On the geometric modulation of skin lesion growth: a mathematical model for melanoma
Mendes, Ana Isabel; Nogueira, Conceição; Pereira, Jorge; Fonseca-Pinto, Rui
http://dx.doi.org/10.1590/2446-4740.02815
Res. Biomed. Eng., vol.32, n1, p.44-54, 2016
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Views: 873
Abstract
Introduction: Early detection of suspicious skin lesions is critical to prevent skin malignancies, particularly the melanoma, which is the most dangerous form of human skin cancer. In the last decade, image processing techniques have been an increasingly important tool for early detection and mathematical models play a relevant role in mapping the progression of lesions. Methods: This work presents an algorithm to describe the evolution of the border of the skin lesion based on two main measurable markers: the symmetry and the geometric growth path of the lesion. The proposed methodology involves two dermoscopic images of the same melanocytic lesion obtained at different moments in time. By applying a mathematical model based on planar linear transformations, measurable parameters related to symmetry and growth are extracted. Results: With this information one may compare the actual evolution in the lesion with the outcomes from the geometric model. First, this method was tested on predefined images whose growth was controlled and the symmetry known which were used for validation. Then the methodology was tested in real dermoscopic melanoma images in which the parameters of the mathematical model revealed symmetry and growth rates consistent with a typical melanoma behavior. Conclusions: The method developed proved to show very accurate information about the target growth markers (variation on the growth along the border, the deformation and the symmetry of the lesion trough the time). All the results, validated by the expected phantom outputs, were similar to the ones on the real images.
Keywords
Digital image skin processing, Melanoma, Segmentation, Dermoscopy, Linear transformations.
References
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Abbas Q, Celebi ME, Garcia IF, Rashid M. Lesion border detection in dermoscopy images using dynamic programming. Skin Research and Technology. 2011; 17(1):91-100. http://dx.doi.org/10.1111/j.1600-0846.2010.00472.x. PMid:21226876.
Afonso A, Silveira M. Hair detection in dermoscopic images using percolation. In: Proceedings of the IEEE Annual International Conference of the Engineering in Medicine and Biology Society ; 2012; San Diego, CA. IEEE; 2012. p. 4378-81.
Andreassi L, Perotti R, Rubegni P, Burroni M, Cevenini G, Biagioli M, Taddeucci P, Dell’Eva G, Barbini P. Digital dermoscopy analysis for the differentiation of atypical nevi and early melanoma: a new quantitative semiology. Archives of Dermatology. 1999; 135(12):1459-65. http://dx.doi.org/10.1001/archderm.135.12.1459. PMid:10606050.
Argenziano G, Catricalà C, Ardigo M, Buccini P, De Simone P, Eibenschutz L, Ferrari A, Mariani G, Silipo V, Sperduti I, Zalaudek I. Seven-point checklist of dermoscopy revisited. British Journal of Dermatology. 2011; 164(4):785-90. http://dx.doi.org/10.1111/j.1365-2133.2010.10194.x. PMid:21175563.
Baumert J, Schmidt M, Giehl KA, Volkenandt M, Plewig G, Wendtner C, Schmid-Wendtner MH. Time trends in tumour thickness vary in subgroups: analysis of 6475 patients by age, tumour site and melanoma subtype. Melanoma Research. 2009; 19(1):24-30. http://dx.doi.org/10.1097/CMR.0b013e32831c6fe7. PMid:19430403.
Benelli C, Roscetti E, Pozzo VD, Gasparini G, Cavicchini S. The dermoscopic versus the clinical diagnosis of melanoma. European Journal of Dermatology. 1999; 9(6):470-6. PMid:10491506.
Bleyer A, Viny A, Barr R. Cancer in 15- to 29-year-olds by primary site. The Oncologist. 2006; 11(6):590-601. http://dx.doi.org/10.1634/theoncologist.11-6-590. PMid:16794238.
Blum A, Rassner G, Garbe C. Modified ABC-point list of dermoscopy: A simplified and highly accurate dermoscopic algorithm for the diagnosis of cutaneous melanocytic lesions. Journal of the American Academy of Dermatology. 2003; 48(5):672-8. http://dx.doi.org/10.1067/mjd.2003.282. PMid:12734495.
