Popadić Mirjana, Sinz Christoph, Kittler Harald
Department of Dermatovenereology, Medical University of Belgrade, Clinic of Dermatovenereology, Clinical Center of Serbia, Belgrade, Serbia.
Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Austria.
J Dtsch Dermatol Ges. 2017 Mar;15(3):302-307. doi: 10.1111/ddg.13192. Epub 2017 Feb 27.
Skin lesions with blue color are frequently excised to rule out malignancy. The objective of the present study was to investigate the significance of blue color.
We retrospectively scanned dermatoscopic images for blue color and classified them according to pattern analysis.
Of 1,123 pigmented skin lesions, 144 (12.8 %) showed blue color, 92 of which (63.9 %) were malignant. Among lesions with blue color, the most common benign diagnoses were nevi (n = 35, 24.3 %) and seborrheic keratoses (n = 8, 5.6 %). Of 103 (71.5 %) lesions with a structureless blue pattern, eight (7.8 %) were entirely blue and 95 (92.2 %) were partly blue, of which 81 (78.6 %) showed peripheral or patchy and 14 (13.6 %) central blue color. Most lesions with peripheral or patchy blue color were melanomas (n = 47, 58 %), whereas most lesions with central blue color were nevi (n = 9, 64.3 %). Of 28 lesions with blue clods, 17 (60.7 %) were basal cell carcinomas. With respect to malignancy, the positive predictive value of blue color was 63.9 % (95 % CI: 56.0-71.8 %).
Among malignant lesions with blue color, structureless peripheral or patchy blue color is a clue for melanoma, while blue clods point to basal cell carcinoma. Pitfalls include seborrheic keratoses, which may show blue color, as well as some nevi, especially combined nevi.
常对蓝色皮肤病变进行切除以排除恶性肿瘤。本研究的目的是探讨蓝色的意义。
我们回顾性扫描皮肤镜图像中的蓝色，并根据模式分析进行分类。
在1123例色素沉着性皮肤病变中，144例（12.8%）显示蓝色，其中92例（63.9%）为恶性。在蓝色病变中，最常见的良性诊断是痣（n = 35，24.3%）和脂溢性角化病（n = 8，5.6%）。在103例（71.5%）无结构蓝色模式的病变中，8例（7.8%）完全为蓝色，95例（92.2%）部分为蓝色，其中81例（78.6%）显示周边或斑片状蓝色，14例（13.6%）显示中央蓝色。大多数周边或斑片状蓝色病变为黑色素瘤（n = 47，58%），而大多数中央蓝色病变为痣（n = 9，64.3%）。在28例有蓝色团块的病变中，17例（60.7%）为基底细胞癌。就恶性程度而言，蓝色的阳性预测值为63.9%（95%CI：56.0 - 71.8%）。
在蓝色恶性病变中，无结构的周边或斑片状蓝色是黑色素瘤的线索，而蓝色团块提示基底细胞癌。陷阱包括可能显示蓝色的脂溢性角化病以及一些痣，尤其是复合痣。
