Lentigo Maligna Diagnosis: Correlation of clinical data, in vivo confocal microscopy and pathology criteria

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Summary

The work will be retrospective (20 patients) and prospective (20 patients). The student will be trained in Clinical/ UV lamp/ dermoscopy/ grading of melanocytic proliferation in In vivo Reflectance Confocal Microscopy (RCM) and Pathology skills. He will be integrated in the heart of the melanoma multidisciplinary clinic and research. The student is expected to write at least one article in peer review journal. The student should begin as soon as possible in 2014.

This a master project that should be achieve in 1year. In case of achievement, an NHMRC project grant is written for scholarship in 2015 to continue as a PhD on a randomised controlled multicentre trial of imiquimod versus radiotherapy for lentigo maligna (LM) where all these skills will be necessary.

Supervisor(s)

Dr Pascale Guitera

Research Location

Sydney Medical School - Generic

Program Type

Masters

Synopsis

LM is a form of melanoma in situ that usually occurs on sun-damaged skin of elderly people. LM is associated with a higher incidence of local recurrence compared with other common melanoma subtypes. Determination of the peripheral margins of LM is difficult from both clinical and pathological perspectives. There are no prospective studies or randomized controlled trials available to form the basis for any recommendations for the management of LM. Surgery is the treatment of choice but topical treatment (imiquimod) and radiotherapy have also been proposed to treat larger fields, with the hope of decreasing recurrence rates and having less cosmetic sequelae. Dermoscopy and Wood light (UV) examination have been described as useful techniques to better define the extent and recurrence of LM. However, a new technology, in vivo reflectance confocal microscopy in vivo RCM appears superior because it provides cellular resolution in the upper layers of the skin.

Additional Information

Research locations:
The University of Sydney
- Melanoma Institute Australia, 40 Rocklands road, North Sydney
- Sydney Melanoma Diagnostic Centre and Pathology department, Royal Prince Alfred Hospital, Missenden Road, Camperdown

Work plan:

1- Better defining the LM diagnosis: Clinical/ UV lamp/ dermoscopy/ grading of MC proliferation/ atypia/ migration in RCM and Pathology
2- Better defining margins and amelanotic area: Clinical/ UV lamp/ dermoscopy/ grading of MC proliferation/ atypia/ migration in RCM and Pathology
3- Better defining treatment failure: Clinical/ UV lamp/ dermoscopy/ grading of MC proliferation in RCM and Pathology
4- Correlation of pathology / RCM grading and outcomes for the patient in term of recurrence in the field or outside the field of treatment and evolution to lentigo maligna melanoma.
5- Provide more reliable classification and the potential to provide a basis for offering different treatment choices
6- Pilot study: RADICAL: RAdiotherapy or Imiquimod with ConfocAL Microscopy ANZMTG 02.12: A Phase III trial of imiquimod topical treatment versus radiotherapy for lentigo maligna (LM) mapped with reflectance confocal microscopy

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Keywords

lentigo maligna, Diagnosis, pathology correlation, confocal microscopy

Opportunity ID

The opportunity ID for this research opportunity is: 58