 1998.
5. Ackerman AB, Cavegn BM, Casintahan MF, Robinson MJ.
Resolving Quandaries in Dermatology, Pathology and Dermatopathology.
Promethean Medical Press/Waverly, 1995.
6. Ackerman AB, Cerroni L, Kerl H.
Pitfalls in Histopathologic Diagnosis of Malignant Melanoma.
Philadelphia: Lea & Febiger, 1994.
7. Ackerman AB. A critique of an NIH consensus development conference about "early melanoma."
Am J Dermatopathol.
15(1):52-58 (February) 1993.
8. Ackerman AB, Borghi S. "Pagetoid melanocytic proliferation" is the latest evasion from a diagnosis of "melanoma in situ."
Am J Dermatopathol.
13(6):583-604 (December) 1991.
9. Ackerman AB, Dubow B. Malignant melanoma in situ: the evolution of a concept.
Mod Pathol.
3(6):734-744, 1990.
10. Maize J, Ackerman AB.
Pigmented Lesions of the Skin.
Philadelphia: Lea & Febiger, 1987.
11. Ackerman AB, David KM. A unifying concept of malignant melanoma: biological aspects.
Hum Pathol.
17:438-440 (May) 1986.
12. Ackerman AB. Malignant melanoma in situ. Pathology:
J Royal Coll Pathol Australasia
17:298-300 (April) 1985.
13. Ackerman AB. Editorial. No one should die of malignant melanoma.
J Am Acad Dermatol.
12:115-116 (January) 1985.
14. Ackerman AB, Ragaz A.
The Lives of Lesions: Chronology in Dermatopathology.
Masson Publishing USA; 1984. (Now on list of Ardor Scribendi, NYC.)
15. Ackerman AB. Controversies in dermatopathology. Histopathologists can diagnose malignant melanoma in situ correctly and consistently.
Am J Dermatopathol.
6:103-108 (Supplement, Summer) 1984.
16. Ackerman AB. Macular and patch lesions of malignant melanoma: malignant melanoma in situ.
J Dermatol Surg Oncol.
9:615-618 (August) 1983.
17. Roses D, Harris M, Ackerman AB.
Diagnosis and Management of Cutaneous Malignant Melanoma.
Philadelphia: WB Saunders; 1983.
18. Ackerman AB. Disagreements with the current classification of malignant melanomas.
Am J Surg Pathol.
6:733-743 (December) 1982.
19. Ackerman AB. Malignant melanoma: a unifying concept.
Hum Pathol.
11:591-597, 1980.
20. Ackerman AB. Malignant melanoma: a unifying concept.
Am J Dermatopathol.
2:309-313,1980.
21. Kopf A, Bart R, Rodriguez-Sains R, Ackerman AB.
Malignant Melanoma.
Masson Publishing USA; 1979. (Now on list of Lippincott Williams & Wilkins, Philadelphia)
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