Ring Pattern Research Articles

Pituitary Crooke cell neuroendocrine tumor of adrenocorticotropic hormone differentiation-specific transcription factor lineage: a clinicopathological analysis of six cases

Objective: To investigate the clinicopathological features of Crooke cell tumor of adrenocorticotropic hormone differentiation specific transcription factor (TPIT, also known as transcription factor 19, TBX19) lineage neuroendocrine tumors. Methods: Six cases of Crooke cell tumor diagnosed at the First Affiliated Hospital of University of Science and Technology of China, Hefei, China from October 2019 to October 2023 were collected. The clinical and pathological features of these cases were analyzed. Results: Among the six cases, one was male and five were female, with ages ranging from 26 to 75 years, and an average age of 44 years. All tumors occurred within the sella turcica. Clinical presentations included visual impairment in two cases, menstrual disorders in one case, Cushing's syndrome in one case, headache in one case, and one asymptomatic case discovered during a physical examination. Preoperative serum analyses revealed elevated levels of cortisol and adrenocorticotropic hormones in two cases, elevated cortisol in two cases, elevated adrenocorticotropic hormone in one case, and one case with a mild increase in prolactin due to the pituitary stalk effect. Magnetic resonance imaging revealed uneven enhancement of masses with maximum diameters ranging from 1.7 to 3.2 cm, all identified as macroadenomas. Microscopically, tumor cells exhibited irregular polygonal shapes, solid sheets, or pseudo-papillary arrangements around blood vessels. The cell nuclei were eccentric or centrally located, varying in size, with abundant cytoplasm. Some tumor cells showed perinuclear halo. Immunohistochemistry demonstrated diffuse strong positivity for TPIT in five cases, focal weak positivity for TPIT in one case, diffuse strong positivity for adrenocorticotropic hormone in all cases, and faint staining around the nuclei in a few cells. CK8/18 showed a strong positive ring pattern in more than 50% of tumor cells, focal weak positive expression of p53, and the Ki-67 positive index ranged 1%-5%. Periodic acid-Schiff staining revealed positive cytoplasm and negative perinuclear areas. Conclusions: Crooke cell tumor is a rare type of pituitary neuroendocrine tumors. Its pathological characteristics include a distinctive perinuclear clear zone and immunohistochemical markers, such as CK8/18 exhibiting a ring or halo pattern. This entity represents a high-risk subtype among pituitary neuroendocrine tumors, displaying a high risk of invasion and a propensity for recurrence. Accurate diagnosis is crucial for the postoperative follow-up and multimodal treatment planning.

1,4-Pyrazolyl-Containing SAFit-Analogues are Selective FKBP51 Inhibitors With Improved Ligand Efficiency and Drug-Like Profile.

The FK506 binding protein 51 (FKBP51) is an appealing drug target due to its role in several diseases such as depression, anxiety, chronic pain and obesity. Towards this, selectivity versus the close homolog FKBP52 is essential. However, currently available FKBP51-selective ligands such as SAFit2 are too large and lack drug-like properties. Here, we present a structure activity relationship (SAR) analysis of the pipecolic ester moiety of SAFit1 and SAFit2, which culminated in the discovery of the 1,4-pyrazolyl derivative 23 d, displaying a binding affinity of 0.077 μM for FKBP51, reduced molecular weight (541.7 g/mol), lower hydrophobicity (cLogP=3.72) and higher ligand efficiency (LE=0.25). Cocrystal structures revealed the importance of the 1,4- and 1,3,4- substitution patterns of the pyrazole ring versus the 1,4,5 arrangement.

Effect of laser powers and sample positions on the self-diffraction ring patterns in CdSe quantum dots solution

We highlighted on the formation of self-diffraction ring patterns in CdSe quantum dots solution using spatial self-phase modulation (SSPM). The self-diffraction ring patterns parameters of the CdSe solutions were extracted using the theoretical diffraction model. The numerical diffraction ring patterns were in consistent with the experimental diffraction rings using different laser powers. Our results give new insight into the CdSe QDs dissolved in toluene and could be valuable for further development and research of semiconductor QDs optical devices.