Cheng B, Joe Stanley R, Stoecker WV, Stricklin SM, Hinton KA, Nguyen TK, Rader RK, Rabinovitz HS, Oliviero M, Moss RH. Analysis of clinical and dermoscopic features for basal cell carcinoma neural network classification. Skin Research and Technology. 2013; 19(1):e217-22. http://dx.doi.org/10.1111/j.1600-0846.2012.00630.x. PMid:22724561.
Dal Pozzo V, Benelli C, Roscetti E. The seven features for melanoma: a new dermoscopic algorithm for the diagnosis of malignant melanoma. European Journal of Dermatology. 1999; 9(4):303-8. PMid:10356410.
Downing A, Newton-Bishop JA, Forman D. Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993-2003. British Journal of Cancer. 2006; 95(1):91-5. http://dx.doi.org/10.1038/sj.bjc.6603216. PMid:16755289.
Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. European Journal of Dermatology. 2013; 49(6):1374-403. PMid:23485231.
Fonseca-Pinto R, Caseiro P, Andrade A. Image Empirical Mode Decomposition (IEMD) in dermoscopic images: artefact removal and lesion border detection. In: Zagar B, Kuijper A, Sahbi H, editors. Proceedings of Signal Processing Pattern Recognition and Applications; 2010 Feb 17-19; Innsbruck, Austria. Austria: Acta Press; 2010.
Holterhues C, Vries E, Louwman MW, Koljenovic S, Nijsten T. Incidence and trends of cutaneous malignancies in the Netherlands, 1989-2005. The Journal of Investigative Dermatology. 2010; 130(7):1807-12. http://dx.doi.org/10.1038/jid.2010.58. PMid:20336085.
Joel G, Schmid-Saugeon P, Guggisberg D, Cerottini JP, Braun R, Krischer J, Saurat JH, Murat K. Validation of segmentation techniques for digital dermoscopy. Skin Research and Technology. 2002; 8(4):240-9. http://dx.doi.org/10.1034/j.1600-0846.2002.00334.x. PMid:12423543.
Liu Z, Sun J, Smith L, Smith M, Warr R. Distribution quantification on dermoscopy images for computer-assisted diagnosis of cutaneous melanomas. Medical & Biological Engineering & Computing. 2012; 50(5):503-13. http://dx.doi.org/10.1007/s11517-012-0895-7. PMid:22438064.
Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine. 18th ed. New York: McGraw-Hill; 2012.
Mendonca T, Marcal AR, Vieira A, Nascimento JC, Silveira M, Marques JS, Rozeira J. Comparison of segmentation methods for automatic diagnosis of dermoscopy images. In: Conference Proceedings IEEE Engineering in Medicine and Biology Society; 2007 Aug 23-26; Lyon, France. Lyon: IEEE Press; 2007. p. 6573-76.
Menzies SW, Ingvar C, McCarthy WH. A sensitivity and specificity analysis of the surface microscopy features of invasive melanoma. Melanoma Research. 1996; 6(1):55-62. http://dx.doi.org/10.1097/00008390-199602000-00008. PMid:8640071.
Pereira JM, Mendes A, Nogueira C, Baptista D, Fonseca-Pinto R. An adaptive approach for skin lesion segmentation in dermoscopy images using a multiscale Local Normalization. In: Bourguignon JP, Jeltsch R, Pinto AA, Viana M, editors. Dynamics, Games and Science DGS II. Springer-Verlang; 2015. p. 537-45. (CIM Series in Mathematical Sciences; 1).
Piccolo D, Crisman G, Schoinas S, Altamura D, Peris K. Computer-automated ABCD versus dermatologists with different degrees of experience in dermoscopy. European Journal of Dermatology. 2014; 24(4):477-81. PMid:24721784.
Piccolo D, Ferrari A, Peris K, Daidone R, Ruggeri B, Chimenti S. Dermoscopic diagnosis by a trained clinician vs. a clinician with minimal dermoscopy training vs. computer-aided diagnosis of 341 pigmented skin lesions: a comparative study. British Journal of Dermatology. 2002; 147(3):481-6. http://dx.doi.org/10.1046/j.1365-2133.2002.04978.x. PMid:12207587.
