American Dermoscopy Meeting 2015

Course Director: Ashfaq Marghoob, MD

Faculty:
Ralph Braun, MD
Natalia Jaimes, MD
Michael Marchetti, MD
George Martin, MD
Steven O'Day, MD
Margaret Oliviero, ARNP
Harold Rabinovitz, MD
Richard Usatine, MD

August 12, 2015

2:00 - 5:00 PM

Registration

August 13, 2015

7:00 - 8:00 AM	Breakfast + Exhibits
8:00 - 8:45 AM	Introduction – A. Marghoob, MD Overview of the current state of dermoscopy in the US & the rational for its use. This lecture will provide the justification for using dermoscopy and explain why the statement “my eyes are just as good as dermoscopy” is not rational.
8:45 - 9:30 AM	Pre-test – A. Marghoob, MD Participants will evaluate a series of unknown cases. These cases were selected for their high didactic value. The cases will provide participants with insights into their level of knowledge and confidence in evaluating dermoscopy images.
9:30 - 10:30 AM	The Bridge: Dermoscopy with Histopathology Correlations – R. Braun, MD This is an extremely important lecture to attend! It sets the stage for all other lectures to follow. Knowledge of the histopathology correlates of dermoscopic structures allows for improved clinical-pathology correlation by allowing the clinician to evaluate the dermoscopy with their knowledge of histopathology and evaluate the histopathology with their knowledge of dermoscopy.
10:30 - 11:00 AM	Break + Exhibits
11:00 - 11:30 AM	Equipment, Techniques and Principles (NPD, PD, etc) – N. Jaimes, MD Lecture is designed to provide participants with a simplified overview of the different types of dermoscopy equipment available and to highlight differences between polarized and non-polarized dermoscopy. This information will allow the participant to purchase the correct scope and to get the most out of the scope they have.
11:30 AM - 12:00 PM	Tricks: Ink Test, Wobble Test, Blink Sign, HDR Imaging – R. Braun, MD Dermoscopy can be used in ingenious ways to improve the clinician’s diagnostic accuracy. The information in this lecture will allow clinicians to fine tune their diagnostic skills.
12:00 - 12:30 PM	Chaos & Clues – N. Jaimes, MD A simplified screening algorithm designed to help in management decisions regarding which lesions to biopsy. This is very helpful for clinicians whose main focus is to correctly triage lesions as quickly as possible.
12:30 - 1:30 PM	Lunch
1:30 - 2:00 PM	2-step – A. Marghoob, MD An algorithm designed not to miss melanoma, make a precise pre-biopsy diagnosis and assist in the management of which lesions to biopsy vs. monitor. This is another key lecture since much of the rest of the course is based on this algorithm.
2:00 - 2:15 PM	Dermatofibroma: The Quirky Tumor – M. Marchetti, MD Although the dermoscopic features of dermatofibromas can be quite complex, understanding the clinical morphology and histopathology can help make the interpretation of the dermoscopic features easy.
2:15 - 2:45 PM	Basal Cell & Squamous Cell Carcinoma – H. Rabinovitz, MD The established criteria for the diagnosis of BCC & SCC together with some newly described criteria makes the identification of these tumors quite easy. The diagnostic features are also visible in very small tumors thus helping clinicians to identify these cancers while they are small and amenable to simple treatments.
2:45 - 3:00 PM	Lentigo/Seborrheic Keratosis – R. Braun, MD Clinically these lesions can be challenging to differentiate from melanoma. Dermoscopy features can greatly facilitate in correctly diagnosing these lesions.
3:00 - 3:30 PM	Break + Exhibits
3:30 - 3:45 PM	Hemangioma/Angiokeratoma – N. Jaimes, MD Vascular lesions can simulate melanoma and melanoma can simulate a vascular tumor. Dermoscopy criteria can facilitate in correctly identifying these lesions.
3:45 - 4:00 PM	Lichen Planus Like Keratosis – H. Rabinovitz, MD LPLK has overlapping features with BCC and melanoma. This lecture will highlight the diagnostic features of LPLK and also show the difficulty of differentiating some of them form BCC/melanoma.
4:00 - 4:10 PM	Sebaceous Hyperplasia & Clear Cell Acanthoma – M. Oliviero, NP Sebaceous hyperplasia can clinically mimic BCC. This lecture will show that these growths have a distinct morphology that can easily be used to differentiate them from BCC. Prior to dermoscopy it was not possible to make a prebiopsy diagnosis of CCA. This lecture will show that CCA has a very unique dermoscopy morphology that can be relied upon to make an accurate diagnosis.
4:10 - 4:30 PM	Q & A

August 14, 2015

7:00 - 8:00 AM Breakfast + Exhibits

Novice

8:00 - 8:30 AM Review of the Two-Step Algorithm and Melanocytic Criteria (30 minutes) – R. Usatine, MD

8:30 - 9:15 AM Patterns of Melanocytic Neoplasms Benign and Malignant: Part 1 – M. Oliviero, NP

9:15 - 10:00 AM Patterns of Melanocytic Neoplasms Benign and Malignant: Part 2 – N. Jaimes, MD

10:00 - 10:30 AM Break + Exhibits

10:30 - 11:00 AM Vascular morphology – M. Oliviero, NP

11:00 - 11:30 AM Unknown Melanocytic Lesions – N. Jaimes, MD

11:30 AM - 12:00 PM Unknown Non-Melanocytic Lesions – R. Usatine, MD

12:00 - 12:30 PM Unknown Mixed Non-Melanocytic and Melanocytic Lesions – N. Jaimes, MD and M. Oliviero, NP

Advanced

8:00 - 8:30 AM Nevus Patterns – R. Braun, MD
Melanocytic nevi tend to manifest a finite number of recurrent patterns. Knowing the benign patterns will help in identifying melanoma and in increasing specificity.

