{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:56:54Z","timestamp":1774659414098,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T00:00:00Z","timestamp":1520467200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ministry of Health, Ricerca Finalizzata","award":["NET-2011-02347213"],"award-info":[{"award-number":["NET-2011-02347213"]}]},{"name":"Intergruppo Melanoma Italiano (IMI)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Experimental Dermatology"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pigmented facial macules are common on sun damage skin. The diagnosis of early stage lentigo maligna (<jats:styled-content style=\"fixed-case\">LM<\/jats:styled-content>) and lentigo maligna melanoma (<jats:styled-content style=\"fixed-case\">LMM<\/jats:styled-content>) is challenging. Reflectance confocal microscopy (<jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>) has been proven to increase diagnostic accuracy of facial lesions. A total of 154 pigmented facial macules, retrospectively collected, were evaluated for the presence of already\u2010described <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features and new parameters depicting aspects of the follicle. Melanocytic nests, roundish pagetoid cells, follicular infiltration, bulgings from the follicles and many bright dendrites and infiltration of the hair follicle (ie, folliculotropism) were found to be indicative of <jats:styled-content style=\"fixed-case\">LM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">LMM<\/jats:styled-content> compared to non\u2010melanocytic skin neoplasms (NMSNs), with an overall sensitivity of 96% and specificity of 83%. Concerning NMSNs, solar lentigo and lichen planus\u2010like keratosis resulted better distinguishable from <jats:styled-content style=\"fixed-case\">LM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">LMM<\/jats:styled-content> because usually lacking malignant features and presenting characteristic diagnostic parameters, such as epidermal cobblestone pattern and polycyclic papillary contours. On the other hand, distinction of pigmented actinic keratosis (<jats:styled-content style=\"fixed-case\">PAK<\/jats:styled-content>) resulted more difficult, and needing evaluation of hair follicle infiltration and bulging structures, due to the frequent observation of few bright dendrites in the epidermis, but predominantly not infiltrating the hair follicle (estimated specificity for <jats:styled-content style=\"fixed-case\">PAK<\/jats:styled-content> 53%). A detailed evaluation of the components of the folliculotropism may help to improve the diagnostic accuracy. The classification of the type, distribution and amount of cells, and the presence of bulging around the follicles seem to represent important tools for the differentiation between <jats:styled-content style=\"fixed-case\">PAK<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">LMM<\/jats:styled-content> at <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> analysis.<\/jats:p>","DOI":"10.1111\/exd.13487","type":"journal-article","created":{"date-parts":[[2017,12,24]],"date-time":"2017-12-24T09:50:48Z","timestamp":1514109048000},"page":"227-232","source":"Crossref","is-referenced-by-count":31,"title":["Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy"],"prefix":"10.1111","volume":"27","author":[{"given":"Flavia","family":"Persechino","sequence":"first","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0823-5731","authenticated-orcid":false,"given":"Nathalie","family":"De Carvalho","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia  Modena Italy"},{"name":"Skin Cancer Unit Scientific Institute of Romagna for The study and Treatment of Cancer IRCSS IRST  Meldola Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvana","family":"Ciardo","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"De Pace","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia  Modena 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Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Longo","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia  Modena Italy"},{"name":"Skin Cancer Unit IRCCS Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Farnetani","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Pellacani","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia  Modena 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