Aimilios Lallas

Aristotle University of Thessaloniki, First Department of Dermatology, Faculty Member

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Aimilios Lallas is a Professor of Dermatology at the First Department of Dermatology of Aristotle University in Thessaloniki, Greece.
He is specialized in skin cancer diagnosis with non-invasive techniques, as well as in the management of skin cancer patients.
His main field of research interest is dermoscopy of skin tumors, the application of the method in general dermatology and the improvement of the management of oncologic patients.
Scientific profile at a glance:
Author of 467 scientific papers published on Pubmed Central, most of them on dermoscopy and skin cancer.
Editor of 11 books published by international publishers and author of several book chapters on dermoscopy.
Co-investigator in 8 Phase III Clinical trials on skin cancer treatment.
Rated among the 1% of top reviewers of scientific papers for 2017 (publons.com)
Several awarded scholarships and scientific awards.
Teaching activities
Over the last years, Dr Lallas has established scientific collaboration with numerous colleagues from several countries. He is invited speaker in several domestic and international congresses and meetings, mainly on dermoscopy and on skin cancer diagnosis and management. He is particularly involved in teaching activities on dermoscopy, having organized and participated in numerous domestic and international courses. He has supervised the training of numerous fellows from several countries on dermoscopy and skin cancer diagnosis and management.
Administrative activities
Dr Lallas is currently the President of the International Dermoscopy Society (IDS).
He is also a Board Member of the European Association of Dermato-Oncology (EADO).
He is also a Board Member of the Professional Insurance Association of the Medical Chamber of Thessaloniki.
Phone: +302313308879
Address: Hospital for Skin and Venereal Diseases
124 Delfon Street, 54643, Thessaloniki, Greece

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Papers by Aimilios Lallas

Faculty of 1000 evaluation for Dynamic Changes in Nevi of a Patient With Melanoma Treated With Vemurafenib: Importance of Sequential Dermoscopy

F1000 - Post-publication peer review of the biomedical literature, 2012

Overdiagnosis of Melanoma: Is it a Real Problem?

Dermatology Practical & Conceptual

Considering all the above, there is little doubt that over-diagnosis of melanoma exists. In addit... more

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Acral Melanocytic Nevi in a High-Risk Population: Prevalence, Clinical Characteristics and Dermatoscopic Patterns

Dermatology

Background: The prevalence of acral nevi and their dermatoscopic patterns have been mainly studie... more Background: The prevalence of acral nevi and their dermatoscopic patterns have been mainly studied in Asian populations. Few data exist on the prevalence and clinico-dermatoscopic morphology of acral nevi in white populations. Objectives: The aim of this study was to assess the prevalence of acral nevi and evaluate their features in a cohort of Caucasian individuals at high risk for skin cancer. Methods: We prospectively examined the palms and soles of 680 high-risk patients who underwent total body clinical and dermatoscopic documentation, as a part of their routine follow-up, between January 2016 and March 2020 at a skin cancer referral center in Greece. Results: Overall, 334 acral lesions were detected in 217 (37.0%) of 585 patients in the study. The presence of acral nevi was associated with 2.6 higher odds of a total nevus count higher than 50 (OR: 2.6, p < 0.05, confidence intervals [CI]: 1.11–6.09). Of 334 acral nevi, 65.0% were clinically flat and 35.0% were clinically pa...

Melanoma: Staging and Follow-Up

Dermatology Practical & Conceptual, 2021

Cancer staging is the process determining to which extent a cancer has spread and where it is loc... more Cancer staging is the process determining to which extent a cancer has spread and where it is located in the body. A thorough staging is of utmost importance, not only because it provides the most accurate prognostic estimation, but also because several crucial decisions, such as the treatment choice and the follow-up strategy, vary according to the tumor’s stage. The current staging system for melanoma is based on the 8th edition of TNM classification issued by the American Joint Committee on Cancer (AJCC) in 2017. It includes a clinical and a pathological staging, both consisting of 5 stages (0-IV). The stage of a melanoma is determined by several factors, among which the Breslow thickness, the pathological presence or absence of ulceration in the primary tumor, the presence and the number of tumor-involved regional lymph nodes, the presence or absence of in-transit, satellite and/or microsatellite metastases, and the presence of distant metastases. Following melanoma diagnosis, a...