Nanopipette dynamic microscopy unveils nano coffee ring

Liquid-phase electron microscopy (LP-EM) imaging has revolutionized our understanding of nanosynthesis and assembly. However, the current closed geometry limits its application for open systems. The ubiquitous physical process of the coffee-ring phenomenon that underpins materials and engineering science remains elusive at the nanoscale due to the lack of experimental tools. We introduce a quartz nanopipette liquid cell with a tunable dimension that requires only standard microscopes. Depending on the imaging condition, the open geometry of the nanopipette allows the imaging of evaporation-induced pattern formation, but it can also function as an ordinary closed-geometry liquid cell where evaporation is negligible despite the nano opening. The nano coffee-ring phenomenon was observed by tracking individual nanoparticles in an evaporating nanodroplet created from a thin liquid film by interfacial instability. Nanoflows drive the assembly and disruption of a ring pattern with the absence of particle-particle correlations. With surface effects, nanoflows override thermal fluctuations at tens of nanometers, in which nanoparticles displayed a "drunken man trajectory" and performed work at a value much smaller than kBT.

Identifying High-Quality Leads among Screened Anticancerous Compounds Using SMILES Representations.

Cancer is a lethal disease that affects numerous people worldwide. Chemotherapy stands as one of the most effective treatment regimens to combat cancer. Nevertheless, anticancer drugs face a high failure rate due to safety and efficacy issues. Drug failure could be subdued by instigating drug leads with reduced toxicity and enhanced efficacy. Computer-aided drug discovery endorses drug leads in manoeuvring protein and ligand structures or representations. Simplified molecular input line entry system (SMILES) is a linear notation representing the three-dimensional structure of a molecule using symbols and alphanumeric characters. SMILES representation hoards rings and scaffold structures in its depiction. Mining ring and scaffold patterns from molecular SMILES would assist in ascertaining biological properties based on molecular patterns. Moreover, the emergence of artificial intelligence (AI) technologies would accelerate identification of efficient anticancer drug leads. AI algorithms proclaimed for their pattern recognition ability could be employed for identifying molecular patterns from SMILES representation, thereby enabling property prediction. Consequently, we developed a multilayer perceptron (MLP) model for the prediction of anticancer activity using SMILES of NCI-60 cancer growth inhibition data. Furthermore, the top 8 frequent scaffolds were identified on preliminary analysis of cancer growth inhibition data and ChEMBL drugs. The developed MLP model classified anticancer and nonanticancer compounds with a classification accuracy of 0.92. Also, benchmarking of the developed model with machine learning algorithms exhibited better performance of the MLP model.

Oscillations in a Spatial Oncolytic Virus Model.

Virotherapy treatment is a new and promising target therapy that selectively attacks cancer cells without harming normal cells. Mathematical models of oncolytic viruses have shown predator-prey like oscillatory patterns as result of an underlying Hopf bifurcation. In a spatial context, these oscillations can lead to different spatio-temporal phenomena such as hollow-ring patterns, target patterns, and dispersed patterns. In this paper we continue the systematic analysis of these spatial oscillations and discuss their relevance in the clinical context. We consider a bifurcation analysis of a spatially explicit reaction-diffusion model to find the above mentioned spatio-temporal virus infection patterns. The desired pattern for tumor eradication is the hollow ring pattern and we find exact conditions for its occurrence. Moreover, we derive the minimal speed of travelling invasion waves for the cancer and for the oncolytic virus. Our numerical simulations in 2-D reveal complex spatial interactions of the virus infection and a new phenomenon of a periodic peak splitting. An effect that we cannot explain with our current methods.

Multicentric Longitudinal Prospective Study in a European Cohort of MYO7A Patients: Disease Course and Implications for Gene Therapy.

