1
|
Farnetani F, Scope A, Mazzoni L, Mandel V, Manfredini M, Magi S, Vaschieri C, Kaleci S, Longo C, Ciardo S, Stanganelli I, Pellacani G. A comparative dermoscopic and reflectance confocal microscopy study of naevi and melanoma with negative pigment network. J Eur Acad Dermatol Venereol 2019; 33:2273-2282. [DOI: 10.1111/jdv.15784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 05/27/2019] [Indexed: 11/30/2022]
Affiliation(s)
- F. Farnetani
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
| | - A. Scope
- The Kittner Skin Cancer Screening & Research Institute Sheba Medical Center and Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - L. Mazzoni
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Meldola Italy
| | - V.D. Mandel
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Meldola Italy
| | - M. Manfredini
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
| | - S. Magi
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Meldola Italy
| | - C. Vaschieri
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
| | - S. Kaleci
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
| | - C. Longo
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
- Centro Oncologico ad Alta Tecnologia Diagnostica Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Reggio Emilia Italy
| | - S. Ciardo
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
| | - I. Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Meldola Italy
- Dermatology Department University of Parma Parma Italy
| | - G. Pellacani
- Dermatology Department University of Modena and Reggio Emilia Modena Italy
| |
Collapse
|
2
|
Affiliation(s)
- Davida A Kornreich
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Jason B Lee
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| |
Collapse
|
3
|
Cengiz FP, Emiroglu N, Wellenhof RH. Dermoscopic and clinical features of pigmented skin lesions of the genital area. An Bras Dermatol 2015; 90:178-83. [PMID: 25830986 PMCID: PMC4371665 DOI: 10.1590/abd1806-4841.20153294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 03/04/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The dermoscopic features of vulvar melanosis lesions are well known. To our
knowledge, there are only a few case reports about dermoscopic features of
pigmented genital lesions in male patients. OBJECTIVE To evaluate dermoscopic and clinical characteristics of benign lesions of the
genital area in both males and females, and to assess the distinguishing
dermoscopic criteria of vulvar melanosis and atypical melanocytic nevi of
the genital type. METHODS 68 patients with pigmented genital lesions were included in this
observational study (28 male and 40 female). A punch biopsy was taken from
all pigmented lesions and histopathological examination was performed on all
specimens. RESULTS We histopathologically diagnosed: genital melanosis in 40 lesions, atypical
melanocytic nevi of the genital type in 15 lesions, melanocytic nevi in 9
lesions, seborrheic keratosis in 4 lesions. The most frequent locations were
the glans penis (19 patients, 67.9%) in males and the labia minora (19
patients, 47.5%) in females. The mean age of patients with atypical nevi
(28,6 ± 11,36) was significantly lower than the mean age of patients with
genital melanosis (47,07 ± 15,33). CONCLUSIONS Parallel pattern is prominent in genital melanosis, ring-like pattern is only
observed in genital melanosis. Most pigmented lesions on the genital area
are solitary. Blue-white veil and irregular dots are only observed in AMNGT.
According to these results, we propose that histopathological examination is
performed, especially if blue-white veil and irregular dots are found by
dermoscopy.
Collapse
Affiliation(s)
| | - Nazan Emiroglu
- Department of dermatology, Bezmialem Vakif University, Istanbul, Turkey
| | | |
Collapse
|
4
|
Negative pigment network and shiny white streaks: a dermoscopic-pathological correlation study. Am J Dermatopathol 2014; 36:433-8. [PMID: 24803064 DOI: 10.1097/dad.0000000000000019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
It has been suggested that both negative pigment network (NPN) and shiny white streaks (SWS) were related to an increase of dermal collagen. To study precisely the dermoscopic-histopathologic correlation of NPN and SWS, we have performed a dermoscopic-pathological correlation study. A total of 25 skin lesions dermoscopically characterized by the presence of NPN and/or SWS, including histopathologically confirmed dermatofibroma (2), Spitz nevus (3), compound nevus (6), dysplastic nevus (7), and melanoma (7), were evaluated for the presence of NPN, SWS, and blue-white veil. The histopathologic features such as orthokeratosis, orthokeratosis plus nests of pigmented melanocytes at the junction, hypergranulosis, hypergranulosis plus nests of pigmented melanocytes at the junction, epidermal invagination plus orthokeratosis, fibrosis, lamellar fibrosis, and elongation and bridging of rete ridges were evaluated. We found a disagreement in 80% of skin lesions between NPN and fibrosis (P = 0.02). For SWS, a significant agreement emerged with hypergranulosis (76%; P = 0.01), and the same occurred with fibrosis (80%; P = 0.01). Moreover, blue-white veil also displayed a significant agreement with hypergranulosis (68%; P = 0.04). Our findings confirm the correlation of SWS with fibrosis, whereas a clear-cut histopathologic substrate of NPN could not be established.
