Clinical and dermoscopic characteristics of melanomas on nonfacial chronically sun-damaged skin - 16/05/15
Abstract |
Background |
Melanomas on chronically sun-damaged skin (CSDS) can be difficult to identify and often manifest morphologic features that overlap with benign lesions.
Objective |
We describe and analyze the clinical and dermoscopic characteristics of melanomas on nonfacial CSDS.
Methods |
Melanoma cases on nonfacial CSDS were retrospectively identified from the biopsy specimen logs of 6 melanoma clinics. Clinical and dermoscopic images were combined into 1 database. Demographics, clinical, dermoscopic, and histopathologic information were analyzed. Descriptive frequencies were calculated.
Results |
One hundred eighty-six cases met the inclusion criteria: 142 melanomas in situ (76%) and 39 invasive (21%; mean thickness, 0.49 mm). Lentigo maligna was the most common histopathologic subtype (n = 76; 40.9%). The most frequent dermoscopic structures were granularity (n = 126; 67.7%) and angulated lines (n = 82; 44%). Vascular structures were more frequent in invasive melanomas (56% vs 12% of in situ melanomas). Most manifested 1 of 3 dermoscopic patterns: patchy peripheral pigmented islands, angulated lines, and tan structureless with granularity pattern.
Limitations |
This was a retrospective study, and evaluators were not blinded to the diagnosis. In addition, interobserver concordance and sensitivity and specificity for dermoscopic structures were not evaluated.
Conclusion |
Outlier lesions manifesting dermoscopic structures, such as granularity, angulated lines, or vessels and any of the 3 described dermoscopic patterns should raise suspicion for melanoma.
Le texte complet de cet article est disponible en PDF.Key words : actinic damage, dermoscopy, lentigo maligna, melanoma, sun-damaged skin, ultraviolet radiation
Abbreviations used : CSDS, SSM, LM, PPPI
Plan
Funding sources: None. |
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Conflicts of interest: None declared. |
Vol 72 - N° 6
P. 1027-1035 - juin 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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