We investigated the natural history of retinal dystrophy owing to variants in the MYO7A gene. Fifty-three patients (mean age, 33.6 ± 16.7years) with Usher syndrome owing to biallelic, mostly pathogenic, variants in MYO7A underwent baseline and two annual follow-up visits. Best-corrected visual acuity (BCVA), semiautomatic kinetic visual field, full-field electroretinogram, color fundus imaging, microperimetry, spectral-domain optical coherence tomography, and fundus autofluorescence were assessed. At baseline, all patients presented with decreased BCVA (66.4 ± 17.9 Early Treatment Diabetic Retinopathy score and 59.5 ± 21.7 Early Treatment Diabetic Retinopathy score, in the better- and worse-seeing eyes, respectively), restricted semiautomatic kinetic visual field (III4e area, 3365.8 ± 4142.1°2; 4176.4 ± 4400.3°2) and decreased macular sensitivity (9.7 ± 9.9dB; 9.0 ± 10.2dB). Spectral-domain optical coherence tomography revealed reduced central macular thickness (259.6 ± 63.0µm; 250.7 ± 63.3µm) and narrowed ellipsoid zone band width (2807.5 ± 2374.6µm; 2615.5 ± 2370.4µm). Longitudinal analyses (50 patients) showed a significant decrease of BCVA in better-seeing eyes, whereas no changes were observed in worse-seeing eyes for any parameter. BCVA, semiautomatic kinetic visual field (III4e and V4e) and macular sensitivity were related significantly to age at baseline. Hyperautofluorescent foveal patch (16 eyes [31.4%]) and abnormal central hypoautofluorescence (9 eyes [17.6%]) were significantly associated with worse morphological and functional read-outs compared with the hyperautofluorescent ring pattern (22 eyes [43.1%]). Our European multicentric study offers the first prospective longitudinal analysis in one of the largest cohorts of MYO7A patients described to date, confirming the slow disease progression. More important, this study emphasizes the key role of fundus autofluorescence patterns in retinal impairment staging and advocates its adoption as an objective biomarker in patient selection for future gene therapy clinical trials.

Numerical simulation of vortex rings in non-Newtonian fluids

The impulsive viscous flow through an orifice produces vortex rings that self-propagate until total dissipation of the vorticity. This work aims to study numerically such vortex rings for different types of non-Newtonian fluids, including the power-law, Carreau and simplified Phan-Thien-Tanner (PTT) rheological models, with particular focus on the post-formation phase. The simulations were carried out with the finite-volume method, considering small stroke ratios (L/D ≤ 4) and laminar flow conditions (ReG ≤ 103), while parametrically varying shear-thinning, inertia and elasticity. The vortex rings generated in power-law fluids revealed some peculiar features compared to Newtonian fluids, such as a faster decay of the total circulation, a reduction of the axial reach and a faster radial expansion. The behavior in Carreau fluids was found to be bounded between that of power-law and Newtonian fluids, with the dimensionless Carreau number controlling the distance to each of these two limits. The vortex rings in PTT fluids showed the most disruptive behavior compared to Newtonian fluids, which resulted from a combined effect between inertia, elasticity and viscous dissipation. Depending on the Reynolds and Deborah numbers, the dye patterns of the vortex rings can either move continuously forward or unwind and invert their trajectory at some point. Elasticity resists the self-induced motion of the vortex rings, lowering the axial reach and creating disperse patterns of vorticity. Overall, this work shows that the particular non-Newtonian rheology of a fluid can modify the vortex ring behavior typically observed in Newtonian fluids, confirming qualitatively some experimental observations.