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Dermatoscopic shiny white structures in benign cutaneous tumours

Clinical and Experimental Dermatology

The dermatoscopic characteristics of shiny white structures (SWS) in malignant skin tumours are w... more The dermatoscopic characteristics of shiny white structures (SWS) in malignant skin tumours are well described, but data on benign skin neoplasms are scarce. To evaluate dermatoscopic features of SWS in common benign tumours, we reviewed our database for histopathologically confirmed cases. The dermatoscopic images were evaluated for the presence of any type of SWS. Those images with SWS were further analyzed for their quantity, distribution and shape. Of 2420 evaluated benign tumours, 357 (14.8%) displayed SWS. The highest frequencies were observed in pyogenic granuloma (62/100, 62.0%), angioma (63/113, 55.8%) and adnexal tumours (42/84, 50.0%). The lowest frequency was found in common nevi (16/1032, 1.6%) and solar lentigo (0%). The presence of SWS was not associated with sex or anatomic location. SWS were usually diffuse and multiple. SWS may be present in a broad spectrum of benign tumours. Therefore, they should not be considered as de-facto indicators of malignancy.

Nodular Non-pigmented Lesions on the Lower Limb

Atlas of Dermatoscopy Cases, 2020

Surgical treatment of basal cell carcinoma and squamous cell carcinoma

Giornale Italiano di Dermatologia e Venereologia

Non melanoma skin cancers (NMSC) are the most common human neoplasms,encompassing basal cell carc... more Non melanoma skin cancers (NMSC) are the most common human neoplasms,encompassing basal cell carcinoma (BCC) and squamous cell carcinoma(SCC), butalso cutaneous lymphomas, adnexal tumors, merckel cell carcinoma and other rare tumors. The incidence of BCC and SCC varies significantly among different populations, and the overall incidence of both tumors has increased over the last decades. Although generally associated with a favorable prognosis, recent evidence suggests that the mortality rates of SCC might have been underestimated up-to-date1.According to Medicare data,NMSC is the fifth most expensive cancer for health care systems. This increased economic burden is not associated withthe cost of treating an individual patient, but with the large number of affected patients and the recurrence rates2. Therefore, the adequate management of the primary tumor with a complete excision becomes a priority not only for the patient but also for the public health systems. Multiple treatment m...

Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society

British Journal of Dermatology, 2017

Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical... more Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical recognition, biologic behavior and management strategies. Dermoscopy improves the clinical recognition of Spitz naevi, but a morphologic overlap between Spitz naevi and spitzoid melanoma does exist. Histopathologically, some tumours cannot be safely diagnosed neither as Spitz naevi nor as melanomas. These controversies result in a significant inconsistency of management of spitzoid tumours among clinicans.

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Complete response of locally advanced basosquamous carcinoma to vismodegib in two patients

European journal of dermatology : EJD, Jan 10, 2018

Clinicopathologically problematic melanocytic tumors: a case-based review

Dermatology practical & conceptual, 2018

In spite of recent advances in the histopathological and molecular diagnosis of melanocytic neopl... more In spite of recent advances in the histopathological and molecular diagnosis of melanocytic neoplasms, a certain proportion of these lesions remain a daunting challenge for both the clinician and the pathologist. To emphasize the importance of close collaboration between clinicians and pathologists in case of problematic melanocytic lesions. We report and discuss 5 problematic scenarios of melanocytic lesions, including tumoral melanosis, nevoid melanoma, lentiginous melanoma, spitzoid melanoma and BAPoma that may pose diagnostic difficulties in our practice. Clinico-dermoscopic-pathological correlation, with incorporation of all the available data, in problematic melanocytic skin neoplasms is of paramount importance for accurate diagnosis.

