Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon 1 University, France.
J Eur Acad Dermatol Venereol. 2013 Feb;27(2):e159-65. doi: 10.1111/j.1468-3083.2012.04533.x. Epub 2012 Apr 6.
The 'dermoscopic island' is a term that was recently proposed to design an area of a pigmented lesion with a uniform dermoscopic pattern different from the remainder of the lesion. The positive predictive value of this sign for the diagnosis of melanoma is about 50%.
The purpose of our study was to see if reflectance confocal microscopy (RCM) permitted to accurately distinguish between nevi and melanoma in such lesions.
Five lesions of five consecutive unselected patients, with a dermoscopic island but no feasible clear cut diagnosis on the basis of dermoscopy alone were examined by RCM before excision for histopathological evaluation.
Two lesions corresponded to nevi, and three lesions were early melanomas arising on a benign naevus in one case, and on a dysplastic naevus in two cases. In all five cases, RCM permitted to make the correct diagnosis, with a very good correlation with conventional histopathology.
Reflectance confocal microscopy appears as a promising tool not only to enhance the early diagnosis of melanoma but also to avoid unnecessary excisions of lesions with a dermoscopic island.
“真皮岛屿”是一个最近提出的术语，用于设计一个具有与病变其余部分不同的均匀皮肤镜模式的色素病变区域。该征象对黑色素瘤的阳性预测值约为 50%。
我们的研究目的是观察反射式共聚焦显微镜（RCM）是否可以在这些病变中准确区分痣和黑色素瘤。
对 5 例连续选择的患者的 5 个病变进行 RCM 检查，这些病变有真皮岛屿，但仅凭皮肤镜检查无法明确诊断。在切除前进行组织病理学评估。
2 个病变对应于痣，3 个病变为早期黑色素瘤，其中 1 例发生在良性痣上，2 例发生在发育不良痣上。在所有 5 例中，RCM 均能做出正确诊断，与常规组织病理学具有很好的相关性。
反射式共聚焦显微镜不仅是提高黑色素瘤早期诊断的有前途的工具，而且还可以避免对具有真皮岛屿的病变进行不必要的切除。