Rogers HW, Weinstock MA, Harris AR, Hinckley MR, Feldman SR, Fleischer AB, Coldiron BM. Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Archives of Dermatology. 2010; 146(3):283-7. http://dx.doi.org/10.1001/archdermatol.2010.19. PMid:20231499.
Sadri AR, Zekri M, Sadri S, Gheissari N, Mokhtari M, Kolahdouzan F. Segmentation of dermoscopy images using wavelet networks. IEEE Transactions on Biomedical Engineering. 2013; 60(4):1134-41. http://dx.doi.org/10.1109/TBME.2012.2227478. PMid:23193305.
Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R. EUROCARE-4. Survival of cancer patients diagnosed in 1995-1999. Results and commentary. European Journal of Cancer. 2009; 45(6):931-91. http://dx.doi.org/10.1016/j.ejca.2008.11.018. PMid:19171476.
Şavk E, Şahinkarakaş E, Okyay P, Karaman G, Erkek M, Şendur N. Interobserver agreement in the use of the ABCD rule for dermoscopy. The Journal of Dermatology. 2004; 31(12):1041-3. http://dx.doi.org/10.1111/j.1346-8138.2004.tb00652.x. PMid:15801273.
Skender-Kalnenas TM, English DR, Heenan PJ. Benign melanocytic lesions: risk markers or precursors of cutaneous melanoma? Journal of the American Academy of Dermatology. 1995; 33(6):1000-7. http://dx.doi.org/10.1016/0190-9622(95)90294-5. PMid:7490345.
Soyer HP, Kerl H. Surface microscopy of pigmented cutaneous tumors. Annales de Dermatologie et de Venereologie. 1993; 120(1):15-20. PMid:8338324.
Soyer HP, Smolle J, Leitinger G, Rieger E, Kerl H. Diagnostic reliability of dermoscopic criteria for detecting malignant melanoma. Dermatology (Basel, Switzerland). 1995; 190(1):25-30. http://dx.doi.org/10.1159/000246629. PMid:7894091.
Stern RS. Prevalence of a history of skin cancer in 2007: Results of an incidence-based model. Archives of Dermatology. 2010; 146(3):279-82. http://dx.doi.org/10.1001/archdermatol.2010.4. PMid:20231498.
Toossi MT, Pourreza HR, Zare H, Sigari MH, Layegh P, Azimi A. An effective hair removal algorithm for dermoscopy images. Skin Research and Technology. 2013; 19(3):230-5. http://dx.doi.org/10.1111/srt.12015. PMid:23560826.
Tryggvadóttir L, Gislum M, Hakulinen T, Klint A, Engholm G, Storm HH, Bray F. Trends in the survival of patients diagnosed with malignant melanoma of the skin in the Nordic countries 1964-2003 followed up to the end of 2006. Acta Oncologica. 2010; 49(5):665-72. http://dx.doi.org/10.3109/02841861003702528. PMid:20491525.
Wang H, Chen X, Moss RH, Stanley RJ, Stoecker WV, Celebi ME, Szalapski TM, Malters JM, Grichnik JM, Marghoob AA, Rabinovitz HS, Menzies SW. Watershed segmentation of dermoscopy images using a watershed technique. Skin Research and Technology. 2010; 16(3):378-84. PMid:20637008.
Whiteman DC, Pavan WJ, Bastian BC. The melanomas: a synthesis of epidemiological, clinical, histopathological, genetic, and biological aspects, supporting distinct subtypes, causal pathways, and cells of origin. Pigment Cell & Melanoma Research. 2011; 24(5):879-97. http://dx.doi.org/10.1111/j.1755-148X.2011.00880.x. PMid:21707960.
Zalaudek I, Argenziano G, Soyer HP, Corona R, Sera F, Blum A, Braun RP, Cabo H, Ferrara G, Kopf AW, Langford D, Menzies SW, Pellacani G, Peris K, Seidenari S. Three-point checklist of dermoscopy: an open internet study. British Journal of Dermatology. 2006a; 154(3):431-7. http://dx.doi.org/10.1111/j.1365-2133.2005.06983.x. PMid:16445771.