Emergent dynamics: Collective motions of polar active particles on surfaces

In this study, we focus on the collective dynamics of polar active particles navigating across three distinct surfaces, each characterized by its own unique blend of topological and geometrical properties. The behavior of these active particles is influenced by a multitude of factors, including self-propulsion, inter-particle interactions, surface constraints, and under-damped stochastic forces simulated via Ornstein–Uhlenbeck processes. Our exploration unveils the prevailing collective patterns observed within these systems across three surface types: a sphere, a torus, and a landscape featuring hills and valleys, each distinguished by its specific topological and geometrical attributes. We underscore the profound impact of surface curvature and symmetry on the sustainable spatial-temporal dynamics witnessed. Our findings illuminate how the interplay between substantial surface curvature and particular symmetrical characteristics gives rise to a diverse spectrum of spatial-temporal patterns. Notably, we discern that high curvature tends to drive collective motion toward cyclic rotation on spheres and tori, or spatial-temporal periodic traveling ring patterns on landscapes with hills and valleys. Additionally, we observe that rough surfaces and the incorporation of excluded volume effects can disrupt the complexity of these collective spatial-temporal patterns. Through this investigation, we provide invaluable insight into the intricate interplay of curvature and symmetry, profoundly shaping collective behaviors among active particles across varied surfaces.

Detection of milk adulteration using coffee ring effect and convolutional neural network

A low-cost and effective method is reported to identify water and synthetic milk adulteration of cow’s milk using coffee ring patterns. The cow’s milk samples were diluted with tap water (TW), distilled water (DW) and mineral water (MW) and drop cast onto glass slides to observe coffee ring patterns. The area of the ring, total particle area and average particle diameter were extracted from these patterns. For each ring, the ratio of total particle area versus total ring area was calculated. The area ratio, regardless of water adulterants, follows an exponential model with respect to average particle diameter. Unlike TW, the ratio for DW and MW adulterated milk are clustered and classified together with respect to the particle diameter. These results were independent of dilution level and are used for adulterant classification. The ring of milk adulterated using synthetic milk gave multiple concentric rings, flower-like structures, and oil globules throughout the dilution level. An Alexnet model was used to classify water and synthetic milk adulterants in authentic milk. The trained model could achieve 96.7% and 95.8% accuracy for binary and tertiary classification respectively. These results enable us to distinguish synthetic milk from pure milk and segregate DW and MW with respect to TW adulterated milk.

Criteria for melanocytic lesions in LC-OCT.

Line-field confocal optical coherence tomography (LC-OCT) is an emerging diagnostic tool with imaging depth reaching ~400 μm and a novel three-dimensional (3D) cube providing cellular resolution. As far as we are aware, there are only a limited number of papers that have reported diagnostic criteria for melanocytic lesions using this technique, and none of them have been multicentric. Our aim was to establish the diagnostic criteria for melanocytic lesions using LC-OCT and identify the most significant architectural and cytologic features associated with malignancy. A retrospective evaluation of 80 consecutive melanocytic lesions from a prospective multicentric data set spanning three European centres was conducted. We excluded facial, acral and mucosal lesions from the study. Dermoscopic and LC-OCT images were evaluated by a consensus of four observers. Multivariate logistic regression with backward elimination was employed. The main melanoma diagnostic criteria include detecting >10 pagetoid cells in 3D acquisition, irregular 3D epidermal architecture, disrupted dermoepidermal junction (DEJ) and clefting. Significant risk factors were irregular 3D epidermal architecture, >10 pagetoid cells, dendritic cells at DEJ without underlying inflammation. Novel malignancy criteria in vertical view were DEJ disruption and clefting around atypical melanocyte nests. Exclusive melanoma features were epidermal nests, epidermal consumption, dense dermal nests with atypia. Protective features in the absence of any malignancy indicators were DEJ ring pattern, cobblestone, elongated rete ridges (vertical), well-defined DEJ and wave pattern (vertical). A series of diagnostic criteria for the identification of melanocytic lesions with LC-OCT have been established. Validation of these criteria in clinical practice through future studies is essential to further establish their utility.

Darobactin Substrate Engineering and Computation Show Radical Stability Governs Ether versus C-C Bond Formation.

