Smallest form of skin cancer ever discovered: a malignant spot under a woman’s eye that measured just 0.65 millimeters. To find out, a team of researchers from the Oregon Health and Science University led by the dermatologist Alexander Witkowski, pupil of Giovanni Pellacaniprofessor of dermatology at the University of La Sapienza in Rome, Italy.
The spot under the eye
Christy Staats, an American woman, had been concerned about a red spot under her eye for years. After being reassured by several dermatologists that there was nothing to worry about, she decided to book another visit when the spot grew. During the consultation, dermatologist Dr. Witkowski diagnosed the spot as a cherry angioma, a common, non-cancerous skin growth.
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However, during the same exam, he noticed a small nearby spot on Christy’s right cheek. Dr. Witkowski took a picture of the spot with a device made for doctors to capture close-up images of skin lesions. He then performed reflection confocal microscopy (RFM), an additional scan that uses a laser to illuminate the spot and highlight the underlying cells. The results showed that there were atypical cells, usually found in melanoma cases.
Dr. Witkowski then took a biopsy of the stain, which his team inspected further. During the diagnostic process, the case was also reviewed by Dr. Pellacani, who is an expert in RFM and trained both the Oregon team’s Dr. Witkowski and Dr. Ludzik before they moved to the United States in 2019.
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The diagnosis
The team confirmed that the spot was in situ melanoma, also called stage 0 melanoma. It means there are cancerous cells in the top layer of skin, the epidermis, but they are contained and have not penetrated deeper into the skin. It can be cured with surgery, which removes the melanoma and a border of healthy skin around it to make sure any abnormal cells are removed. This discovery is an important reminder of the importance of prevention and early detection of skin cancer. Even seemingly harmless spots should be monitored by a dermatologist and checked regularly to prevent them from becoming a more serious health problem in the future, researchers say.
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