Collapse
|
5
|
Fargnoli MC, Sera F, Suppa M, Piccolo D, Landi MT, Chiarugi A, Pellegrini C, Seidenari S, Peris K. Dermoscopic features of cutaneous melanoma are associated with clinical characteristics of patients and tumours and with MC1R genotype. J Eur Acad Dermatol Venereol 2014; 28:1768-75. [PMID: 24588892 DOI: 10.1111/jdv.12411] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/25/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several algorithms are available for the dermoscopic diagnosis of pigmented skin lesions. The MC1R gene is a key determinant of pigmentation characteristics that are established host-related melanoma risk factors. OBJECTIVES To investigate the association of dermoscopic features of sporadic cutaneous melanomas with clinical characteristics of patients and corresponding tumours and with genetic changes in the MC1R and BRAF genes. METHODS A total of 64 dermoscopic images of 62 patients were scored by ABCD rule and modified pattern analysis. Detailed patients' and melanomas' characteristics were collected. Patients were screened for germline MC1R variants and related melanomas for somatic V600 BRAF mutations. RESULTS A lower total dermoscopic score (TDS) was observed in melanomas of patients with red hair (P = 0.019), due to reduced dermoscopic structures (P < 0.0001). Thicker melanomas showed higher TDS values (P = 0.021) due to sharper borders (P < 0.0001) and higher number of colors (P = 0.004). An atypical pigment network was prevalent in superficial spreading melanomas (P = 0.010), in individuals with dark skin (P = 0.043) and hair color (P = 0.001). An atypical vascular pattern was more frequent in nodular (P < 0.0001) and thick (P < 0.0001) melanomas, in individuals with skin type I-II (P = 0.037), blond or red hair color (P = 0.032) and blue or green eyes (P = 0.014). Melanomas of MC1R R carriers showed lower TDS value (P = 0.037), reduced dermoscopic structures (P = 0.001) and lower prevalence of atypical pigment network (P = 0.001). No differences were identified between BRAF-mutated or wild-type melanomas. CONCLUSIONS We suggest a phenotypic/MC1R profile for melanoma patients and their tumours. Melanomas of MC1R R carriers show a significant lower TDS value, with reduced dermoscopic structures, and a lower prevalence of an atypical pigment network. Non-carriers of MC1R R variants develop melanomas dermoscopically characterized by an atypical pigment network which is prevalent in superficial spreading melanomas, in patients with dark complexion and less frequent in red-haired individuals.