The Gram-negative selective antibiotic darobactin A has attracted interest owing to its intriguing fused bicyclic structure and unique targeting of the outer membrane protein BamA. Darobactin, a ribosomally synthesized and post-translationally modified peptide (RiPP), is produced by a radical S-adenosyl methionine (rSAM)-dependent enzyme (DarE) and contains one ether and one C-C cross-link. Herein, we analyze the substrate tolerance of DarE and describe an underlying catalytic principle of the enzyme. These efforts produced 51 enzymatically modified darobactin variants, revealing that DarE can install the ether and C-C cross-links independently and in different locations on the substrate. Notable variants with fused bicyclic structures were characterized, including darobactin W3Y, with a non-Trp residue at the twice-modified central position, and darobactin K5F, which displays a fused diether ring pattern. While lacking antibiotic activity, quantum mechanical modeling of darobactins W3Y and K5F aided in the elucidation of the requisite features for high-affinity BamA engagement. We also provide experimental evidence for β-oxo modification, which adds support for a proposed DarE mechanism. Based on these results, ether and C-C cross-link formation was investigated computationally, and it was determined that more stable and longer-lived aromatic Cβ radicals correlated with ether formation. Further, molecular docking and transition state structures based on high-level quantum mechanical calculations support the different indole connectivity observed for ether (Trp-C7) and C-C (Trp-C6) cross-links. Finally, mutational analysis and protein structural predictions identified substrate residues that govern engagement to DarE. Our work informs on darobactin scaffold engineering and further unveils the underlying principles of rSAM catalysis.

Multi-parameter terahertz metamaterial sensors based on single-layer quarter ring patterns

A terahertz metamaterial sensor based on a single-layer quarter ring pattern is proposed to realize the simultaneous measurement of temperature, refractive index, and other parameters through a metasurface consisting of a patterned quarter ring gold layer and a silicon substrate. Field finite element numerical simulations were performed to analyse the transmission and reflection spectra. A two-parameter sensor combined with electric field distribution was realized using multiple peaks, thus revealing the physical mechanisms of the interaction in metamaterial structures. In addition, the effect of each geometrical parameter on the sensor performance is also simultaneously analysed to verify the optimal selection of structural parameters. On this basis, the sensors are theoretically analysed at different incidence and polarization angles, and the results show that the transmittance is not sensitive to the polarization angle. The simulation results show that the transmittance at the resonant frequencies of 0.48 THz, 0.64 THz, 0.79 THz and 1.04 THz are 93.7 %, 79.1 %, 38.4 % and 50.8 %, respectively, and the refractive index sensitivities at the resonant frequencies are 6.84 GHz/RIU, 7.42 GHz/RIU, 8.22 GHz/RIU and 32.11 GHz/RIU, and quality factor Q of 6.76, 9.63, 15.51 and 26.28, respectively. The devices proposed in this study are simple in structure, easy to fabricate, easy to miniaturize and can be integrated for sensitivity, multi-parameter sensors. They can be functionally designed for chemical and biological sensing and other important applications.

DESCRIBING THE LOCATION AND MORPHOLOGY OF THE DOTS IN WHITE DOT FOVEA USING ADAPTIVE OPTICS.

To characterize the white dots in white dot fovea, an entity chiefly described in Japan, using adaptive optics imaging and propose a hypothesis regarding their origin. The patient underwent comprehensive ophthalmic examination, including color and green monochromatic fundus photography, fluorescein angiography, spectral-domain optical coherence tomography, and adaptive optics imaging. An asymptomatic 66-year-old Korean woman presented with bilateral white, glistening deposits in a ring pattern around the fovea of both eyes. The dots were highly reflective on green monochromatic images, were not visible on fluorescein angiography, and appeared hyperreflective in the inner retina using spectral-domain optical coherence tomography. Adaptive optics showed polygonal granules ranging from 1 to 10 μ m in size. The patient denied any systemic disorder or the use of any medications related to crystalline retinopathy. The patient had lived in Japan for 35 years before just moving to the United States. The location, small size, and polygonal shape of the dots in white dot fovea are suggestive of intraretinal deposition of crystals, and not cells on the surface of the fovea as has been previously proposed. Carotenoid deposition related to dietary habits is a plausible cause because of the similarity to other retinopathies associated to these compounds.