Zalaudek I, Leinweber B, Hofmann-Wellenhof R, Soyer HP. The impact of dermoscopic-pathologic correlates in the diagnosis and management of pigmented skin tumors. Expert Review of Dermatology. 2006b; 1(4):579-87. http://dx.doi.org/10.1586/17469872.1.4.579.
Zalaudek I, Kreusch J, Giacomel J, Ferrara G, Catricala C, Argenziano G. How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part I. Melanocytic skin tumors. Journal of the American Academy of Dermatology. 2010; 63(3):361-74, quiz 375-6. http://dx.doi.org/10.1016/j.jaad.2009.11.698. PMid:20708469.
Abbas Q, Celebi ME, Garcia IF, Rashid M. Lesion border detection in dermoscopy images using dynamic programming. Skin Research and Technology. 2011; 17(1):91-100. http://dx.doi.org/10.1111/j.1600-0846.2010.00472.x. PMid:21226876.
Afonso A, Silveira M. Hair detection in dermoscopic images using percolation. In: Proceedings of the IEEE Annual International Conference of the Engineering in Medicine and Biology Society ; 2012; San Diego, CA. IEEE; 2012. p. 4378-81.
Andreassi L, Perotti R, Rubegni P, Burroni M, Cevenini G, Biagioli M, Taddeucci P, Dell’Eva G, Barbini P. Digital dermoscopy analysis for the differentiation of atypical nevi and early melanoma: a new quantitative semiology. Archives of Dermatology. 1999; 135(12):1459-65. http://dx.doi.org/10.1001/archderm.135.12.1459. PMid:10606050.
Argenziano G, Catricalà C, Ardigo M, Buccini P, De Simone P, Eibenschutz L, Ferrari A, Mariani G, Silipo V, Sperduti I, Zalaudek I. Seven-point checklist of dermoscopy revisited. British Journal of Dermatology. 2011; 164(4):785-90. http://dx.doi.org/10.1111/j.1365-2133.2010.10194.x. PMid:21175563.
Baumert J, Schmidt M, Giehl KA, Volkenandt M, Plewig G, Wendtner C, Schmid-Wendtner MH. Time trends in tumour thickness vary in subgroups: analysis of 6475 patients by age, tumour site and melanoma subtype. Melanoma Research. 2009; 19(1):24-30. http://dx.doi.org/10.1097/CMR.0b013e32831c6fe7. PMid:19430403.
Benelli C, Roscetti E, Pozzo VD, Gasparini G, Cavicchini S. The dermoscopic versus the clinical diagnosis of melanoma. European Journal of Dermatology. 1999; 9(6):470-6. PMid:10491506.
Bleyer A, Viny A, Barr R. Cancer in 15- to 29-year-olds by primary site. The Oncologist. 2006; 11(6):590-601. http://dx.doi.org/10.1634/theoncologist.11-6-590. PMid:16794238.
Blum A, Rassner G, Garbe C. Modified ABC-point list of dermoscopy: A simplified and highly accurate dermoscopic algorithm for the diagnosis of cutaneous melanocytic lesions. Journal of the American Academy of Dermatology. 2003; 48(5):672-8. http://dx.doi.org/10.1067/mjd.2003.282. PMid:12734495.
Cheng B, Joe Stanley R, Stoecker WV, Stricklin SM, Hinton KA, Nguyen TK, Rader RK, Rabinovitz HS, Oliviero M, Moss RH. Analysis of clinical and dermoscopic features for basal cell carcinoma neural network classification. Skin Research and Technology. 2013; 19(1):e217-22. http://dx.doi.org/10.1111/j.1600-0846.2012.00630.x. PMid:22724561.
Dal Pozzo V, Benelli C, Roscetti E. The seven features for melanoma: a new dermoscopic algorithm for the diagnosis of malignant melanoma. European Journal of Dermatology. 1999; 9(4):303-8. PMid:10356410.
