University Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Center of Dermatooncology, Department of Dermatology, Eberhard Karls University, Tübingen, Germany.
J Dtsch Dermatol Ges. 2020 Jul;18(7):682-690. doi: 10.1111/ddg.14163. Epub 2020 Jul 12.
The melanin fluorescence of skin lesions is measurable with two-photon excitation, a process termed dermatofluoroscopy, which has shown a shift from the green spectra in benign melanocytic lesions to the red spectra in melanoma. This study addressed the question as to which kind of pigmented lesions can be correctly diagnosed as melanin-bearing malignant tumors.
476 pigmented lesions including 101 cutaneous melanomas were analyzed with dermatofluoroscopy, measuring the melanin fluorescence in a grid-like fashion with a separation of measurement points of 0.2 mm. The results of the dermatofluoroscopy are presented as a diagnostic score with a cut-off score of ≥ 28 for the diagnosis of melanin-bearing malignant tumors, and were compared to the gold standard of histopathology.
A highly significant difference (p < 0.0001) between the diagnostic scores of different skin tumors was found. Dermatofluoroscopy scores showed the highest sensitivity for melanomas (92.1 %). Interestingly, most pigmented basal cell carcinomas (BCCs, 88.9 %) were diagnosed as melanin-bearing malignant tumors. A higher sensitivity for the correct diagnosis was observed in older patients (≥ 53 years, p = 0.003), in patients with skin tanning (p = 0.025), and in patients with freckles during childhood (p = 0.046).
Two-photon fluorescence is an innovative technique for the diagnosis of pigmented skin lesions, and shows a high sensitivity for detection of melanomas and pigmented BCCs.
皮肤病变的黑色素荧光可通过双光子激发来测量，这一过程被称为皮肤荧光检查，它已经显示出良性黑色素瘤病变的光谱从绿色向黑色素瘤的红色转移。本研究旨在探讨哪些色素性病变可以被正确诊断为含有黑色素的恶性肿瘤。
分析了包括 101 例皮肤黑素瘤在内的 476 个色素性病变，采用皮肤荧光检查法以 0.2mm 的测量点间隔对黑色素荧光进行网格状测量。将皮肤荧光检查的结果表示为诊断评分，诊断评分≥28 用于诊断含有黑色素的恶性肿瘤，并与组织病理学的金标准进行比较。
不同皮肤肿瘤的诊断评分存在显著差异（p<0.0001）。皮肤荧光检查对黑素瘤的敏感性最高（92.1%）。有趣的是，大多数色素性基底细胞癌（BCC，88.9%）被诊断为含有黑色素的恶性肿瘤。在年龄较大的患者（≥53 岁，p=0.003）、皮肤晒黑的患者（p=0.025）和儿童时期有雀斑的患者（p=0.046）中，观察到正确诊断的敏感性更高。
双光子荧光是一种用于诊断色素性皮肤病变的创新技术，对黑色素瘤和色素性 BCC 的检测具有很高的敏感性。