Log cross section quality metrics: Assessing the usability of roundwood image data for roundwood tracking

The proof of origin of roundwood is becoming increasingly important. As part of the digitization of the forest-based sector and to combat illegal logging, there is a growing interest in tracking wood logs individually. There are several previous publications on biometric wood log tracking based on log image data. A major problem for wood log tracking is the often poor visibility of discriminative features in log ends, such as the annual ring pattern, which makes it very difficult to track such logs. In this work we propose a method that quantifies the usability of image data for the purpose of roundwood tracking. There are no previous publications on this topic. More specifically, we propose a quality map that assesses the usability of different regions of the log cross section and a global quality metric that assesses the quality of entire images. We will show that the local and global quality metrics reliably assess the quality of log cross section images. Furthermore, we will show that the quality map can be used to improve the results of deep learning based log recognition systems. By combining the image data with the local quality map, the roundwood tracking system gets additional information about the usability of the different regions of the log cross section for roundwood tracking, which leads to improvements in most of the results.

Learned Inference of Annual Ring Pattern of Solid Wood

AbstractWe propose a method for inferring the internal anisotropic volumetric texture of a given wood block from annotated photographs of its external surfaces. The global structure of the annual ring pattern is represented using a continuous spatial scalar field referred to as the growth time field (GTF). First, we train a generic neural model that can represent various GTFs using procedurally generated training data. Next, we fit the generic model to the GTF of a given wood block based on surface annotations. Finally, we convert the GTF to an annual ring field (ARF) revealing the layered pattern and apply neural style transfer to render orientation‐dependent small‐scale features and colors on a cut surface. We show rendered results of various physically cut real wood samples. Our method has physical and virtual applications such as cut‐preview before subtractive fabricating solid wood artifacts and simulating object breaking.

A para- to meta-isomerization of phenols.

Phenols and their derivatives are ubiquitous in nature and critically important industrial chemicals. Their properties are intimately linked to the relative substitution pattern of the aromatic ring, reflecting well-known electronic effects of the OH group. Because of these ortho-, para-directing effects, meta-substituted phenols have historically been more difficult to synthesize. Here we describe a procedure to transpose phenols that hinges on a regioselective diazotization of the corresponding ortho-quinone. The procedure affords the meta-substituted phenol directly from its more common and accessible para-substituted isomer, and demonstrates good chemoselectivity that enables its application in late-stage settings. By changing the electronic effect of the OH group and its trajectory of hydrogen bonding, our transposition can be used to diversify natural products and existing chemical libraries, and potentially shorten the length and cost of producing underrepresented arene isomers.

Spatiotemporal reshaping of femtosecond laser pulses on interaction with gas sheath at ionization saturation intensity regime

Interaction of intense ultrashort laser pulse with gases generates a transient spatiotemporal electron density distribution via field ionization, which may lead to the spatiotemporal reshaping of the pulse, viz., its beam profile, pulse width, etc. Here, we present an experimental study on ultrashort laser pulse interaction with argon gas sheath in an ionization saturation intensity regime (∼1015–1017 W/cm2). The present investigation has been performed using a 6 mJ, 1 kHz, and 55−60 fs Ti:Sapphire laser pulse interaction with a ∼2.5 mm long argon sheath. After the laser gas interaction, the laser spatial profile exhibits a multi-ring structure around a central maximum spot. Laser gas interaction parameters, such as laser intensity, gas pressure, etc., affect the ring pattern significantly. Under optimum parameter conditions, the laser pulse has two rings in spatial profile, and the pulse width of the central spot is self-compressed to ∼35 fs. A theoretical calculation reveals that the laser beam’s spatiotemporal profile evolves as it propagates inside the gas sheath. The calculation also demonstrates that the gas ionization profile plays a crucial role in the spatiotemporal reshaping and self-compression of the laser beam. The calculation also shows that the generation of concentric ring patterns in the spatial profile is mainly due to the ionization of argon atoms into Ar+, Ar2+, and Ar3+ species in the interaction region. Such self-compressed laser pulses with concentric ring beam profiles may be useful for high-harmonic generation and shorter attosecond pulse trains.