Downing A, Newton-Bishop JA, Forman D. Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993-2003. British Journal of Cancer. 2006; 95(1):91-5. http://dx.doi.org/10.1038/sj.bjc.6603216. PMid:16755289.
Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. European Journal of Dermatology. 2013; 49(6):1374-403. PMid:23485231.
Fonseca-Pinto R, Caseiro P, Andrade A. Image Empirical Mode Decomposition (IEMD) in dermoscopic images: artefact removal and lesion border detection. In: Zagar B, Kuijper A, Sahbi H, editors. Proceedings of Signal Processing Pattern Recognition and Applications; 2010 Feb 17-19; Innsbruck, Austria. Austria: Acta Press; 2010.
Holterhues C, Vries E, Louwman MW, Koljenovic S, Nijsten T. Incidence and trends of cutaneous malignancies in the Netherlands, 1989-2005. The Journal of Investigative Dermatology. 2010; 130(7):1807-12. http://dx.doi.org/10.1038/jid.2010.58. PMid:20336085.
Joel G, Schmid-Saugeon P, Guggisberg D, Cerottini JP, Braun R, Krischer J, Saurat JH, Murat K. Validation of segmentation techniques for digital dermoscopy. Skin Research and Technology. 2002; 8(4):240-9. http://dx.doi.org/10.1034/j.1600-0846.2002.00334.x. PMid:12423543.
Liu Z, Sun J, Smith L, Smith M, Warr R. Distribution quantification on dermoscopy images for computer-assisted diagnosis of cutaneous melanomas. Medical & Biological Engineering & Computing. 2012; 50(5):503-13. http://dx.doi.org/10.1007/s11517-012-0895-7. PMid:22438064.
Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine. 18th ed. New York: McGraw-Hill; 2012.
Mendonca T, Marcal AR, Vieira A, Nascimento JC, Silveira M, Marques JS, Rozeira J. Comparison of segmentation methods for automatic diagnosis of dermoscopy images. In: Conference Proceedings IEEE Engineering in Medicine and Biology Society; 2007 Aug 23-26; Lyon, France. Lyon: IEEE Press; 2007. p. 6573-76.
Menzies SW, Ingvar C, McCarthy WH. A sensitivity and specificity analysis of the surface microscopy features of invasive melanoma. Melanoma Research. 1996; 6(1):55-62. http://dx.doi.org/10.1097/00008390-199602000-00008. PMid:8640071.
Pereira JM, Mendes A, Nogueira C, Baptista D, Fonseca-Pinto R. An adaptive approach for skin lesion segmentation in dermoscopy images using a multiscale Local Normalization. In: Bourguignon JP, Jeltsch R, Pinto AA, Viana M, editors. Dynamics, Games and Science DGS II. Springer-Verlang; 2015. p. 537-45. (CIM Series in Mathematical Sciences; 1).
Piccolo D, Crisman G, Schoinas S, Altamura D, Peris K. Computer-automated ABCD versus dermatologists with different degrees of experience in dermoscopy. European Journal of Dermatology. 2014; 24(4):477-81. PMid:24721784.
Piccolo D, Ferrari A, Peris K, Daidone R, Ruggeri B, Chimenti S. Dermoscopic diagnosis by a trained clinician vs. a clinician with minimal dermoscopy training vs. computer-aided diagnosis of 341 pigmented skin lesions: a comparative study. British Journal of Dermatology. 2002; 147(3):481-6. http://dx.doi.org/10.1046/j.1365-2133.2002.04978.x. PMid:12207587.
Rogers HW, Weinstock MA, Harris AR, Hinckley MR, Feldman SR, Fleischer AB, Coldiron BM. Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Archives of Dermatology. 2010; 146(3):283-7. http://dx.doi.org/10.1001/archdermatol.2010.19. PMid:20231499.
Sadri AR, Zekri M, Sadri S, Gheissari N, Mokhtari M, Kolahdouzan F. Segmentation of dermoscopy images using wavelet networks. IEEE Transactions on Biomedical Engineering. 2013; 60(4):1134-41. http://dx.doi.org/10.1109/TBME.2012.2227478. PMid:23193305.
Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R. EUROCARE-4. Survival of cancer patients diagnosed in 1995-1999. Results and commentary. European Journal of Cancer. 2009; 45(6):931-91. http://dx.doi.org/10.1016/j.ejca.2008.11.018. PMid:19171476.
Şavk E, Şahinkarakaş E, Okyay P, Karaman G, Erkek M, Şendur N. Interobserver agreement in the use of the ABCD rule for dermoscopy. The Journal of Dermatology. 2004; 31(12):1041-3. http://dx.doi.org/10.1111/j.1346-8138.2004.tb00652.x. PMid:15801273.
Skender-Kalnenas TM, English DR, Heenan PJ. Benign melanocytic lesions: risk markers or precursors of cutaneous melanoma? Journal of the American Academy of Dermatology. 1995; 33(6):1000-7. http://dx.doi.org/10.1016/0190-9622(95)90294-5. PMid:7490345.
Soyer HP, Kerl H. Surface microscopy of pigmented cutaneous tumors. Annales de Dermatologie et de Venereologie. 1993; 120(1):15-20. PMid:8338324.
Soyer HP, Smolle J, Leitinger G, Rieger E, Kerl H. Diagnostic reliability of dermoscopic criteria for detecting malignant melanoma. Dermatology (Basel, Switzerland). 1995; 190(1):25-30. http://dx.doi.org/10.1159/000246629. PMid:7894091.
Stern RS. Prevalence of a history of skin cancer in 2007: Results of an incidence-based model. Archives of Dermatology. 2010; 146(3):279-82. http://dx.doi.org/10.1001/archdermatol.2010.4. PMid:20231498.
Toossi MT, Pourreza HR, Zare H, Sigari MH, Layegh P, Azimi A. An effective hair removal algorithm for dermoscopy images. Skin Research and Technology. 2013; 19(3):230-5. http://dx.doi.org/10.1111/srt.12015. PMid:23560826.
Tryggvadóttir L, Gislum M, Hakulinen T, Klint A, Engholm G, Storm HH, Bray F. Trends in the survival of patients diagnosed with malignant melanoma of the skin in the Nordic countries 1964-2003 followed up to the end of 2006. Acta Oncologica. 2010; 49(5):665-72. http://dx.doi.org/10.3109/02841861003702528. PMid:20491525.
Wang H, Chen X, Moss RH, Stanley RJ, Stoecker WV, Celebi ME, Szalapski TM, Malters JM, Grichnik JM, Marghoob AA, Rabinovitz HS, Menzies SW. Watershed segmentation of dermoscopy images using a watershed technique. Skin Research and Technology. 2010; 16(3):378-84. PMid:20637008.
Whiteman DC, Pavan WJ, Bastian BC. The melanomas: a synthesis of epidemiological, clinical, histopathological, genetic, and biological aspects, supporting distinct subtypes, causal pathways, and cells of origin. Pigment Cell & Melanoma Research. 2011; 24(5):879-97. http://dx.doi.org/10.1111/j.1755-148X.2011.00880.x. PMid:21707960.
Zalaudek I, Argenziano G, Soyer HP, Corona R, Sera F, Blum A, Braun RP, Cabo H, Ferrara G, Kopf AW, Langford D, Menzies SW, Pellacani G, Peris K, Seidenari S. Three-point checklist of dermoscopy: an open internet study. British Journal of Dermatology. 2006a; 154(3):431-7. http://dx.doi.org/10.1111/j.1365-2133.2005.06983.x. PMid:16445771.
Zalaudek I, Leinweber B, Hofmann-Wellenhof R, Soyer HP. The impact of dermoscopic-pathologic correlates in the diagnosis and management of pigmented skin tumors. Expert Review of Dermatology. 2006b; 1(4):579-87. http://dx.doi.org/10.1586/17469872.1.4.579.
Zalaudek I, Kreusch J, Giacomel J, Ferrara G, Catricala C, Argenziano G. How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part I. Melanocytic skin tumors. Journal of the American Academy of Dermatology. 2010; 63(3):361-74, quiz 375-6. http://dx.doi.org/10.1016/j.jaad.2009.11.698. PMid:20708469.
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