Collapse
Affiliation(s)
- M C Fargnoli
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
“White” network in Spitz nevi and early melanomas lacking significant pigmentation. J Am Acad Dermatol 2013; 69:56-60. [DOI: 10.1016/j.jaad.2012.12.974] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 12/18/2012] [Accepted: 12/24/2012] [Indexed: 11/20/2022]
|
7
|
BaŞak PY, Hofmann-Wellenhof R, Massone C. Three cases of reverse pigment network on dermatoscopy with three distinctive histopathologic diagnoses. Dermatol Surg 2013; 39:818-20. [PMID: 23531176 DOI: 10.1111/dsu.12186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
8
|
Ferrari A, Argenziano G, Buccini P, Cota C, Sperduti I, De Simone P, Eibenschutz L, Silipo V, Zalaudek I, Catricalà C. Typical and atypical dermoscopic presentations of dermatofibroma. J Eur Acad Dermatol Venereol 2012; 27:1375-80. [PMID: 23176079 DOI: 10.1111/jdv.12019] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dermatofibroma is a common skin neoplasm that is usually easy to recognize, but in some cases its differentiation from melanoma and other tumours may be difficult. OBJECTIVE To describe the dermoscopic features of dermatofibromas, with special emphasis on the characteristics of atypical patterns, and to calculate pattern frequency according to the patients age and gender, anatomical site and histopathological subtype. METHODS Two groups of patients were consecutively seen, one with dermatofibromas that were surgically excised because of clinically and/or dermoscopically equivocal aspects or following patient request, and another with non-equivocal dermatofibromas. Each lesion was scored for previously reported global dermoscopic patterns and for additional features. RESULTS A typical pattern was observed in 92 of 130 (70.8%) lesions, whereas an atypical pattern, that we named the 'non Dermatofibroma (DF)-like' pattern, was seen in 38 of 130 (29.2%). Atypical dermatofibromas showed features reminiscent of different conditions, such as melanoma in 21(16.2%) cases, vascular tumour in six (4.6%), basal cell carcinoma in five (3.8%), collision tumour in three (2.3%) and psoriasis in three (2.3%). A significant association was found between the 'melanoma-like' pattern/'vascular tumour-like' pattern and males, whereas a trend was observed between the above-mentioned patterns and hemosiderotic/aneurysmal DFs. 'Peripheral pigment network and central white scar-like patch' pattern was found associated with females and classic histopathological variant of DF. CONCLUSION Dermatofibromas may display different morphological faces. The typical dermoscopic patterns allow a confident diagnosis, whereas a full surgical excision is always recommended in all doubtful cases.
Collapse
Affiliation(s)
- A Ferrari
- Department of Oncologic Dermatology, San Gallicano Dermatological Institute, Rome, ItalyDermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, ItalyLaboratory of Pathology, San Gallicano Dermatologic Institute, Rome, ItalyUnit of Biostatistics, Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Pizzichetta MA, Talamini R, Marghoob AA, Soyer HP, Argenziano G, Bono R, Corradin MT, De Giorgi V, Gonzalez MA, Kolm I, Kopf AW, Malvehy J, Nami N, Oliviero M, Pellacani G, Puig S, Rabinovitz H, Rubegni P, Seidenari S, Stanganelli I, Veronesi A, Zalaudek I, Zampieri P, Menzies SW. Negative pigment network: an additional dermoscopic feature for the diagnosis of melanoma. J Am Acad Dermatol 2012; 68:552-559. [PMID: 23062610 DOI: 10.1016/j.jaad.2012.08.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 07/23/2012] [Accepted: 08/09/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The negative pigment network (NPN) is seen as a negative of the pigmented network and it is purported to be a melanoma-specific structure. OBJECTIVES We sought to assess the frequency, sensitivity, specificity, and odds ratios (ORs) of NPN between melanoma cases and a group of control lesions. METHODS Digitalized images of skin lesions from 679 patients with histopathological diagnosis of dermatofibroma (115), melanocytic nevus (220), Spitz nevus (139), and melanoma (205) were retrospectively collected and blindly evaluated to assess the presence/absence of NPN. RESULTS The frequency of occurrence of NPN was higher in the melanoma group (34.6%) than in Spitz nevus (28.8%), melanocytic nevus (18.2%), and dermatofibroma (11.3%) groups. An OR of 1.8 emerged for the diagnosis of melanoma in the presence of NPN as compared with nonmelanoma diagnosis. Conversely, for melanocytic nevi and dermatofibromas the OR was very low (0.5 and 0.3, respectively). For Spitz nevi the OR of 1.1 was not statistically significant. When comparing melanoma with dermatofibroma, melanocytic nevus, and Spitz nevus, we observed a significantly higher frequency of multicomponent pattern (68.1%), asymmetric pigmentation (92.9%), irregularly distributed NPN (87.3%), and peripheral location of NPN (66.2%) in melanomas. LIMITATIONS Further studies can provide the precise dermoscopic-histopathologic correlation of NPN in melanoma and other lesions. CONCLUSIONS The overall morphologic pattern of NPN, such as the irregular distribution and the peripheral location of NPN, along with the multicomponent pattern and the asymmetric pigmentation could be used as additional features in distinguishing melanoma from Spitz nevus and other benign lesions.
