Iryna Blaga - Academia.edu (original) (raw)

Papers by Iryna Blaga

Clinical evolution of Spitz nevi, 2020

Nevus Spitz is a benign melanocytic proliferation, first described in 1948 by Sophie Spitz as a c... more Nevus Spitz is a benign melanocytic proliferation, first described in 1948 by Sophie Spitz as a childhood melanoma. Initially, it was described as an erythematous papule or node, but further studies of the Spitz nevus proved that in 71-92% cases it is a pigmented formation. This pigmentation is often quite intense due to the rapid growth of the formation, which leads to the need for differential diagnosis with skin melanoma. After all, dermatoscopy can be used for this purpose and, when applying this research method, typically a pattern of an exploding star formed by streaks of linear pigmentation and symmetrically located pigment globules placed in the peripheral zone can be revealed. In case of non-pigmented Spitz nevus, spot vessels and reticular depigmentation are visualized. Both pigmented and non-pigmented forms of Spitz nevus in the process of evolution can regress partially or completely. Several clinical cases of different types of spitzoids, both typical and atypical, base...

The BRAAFF index practical application in the diagnosis of acral melanocytic tumors, 2021

Melanoma is one of the most dangerous tumors due to its ability to rapidly unpredictable metastas... more Melanoma is one of the most dangerous tumors due to its ability to rapidly unpredictable metastasis. When the tumor is in open areas,
the possibility of timely diagnosis increases, and with acral localization,
melanoma for a long time may be neglected. To improve the prognosis
of patients with acral melanoma, it is a prerequisite to ensure early diagnosis, which is the method of dermatoscopy. The role in the diagnosis of acral located pigmentation is to assess the features of the structure, which, unlike nevi of other localizations, is most often manifested in the form of patterns of parallel furrows, fibers, lattice-like pattern, and parallel ridge pattern. However, about 1⁄₃ of acral melanomas may consist of irregular diffuse pigments and other components, so additional criteria would be needed to reduce the likelihood of diagnostic errors. The result was the development, by a team of scientists from around the world, of the BRAAFF index, which is a score system for six variables that demonstrated the highest sensitivity and specificity for acral melanoma. Predictors such as irregular spotting, parallel ridge pattern, asymmetry of structures and colors give positive points, whereas parallel furrow and fibrillar pattern is negative. A diagnosis of acral melanoma is considered probable if the result of the calculations is ≥1. Use of the BRAAFF index can greatly improve the quality and specificity of the examination when used in daily practice. It will also be useful for doctors who are just starting their careers and do not have sufficient experience to confidently prescribe therapeutic tactics. The publication provides clinical example of the use of an algorithmic approach for the management of patient with acral lesions on the skin.

Dermatoscopy and management of patients with basal cell carcinoma. Review of clinical cases, 2020

The theoretical bases and practical aspects of the dermatoscopy application in clinical practice ... more The theoretical bases and practical aspects of the dermatoscopy
application in clinical practice as a method of basal cell skin
carcinoma diagnosis are considered in the article. Dermatoscopic
criteria for this type of skin tumor are described in detail. The
information about the basic anatomic-histological subtypes and
the most expedient ways of tumors eradication, both by surgical
and conservative methods, are given. The possibility of using
epiluminescent microscopy as a method before surgical planning
of the resection limits or control of the topical therapy effectiveness
is considered. As long as the disappearance of dermatoscopic criteria
in case of basal cell carcinoma is a recovery criterion that can
be obtained faster than a macroscopically visible result, at the same
time, the presence of such criteria can serve as a basis for repeated
courses of treatment. In difficult cases, the use of algorithmic
methods to analyze the dermatoscopic image is suggested. Among
these, it is recommended to consider «Prediction without pigment»,
which is a complement to the «Chaos and Clues» algorithm
developed by a team of authors to streamline the differential
diagnosis of non-pigmented formations and those with unproven
pigmentation by melanin. When analyzing this method, the first
question to be resolved is the presence of ulcer or white features (white
lines, surface keratin tips, white structureless areas, or white circles).
These clues are the basis for excision biopsy performing. In case
of their absence, vessel analysis is used. There are four monomorphic
vascular structures that correspond to a benign diagnosis: red, purple
or blue tubercles, centrally located, serpiginous and reticular vessels.
All other monomorphic structures, and especially the polymorphic
vascular pattern, should be evaluated as a reason for biopsy. Several
clinical cases were analyzed at the end of the publication. Illustrative
material was provided and dermatoscopic criteria were found,
appeared to be a key in the diagnosis of basal cell carcinoma for the
patients under consideration.

