Clinical and dermoscopic characterization of pediatric and adolescent melanomas: Multicenter study of 52 cases - 13/01/18
Abstract |
Background |
Knowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse, and this may in part contribute to delay in detection and thicker tumors.
Objective |
To analyze the clinicodermoscopic characteristics of PM.
Methods |
Retrospective study of 52 melanomas diagnosed in patients before the age of 20 years.
Results |
On the basis of its clinical, dermoscopic, and histopathologic characteristics, PM can be classified as spitzoid or nonspitzoid. The nonspitzoid melanomas (n = 37 [72.3%]) presented in patients with a mean age of 16.3 years (range, 8-20) and were associated with a high-risk phenotype and a pre-existing nevus (62.2%). The spitzoid melanomas (n = 15 [27.7%]) were diagnosed in patients at a mean age of 12.5 years (range, 2-19) and were mostly de novo lesions (73.3%) located on the limbs (73.3%). Whereas less than 25% of PMs fulfilled the modified clinical ABCD criteria (amelanotic, bleeding bump, color uniformity, de novo at any diameter), 40% of spitzoid melanomas did. Dermoscopic melanoma criteria were found in all cases. Nonspitzoid melanomas tended to be multicomponent (58.3%) or have nevus-like (25%) dermoscopic patterns. Spitzoid melanomas revealed atypical vascular patterns with shiny white lines (46.2%) or an atypical pigmented spitzoid pattern (30.8%). There was good correlation between spitzoid subtype histopathologically and dermoscopically (κ = 0.66).
Limitations |
A retrospective study without re-review of pathologic findings.
Conclusion |
Dermoscopy in addition to conventional and modified clinical ABCD criteria helps in detecting PM. Dermoscopy assists in differentiating spitzoid from nonspitzoid melanomas.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Schematics with the main dermoscopic features of the 4 patterns. Dermoscopic patterns found in pediatric melanoma: Pattern 1, Multicomponent pattern, mostly found in non-Spitzoid melanomas associated with nevus. Asymmetric polychromic multicomponent pattern, with irregular globules, negative network and structureless areas and some regression features. Pattern 2, Nevus-like; only found in adolescents with non-Spitzoid melanomas. Symmetric 1 or 2 patterns, with a few melanoma local features. Pattern 3, Pink vascular Spitzoid pattern. Polymorphic vascular pattern and shiny white structures. Pattern 4, Atypical pigmented Spitzoid pattern. Asymmetrical distributed starburst or globular pattern with pseudopods at the periphery.
Key words : childhood, dermoscopy, detection, melanoma, pediatric melanoma, Spitz, spitzoid
Abbreviations used : ABCD, CI, Modified ABCD, OR, PM, SD
Plan
| Supported in part through the National Institutes of Health/National Cancer Institute Cancer Support Grant P30 CA008748. The research at the Melanoma Unit in Barcelona was partially funded by Spanish Fondo de Investigaciones Sanitarias grants PI12/00840, PI15/00716 and PI15/00956 and CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain. It was cofinanced by the following: European Development Regional Fund A Way to Achieve Europe ERDF; AGAUR 2014_SGR_603 of the Catalan Government, Spain; European Commission under the Sixth Framework Programme, Contract No. LSHC-CT-2006-018702 (GenoMEL) and the European Commission under the Seventh Framework Programme, Diagnoptics; a grant from Fundació La Marató de TV3, 201331-30, Catalonia, Spain; a grant from Telemaraton of Spain Todos somos raros; and a grant from Asociación Española Contra el Cáncer (AECC). |
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| Conflicts of interests: None declared. |
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| Graphical abstract available at www.jaad.org. |
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| Reprints not available from the authors. |
Vol 78 - N° 2
P. 278-288 - février 2018 Retour au numéro
Article précédent
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