Collapse
Affiliation(s)
| | - Renato Talamini
- Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Ash A Marghoob
- Dermatology Section, Memorial Sloan Kettering Cancer Center, New York, New York
| | - H Peter Soyer
- Dermatology Research Center, University of Queensland, School of Medicine, Princess Alexandra Hospital, Brisbane, Australia
| | - Giuseppe Argenziano
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS), Reggio Emilia, Italy
| | | | | | | | | | - Isabel Kolm
- Department of Dermatology, University of Miami, Miami, Florida
| | - Andrew W Kopf
- New York University School of Medicine, New York, New York
| | - Joseph Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - Niccolò Nami
- Department of Dermatology, University of Siena, Siena, Italy
| | | | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
| | - Susana Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | | | - Pietro Rubegni
- Department of Dermatology, University of Siena, Siena, Italy
| | - Stefania Seidenari
- Department of Dermatology, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy
| | | | - Andrea Veronesi
- Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | | | | | - Scott W Menzies
- Sydney Melanoma Diagnostic Center, Royal Prince Alfred Hospital and Discipline of Dermatology, University of Sydney, Sydney, Australia
| |
Collapse
|
10
|
Seidenari S, Bassoli S, Borsari S, Ferrari C, Giusti F, Ponti G, Tomasini C, Magnoni C. Variegated dermoscopy of in situ melanoma. Dermatology 2012; 224:262-70. [PMID: 22653091 DOI: 10.1159/000338696] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 03/13/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Melanomas in situ (MIS) are difficult to diagnose, lacking well-established dermoscopic descriptors. OBJECTIVE The aim of this study was to improve the identification of early melanomas describing the variegated dermoscopic features of MIS and their correlation with demographic and clinical aspects. METHODS Dermoscopic images of 114 histologically proven MIS were evaluated by 3 expert dermoscopists and classified into their main dermoscopic patterns. Dermoscopic features were also considered for their correlation with clinical parameters. RESULTS Eight different dermoscopic subtypes of MIS were identified: reticular grey-blue (27.2%), reticular (21.1%), multicomponent (20.2%), island (10.5%), spitzoid (7%), inverse network (6.1%), 'net-blue globules' (5.3%) and globular (2.6%). Clinical characteristics of lesions and patients varied according to the different dermoscopic groups. CONCLUSION We hypothesize that the different dermoscopic subgroups of MIS correspond to lesions with a different origin and, possibly, various patterns of growth and a different biological behaviour.
Collapse
|
11
|
Estudio descriptivo dermatoscópico de los nevos melanocíticos con despigmentación sin halo clínico. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:344-53. [DOI: 10.1016/j.ad.2010.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Revised: 10/26/2010] [Accepted: 10/27/2010] [Indexed: 11/21/2022] Open
|
12
|
Ferrari A, Zalaudek I, Argenziano G, Buccini P, De Simone P, Silipo V, Eibenschutz L, Mariani G, Covello R, Sperduti I, Mariani L, Catricalà C. Dermoscopy of pigmented lesions of the vulva: a retrospective morphological study. Dermatology 2011; 222:157-66. [PMID: 21311169 DOI: 10.1159/000323409] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 12/01/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The dermoscopic patterns of pigmented skin tumors are influenced by the body site. OBJECTIVE To evaluate the clinical and dermoscopic features associated with pigmented vulvar lesions. METHODS Retrospective analysis of clinical and dermoscopic images of vulvar lesions. The χ² test was used to test the association between clinical data and histopathological diagnosis. RESULTS A total of 42 (32.8%) melanocytic and 86 (67.2%) nonmelanocytic vulvar lesions were analyzed. Nevi significantly prevailed in younger women compared with melanomas and melanosis and exhibited most commonly a globular/cobblestone (51.3%) and a mixed (21.6%) pattern. Dermoscopically all melanomas showed a multicomponent pattern. Melanotic macules showed clinical overlapping features with melanoma, but their dermoscopic patterns differed significantly from those observed in melanomas. CONCLUSION The diagnosis and management of pigmented vulvar lesions should be based on a good clinicodermoscopic correlation. Dermoscopy may be helpful in the differentiation of solitary melanotic macules from early melanoma.
Collapse
Affiliation(s)
- Angela Ferrari
- Department of Oncologic Dermatology, Santa Maria and San Gallicano Institute of Rome, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Martín J, Núñez J, López V, Rubio M, Monteagudo C, Jordá E. Descriptive Dermoscopic Study of Depigmentation in Melanocytic Nevi Without a Visible Halo. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/s1578-2190(11)70817-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
14
|
|