Debarbieux S, Ronger-Salve S, Dalle S, Balme B, Thomas L
Department of Dermatology, Lyon 1 University, Hôpital de l'Hôtel Dieu, 69288 Lyon Cedex 02, France.
Br J Dermatol. 2008 Aug;159(2):360-3. doi: 10.1111/j.1365-2133.2008.08687.x. Epub 2008 Jun 28.
Desmoplastic melanoma (DM) is a rare variant of cutaneous melanoma. Its diagnosis is often delayed by an unusual clinical presentation. The dermoscopic features of DM have not yet been described.
To define the dermoscopic features of DM. Patients and methods A single-institution register-based retrospective study of six cases of histology-proven desmoplastic melanoma for which dermoscopy data were available. The criteria we studied included: network, dots and globules, streaks, regression features, ulceration, number of colours, blue/white veil, and vascular pattern.
Only three cases exhibited one classical feature for a melanocytic lesion; other cases were recognized on the basis of the presence of figures of regression (all six), i.e. white scar-like areas and 'peppering' (three of six), multiple (> 4) colours (five of six), and of melanoma-related vascular patterns (five) such as linear-irregular vessels (four) and milky-red areas (two).
We believe that dermoscopy could help in the accurate diagnosis of this rare neoplasm. In the absence of a pigmented network, attention should be given to the identification of features of regression and to melanoma-associated vascular patterns.
促纤维增生性黑色素瘤（DM）是皮肤黑色素瘤的一种罕见变异型。其诊断常因不寻常的临床表现而延迟。DM的皮肤镜特征尚未见描述。
明确DM的皮肤镜特征。患者与方法 对6例经组织学证实的促纤维增生性黑色素瘤进行单机构基于登记的回顾性研究，这些病例有皮肤镜检查数据。我们研究的标准包括：网状结构、点状和球状结构、条纹、消退特征、溃疡、颜色数量、蓝白幕、血管形态。
仅3例表现出黑素细胞性病变的一种典型特征；其他病例是根据消退表现（全部6例）来识别的，即白色瘢痕样区域和“胡椒样”改变（6例中的3例）、多种（>4种）颜色（6例中的5例）以及与黑色素瘤相关的血管形态（5例），如线性不规则血管（4例）和乳红色区域（2例）。
我们认为皮肤镜有助于准确诊断这种罕见肿瘤。在没有色素性网状结构时，应注意识别消退特征和与黑色素瘤相关的血管形态。