Decisive role of preparation technique on the structural, electrical and magnetic properties of vanadium doped ZnO nanoparticles

1% vanadium doped ZnO powders have been successfully synthesized via two different preparation techniques viz., glycine assisted combustion method and mechanical attrition method to understand their impact on the structure-property relation. X-ray Diffraction study validates the Wurtzite phase formation of ZnO with hexagonal structure. X-ray diffraction peak discloses the marked role of size and strain component. Evidently, the shift of lattice strain with the preparation techniques from compressive to tensile nature show the importance of structure property relations in the ZnO compounds. SEM micrographs depict the formation of densely populated nanograins with networking like structures which is characteristics of combustion synthesized product whereas as top down approach exhibits the presence of coarse grains amidst the broken sea of fine particles. Selected area electron diffraction (SAED) images display ring and bright circular spot pattern with changes in method of preparation, which further clarifies the distinct nature of investigated ZnO:V particles. Vibrational spectral study gives clear evidence on the structural disorder as deduced from the changes associated with longitudinal optical mode phonon scattering. Interestingly, the UV spectral study divulges the increment in optical band gap as well as a strong visible light absorption (about 30 %) for milled ZnO:V over their chemically prepared counterparts. Photoluminescence spectra of milled V doped ZnO upheld the structural disorder taken place with the suppression of Near Band Edge (NBE) transition and the shifting of broad asymmetric defect emission band towards the lower wavelength regime. Impedance study enlightens the crucial role of synthesis method with 5 times enhanced grain boundary resistance along with suppression of grain contribution in the milled samples. Magnetic study highlights the remarkable distinction of preparation route which alters the ferromagnetic ordering in the combustion synthesized samples to conventional diamagnetic signature of the host ZnO in the milled samples.

Correlation between super-high magnification (400x) dermoscopy and reflectance confocal microscopy for the diagnosis of melanosis and other pigmented genital lesions.

The clinical diagnosis of pigmented genital lesions is challenging. Reflectance confocal microscopy (RCM) is effective for diagnosis but is limited in its application due to elevated costs. A more affordable dermatoscope with a 400x magnification (D400) has recently been brought to market. The aim of our study was to compare these two imaging techniques for the analysis of pigmented genital tumours. An observational, prospective and mono-centric study was carried out from October 2017 to May 2019, in which clinical, dermatoscopic (20x and 400x) and RCM data from 207 pigmented genital lesions were collected. The images generated via D400 and RCM were analysed by three expert investigators. Similarities between the criteria observed using D400 and RCM were evaluated by each investigator. In total, 207 lesions were included: 183 melanosis, 19 nevi, one basal cell carcinoma (BCC), two condylomas and two melanomas in situ. Our series correlates well with data found in the literature especially for the distribution of different lesions, their topography, and their aspect using x20 dermatoscopy and RCM. Pattern and cell criteria defined using RCM largely paralleled those observed with D400 for all three investigators. Correlation between D400 and RCM was moderate to strong with regards to the identification of the ring pattern and clustered round cells, strong for dendritic and plump cells, and perfect for isolated round cells and spindle cells. D400 is an easy-to-use, cost-effective alternative for the analysis of pigmented genital lesions, particularly for melanosis.