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Impact of clinical and personal data in the dermoscopic differentiation between early melanoma and atypical nevi

Dermatology practical & conceptual, 2018

Differential diagnosis of clinically atypical nevi (aN) and early melanomas (eMM) still represent... more Differential diagnosis of clinically atypical nevi (aN) and early melanomas (eMM) still represents a challenge even for experienced dermoscopists, as dermoscopy alone is not sufficient to adequately differentiate these equivocal melanocytic skin lesions (MSLs). The objectives of this study were to investigate what were the most relevant parameters for noninvasive differential diagnosis between eMM and aN among clinical, personal, and dermoscopic data and to evaluate their impact as risk factors for malignancy. This was a retrospective study performed on 450 MSLs excised from 2014 to 2016 with a suspicion of malignancy. Dermoscopic standardized images of the 450 MSLs (300 aN and 150 eMM) were collected and evaluated. Patients' personal data (ie, age, gender, body site, maximum diameter) were also recorded. Dermoscopic evaluations were performed by 5 different experts in dermoscopy blinded to histopathological diagnosis. Fleiss' κ was calculated to measure concordance level be...

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Pigmented skin lesions displaying regression features: Dermoscopy and reflectance confocal microscopy criteria for diagnosis

Experimental Dermatology, 2018

Melanomas and nevi displaying regression features can be difficult to differentiate. To describe ... more Melanomas and nevi displaying regression features can be difficult to differentiate. To describe reflectance confocal microscopy features in benign and malignant pigmented skin lesions characterized by regression features in dermoscopy. Methods: Observational retrospective study. Inclusion criteria were presence of dermoscopic features of regression; availability of clinical, dermoscopic and RCM imaging; definite histopathologic diagnosis.

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Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks

JAMA Dermatology, 2018

Importance: Convolutional neural networks (CNNs) achieve expert-level accuracy in the diagnosis o... more Importance: Convolutional neural networks (CNNs) achieve expert-level accuracy in the diagnosis of pigmented melanocytic lesions. However, the most common types of skin cancer are nonpigmented and nonmelanocytic, and are more difficult to diagnose. Objective: To compare the accuracy of a CNN-based classifier with that of physicians with different levels of experience. Design, Setting, and Participants: A CNN-based classification model was trained on 7895 dermoscopic and 5829 close-up images of lesions excised at a primary skin cancer clinic between January 1, 2008, and July 13, 2017, for a combined evaluation of both imaging methods. The combined CNN (cCNN) was tested on a set of 2072 unknown cases and compared with results from 95 human raters who were medical personnel, including 62 board-certified dermatologists, with different experience in dermoscopy. Main Outcomes and Measures: The proportions of correct specific diagnoses and the accuracy to differentiate between benign and malignant lesions measured as an area under the receiver operating characteristic curve served as main outcome measures. Results: Among 95 human raters (51.6% female; mean age, 43.4 years; 95% CI, 41.0-45.7 years), the participants were divided into 3 groups (according to years of experience with dermoscopy): beginner raters (<3 years), intermediate raters (3-10 years), or expert raters (>10 years). The area under the receiver operating characteristic curve of the trained cCNN was higher than human ratings (0.742; 95% CI, 0.729-0.755 vs 0.695; 95% CI, 0.676-0.713; P < .001). The specificity was fixed at the mean level of human raters (51.3%), and therefore the sensitivity of the cCNN (80.5%; 95% CI, 79.0%-82.1%) was higher than that of human raters (77.6%; 95% CI, 74.7%-80.5%). The cCNN achieved a higher percentage of correct specific diagnoses compared with human raters (37.6%; 95% CI, 36.6%-38.4% vs 33.5%; 95% CI, 31.5%-35.6%; P = .001) but not compared with experts (37.3%; 95% CI, 35.7%-38.8% vs 40.0%; 95% CI, 37.0%-43.0%; P = .18). Conclusions and Relevance: Neural networks are able to classify dermoscopic and close-up images of nonpigmented lesions as accurately as human experts in an experimental setting.

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Dermoscopy of papuloerythroderma of Ofuji

Photodermatology, Photoimmunology & Photomedicine, 2018

Papuloerythroderma of Ofuji is a clinical entity originally described in 1984, with a predilectio... more Papuloerythroderma of Ofuji is a clinical entity originally described in 1984, with a predilection in elderly Asian males.1 It is clinically characterized by coalescent flat-topped papules on an erythematous base that spare the skin folds.2 We herein report a new case of papuloerythroderma of Ofuji in a Caucasian male individual, and we describe the characteristic dermoscopic pattern of the syndrome for the first time in the literature. This article is protected by copyright. All rights reserved.