8:30 - 9:15 AM Melanoma Specific Structures – A. Marghoob, MD
Melanomas tend to be dermoscopically asymmetric lesions. In addition, they usually display at least one of 10 structures, which help in their detection.

9:15 - 10:00 AM Unknowns – M. Marchetti, MD
An opportunity for participants to test their knowledge on a series of unknowns.

10:00 - 10:30 AM Break + Exhibits

10:30 - 11:00 AM Vessels & Pink Lesions – H. Rabinovitz, MD
The morphology, arrangement and distribution of blood vessels in a lesion can be helpful in diagnosis. This lecture will highlight the importance of blood vessels in the diagnosis of pink lesions.

11:00 - 11:30 AM Melanoma Subtypes – R. Braun, MD
Numerous subtypes of melanomas have been identified. These subtypes present with different clinical characteristics, growth rates, mutation profiles and dermoscopic features.

11:30 - 11:45 AM Regression Structures – M. Oliviero, NP
Regression structures are important dermoscopic features to recognize. They can help in the diagnosis of melanoma and can help identify lichen planas like keratosis.

11:45 AM -12:00 PM White Shiny Areas – H. Rabinovitz, MD
Polarized dermoscopy has allowed us to see white shiny structures including crystalline, blotches, strands and rosettes. These structures can help in diagnosing melanoma, BCC and SCC.

12:00 - 12:30 PM Unknowns – R. Braun, MD
An opportunity for participants to test their knowledge on a series of unknowns.

12:30 - 1:30 PM Lunch

1:30 - 2:30 PM Targeted Therapy for Melanoma – S. O’Day, MD
Targeting the immune system and the MAP-kinase pathway is helping prolong survival in stage IV melanoma patients. These patients will be seen more frequently by dermatologists, family physicians, NPs and PAs and it behooves them to understand the mechanism of action of these drugs. These patients will need to be under surveillance for the development of cutaneous side effects including increased risk for developing new primary melanomas.

2:30 - 3:15 PM Difficult to dx MM & Spitz Nevus Conundrum – A. Marghoob, MD
Some melanomas are challenging to diagnose and are over represented in litigation cases. The dermoscopic features of these more difficult to diagnose melanomas will be discussed. In addition, melanomas misdiagnosed as Spitz nevi has created anxiety regarding the management of Spitz nevi. This issue will be discussed and dermoscopy clues to diagnosis of Spitz/Reeds nevi will be outlined.

3:15 - 3:45 PM Break + Exhibits

3:45 - 5:00 PM Unknowns for all/App Unknowns – M. Marchetti, MD / R. Usatine, MD
An opportunity for participants to test their knowledge on a series of unknowns.

August 15, 2015

7:00 - 8:00 AM Breakfast + Exhibits

8:00 - 9:00 AM Volar/Nails – R. Braun, MD
Pigmented lesions on palms, soles and nail often create unnecessary anxiety. This lecture will highlight the features seen in benign lesions and provide an algorithm to help in their management.

9:00 - 9:30 AM Facial – M. Oliviero, NP
Differentiating a lentigo from a melanoma from a LPLK can be challenging based on clinical examination. This lecture will disclose the dermoscopic features that aid in their diagnosis.

9:30 - 10:00 AM Mucosal – M. Marchetti, MD
Lesions on mucosal surfaces have received little attention until recently. Dermoscopy is proving helpful in assessing these lesions and this lecture will highlight what is currently known about this subject matter.

10:00 - 10:30 AM Break + Exhibits

10:30 - 11:00 AM AK (non-pigmented & pigmented) – H. Rabinovitz, MD
Actinic keratosis can be precursors to SCC and perhaps even BCC. In addition, they can clinically mimic melanoma. This lecture will highlight the dermoscopic morphology of AK and also highlight how this morphology can impact management.

11:00 AM - 12:00 PM Treatment of AK – G. Martin, MD
Dermoscopy can help in differentiating an AK from invasive SCC. Once AKs have been identified, decisions need to be made regarding their management. The treatment armamentarium for AKs is ever expanding and this lecture will highlight what is currently know about this subject matter.

12:00 - 12:30 PM General Derm – N. Jaimes, MD
Dermoscopy can be used in diagnosing hair disorders, psoriasis, infestations and much more. This lecture will provide an overview on the myriad of uses of dermoscopy for the diagnosis and management of non-tumor related cutaneous conditions. Any clinician looking at skin will find something beneficial in this lecture.

12:30 - 1:30 PM Lunch

1:30 - 3:30 PM Post-Test – A. Marghoob, MD
Participants will evaluate a series of unknown cases. These cases were selected for their high didactic value. The cases will provide participants with insights into their level of knowledge and confidence in evaluating dermoscopy images.

3:30 - 4:00 PM Closing Summary – A. Marghoob, MD