Clinical evolution of Spitz nevi, 2020

Nevus Spitz is a benign melanocytic proliferation, first described in 1948 by Sophie Spitz as a c... more Nevus Spitz is a benign melanocytic proliferation, first described in 1948 by Sophie Spitz as a childhood melanoma. Initially, it was described as an erythematous papule or node, but further studies of the Spitz nevus proved that in 71-92% cases it is a pigmented formation. This pigmentation is often quite intense due to the rapid growth of the formation, which leads to the need for differential diagnosis with skin melanoma. After all, dermatoscopy can be used for this purpose and, when applying this research method, typically a pattern of an exploding star formed by streaks of linear pigmentation and symmetrically located pigment globules placed in the peripheral zone can be revealed. In case of non-pigmented Spitz nevus, spot vessels and reticular depigmentation are visualized. Both pigmented and non-pigmented forms of Spitz nevus in the process of evolution can regress partially or completely. Several clinical cases of different types of spitzoids, both typical and atypical, base...

The BRAAFF index practical application in the diagnosis of acral melanocytic tumors, 2021

Melanoma is one of the most dangerous tumors due to its ability to rapidly unpredictable metastas... more Melanoma is one of the most dangerous tumors due to its ability to rapidly unpredictable metastasis. When the tumor is in open areas,
the possibility of timely diagnosis increases, and with acral localization,
melanoma for a long time may be neglected. To improve the prognosis
of patients with acral melanoma, it is a prerequisite to ensure early diagnosis, which is the method of dermatoscopy. The role in the diagnosis of acral located pigmentation is to assess the features of the structure, which, unlike nevi of other localizations, is most often manifested in the form of patterns of parallel furrows, fibers, lattice-like pattern, and parallel ridge pattern. However, about 1⁄₃ of acral melanomas may consist of irregular diffuse pigments and other components, so additional criteria would be needed to reduce the likelihood of diagnostic errors. The result was the development, by a team of scientists from around the world, of the BRAAFF index, which is a score system for six variables that demonstrated the highest sensitivity and specificity for acral melanoma. Predictors such as irregular spotting, parallel ridge pattern, asymmetry of structures and colors give positive points, whereas parallel furrow and fibrillar pattern is negative. A diagnosis of acral melanoma is considered probable if the result of the calculations is ≥1. Use of the BRAAFF index can greatly improve the quality and specificity of the examination when used in daily practice. It will also be useful for doctors who are just starting their careers and do not have sufficient experience to confidently prescribe therapeutic tactics. The publication provides clinical example of the use of an algorithmic approach for the management of patient with acral lesions on the skin.

Dermatoscopy and management of patients with basal cell carcinoma. Review of clinical cases, 2020

The theoretical bases and practical aspects of the dermatoscopy application in clinical practice ... more The theoretical bases and practical aspects of the dermatoscopy
application in clinical practice as a method of basal cell skin
carcinoma diagnosis are considered in the article. Dermatoscopic
criteria for this type of skin tumor are described in detail. The
information about the basic anatomic-histological subtypes and
the most expedient ways of tumors eradication, both by surgical
and conservative methods, are given. The possibility of using
epiluminescent microscopy as a method before surgical planning
of the resection limits or control of the topical therapy effectiveness
is considered. As long as the disappearance of dermatoscopic criteria
in case of basal cell carcinoma is a recovery criterion that can
be obtained faster than a macroscopically visible result, at the same
time, the presence of such criteria can serve as a basis for repeated
courses of treatment. In difficult cases, the use of algorithmic
methods to analyze the dermatoscopic image is suggested. Among
these, it is recommended to consider «Prediction without pigment»,
which is a complement to the «Chaos and Clues» algorithm
developed by a team of authors to streamline the differential
diagnosis of non-pigmented formations and those with unproven
pigmentation by melanin. When analyzing this method, the first
question to be resolved is the presence of ulcer or white features (white
lines, surface keratin tips, white structureless areas, or white circles).
These clues are the basis for excision biopsy performing. In case
of their absence, vessel analysis is used. There are four monomorphic
vascular structures that correspond to a benign diagnosis: red, purple
or blue tubercles, centrally located, serpiginous and reticular vessels.
All other monomorphic structures, and especially the polymorphic
vascular pattern, should be evaluated as a reason for biopsy. Several
clinical cases were analyzed at the end of the publication. Illustrative
material was provided and dermatoscopic criteria were found,
appeared to be a key in the diagnosis of basal cell carcinoma for the
patients under consideration.