Elwan Nagwa M, Eltatawy Rania A, Elfar Nashwa N, Elsakka Omnia M
Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt.
The Ministry of Health, Tanta, Egypt.
Int J Dermatol. 2016 Feb;55(2):187-92. doi: 10.1111/ijd.12882. Epub 2015 Sep 4.
Dermoscopy is a non-invasive technique allowing rapid and magnified in vivo observation of the skin. The anatomical structure of acral volar skin results in unique dermoscopic features in this location.
To describe and analyze the characteristic dermoscopic features of various kinds of acral pigmented lesions and emphasize the diagnostic value of the dermoscope in early melanoma at this anatomic site in a sample of Egyptians.
This study included 200 patients with 224 acral pigmented lesions. Dermoscopic examination was done to evaluate different dermoscopic patterns of these lesions. Clinically and dermoscopically suspicious lesions for malignancy were selected for more evaluation by histopathological examination by hematoxylin-eosin staining.
The most frequent dermoscopic pattern was the parallel furrow pattern, (66.1%), followed by the lattice-like (8.9%), homogeneous (7.6%), fibrillar (6.3%), non-typical (5.4%), and then parallel ridge (2.2%). The least commonly reported patterns in our cases were the reticular and globular patterns (1.8% each). There was one case of acral lentiginous melanoma of the palm with a multicomponent dermoscopic pattern.
The recognition of different dermoscopic patterns is essential for diagnosis of various types of acral pigmented lesions. In addition, dermoscopy is useful in discriminating between acral nevi and early acral melanoma and narrows down the number of biopsies needed.
皮肤镜检查是一种非侵入性技术,可在体内快速且放大观察皮肤。掌跖部皮肤的解剖结构导致该部位具有独特的皮肤镜特征。
描述和分析各种掌跖部色素性皮损的特征性皮肤镜表现,并强调皮肤镜对埃及人群样本中该解剖部位早期黑色素瘤的诊断价值。
本研究纳入200例患者的224处掌跖部色素性皮损。进行皮肤镜检查以评估这些皮损的不同皮肤镜模式。对临床和皮肤镜检查怀疑为恶性的皮损,通过苏木精-伊红染色进行组织病理学检查以作进一步评估。
最常见的皮肤镜模式是平行沟纹模式(66.1%),其次是网格状(8.9%)、均匀型(7.6%)、纤维状(6.3%)、非典型型(5.4%),然后是平行嵴状(2.2%)。在我们的病例中,报告最少的模式是网状和球状模式(各1.8%)。有1例手掌部肢端雀斑样黑色素瘤具有多成分皮肤镜模式。
识别不同的皮肤镜模式对于诊断各种类型的掌跖部色素性皮损至关重要。此外,皮肤镜有助于区分掌跖部痣和早期掌跖部黑色素瘤,并减少所需活检的数量。