Management of Flat Pigmented Spitz and Reed Nevi in Children

JAMA dermatology, Jan 12, 2018

According to recently introduced guidelines, the management of spitzoid-looking lesions should de... more According to recently introduced guidelines, the management of spitzoid-looking lesions should depend on the patient's age. 1 Specifically, any spitzoid-looking lesion after the age of 12 years and any asymmetric and nodular lesion at any age should be excised, whereas lesions with a typical starburst pattern before puberty should be monitored until stabilization. 1,2 We aimed to evaluate the efficacy of monitoring flat symmetric pigmented spitzoid-looking lesions in prepubertal children.

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Complete response of extramammary Paget's disease with imiquimod and PDT: Report of two cases

Photodermatology, photoimmunology & photomedicine, Jan 24, 2018

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Scabies escaping detection until dermoscopy was applied

Dermatology practical & conceptual, 2017

Dermoscopy is already considered a fairly established method for diagnosing scabies. This is beca... more Dermoscopy is already considered a fairly established method for diagnosing scabies. This is because dermoscopy enables the visualization both of the burrow and the mite itself, forming the so-called "jet with a contrail" structure. In the present report we present an extraordinary case of a patient with scabies lesions on the face and neck, which was misdiagnosed during sequential visits and underwent unnecessary surgical diagnostic procedures. Finally, the diagnostic problem was solved when dermoscopy was applied.

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Epidemiological trends in skin cancer

Dermatology practical & conceptual, 2017

Skin cancer, including melanoma and non-melanoma skin cancer (NMSC), represents the most common t... more Skin cancer, including melanoma and non-melanoma skin cancer (NMSC), represents the most common type of malignancy in the white population. The incidence rate of melanoma is increasing worldwide, while the associated mortality remains stable, or is slightly decreasing. On the other hand, the incidence for NMSC varies widely, with the highest rates reported in Australia. In the current review, we highlight recent global trends in epidemiology of skin cancer. We discuss controversial issues raised in current epidemiological data, we analyze the most important risk factors associated with the development of melanoma and NMSC and the impact of skin cancer on health care services. Furthermore, we underline the pressing need for improved registration policies, especially for NMSC, and lastly, we refer to the ongoing primary and secondary prevention strategies and their outcomes so far.

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Rosacea and Helicobacter pylori: links and risks

Clinical, cosmetic and investigational dermatology, 2017

Rosacea is a chronic skin disease characterized by facial erythema and telangiectasia. Despite th... more Rosacea is a chronic skin disease characterized by facial erythema and telangiectasia. Despite the fact that many hypotheses have been proposed, its etiology remains unknown. In the present review, the possible link and clinical significance of Helicobacter pylori in the pathogenesis of rosacea are being sought. A PubMed and Google Scholar search was performed using the terms "rosacea", "H.pylori", "gastrointestinal disorders and H.pylori", "microorganisms and rosacea", "pathogenesis and treatment of rosacea", and "risk factors of rosacea", and selected publications were studied and referenced in text. Although a possible pathogenetic link between H. pylori and rosacea is advocated by many authors, evidence is still interpreted differently by others. We conclude that further studies are needed in order to fully elucidate the pathogenesis of rosacea.

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5-POINT Checklist for Skin Cancer Detection in Primary Care

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia, Jan 16, 2017

Skin cancer screening interventions often relay on the involvement of general practitioners (GPs)... more Skin cancer screening interventions often relay on the involvement of general practitioners (GPs). Many interventions up to now have been directed to training approaches focusing on the clinical features of skin malignancies to increase GPs skill in skin cancer recognition. Based on the available current knowledge about skin cancer epidemiology and risk factors, we built up a 5-point checklist to help GPs in triaging patients to be referred to a dermatologist. 5 point check-list: I) visible sun damaged skin on exposed areas (red and brown to black macules and crusts on visible skin); II) more than 20 nevi on the arms; III) one or more ABCD positive lesions (flat, large and asymmetric macules); IV) one or more EFG positive lesions (elevated, firm and growing skin lesions); V) a pigmented lesion larger than 1.5 cm in diameter. Our aim was to provide a short list of practical rules, easy to adopt into a routine practice, in order to achieve a more effective triage of patients requiring...

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