Reiter O, Kurtansky N, Nanda J K, Busam K J, Scope A, Musthaq S, Marghoob A A
Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Dermatology, Rabin Medical Center, Petah Tikvah and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Eur Acad Dermatol Venereol. 2021 May;35(5):1111-1118. doi: 10.1111/jdv.17133. Epub 2021 Feb 23.
Nevus-associated melanomas (NAM) account for 30% of all melanomas and are associated with younger age and with thinner Breslow thickness. Previous studies of NAM dermoscopy found conflicting results.
To compare the clinical and dermoscopic features of NAM and de novo melanomas (DNM), stratified by melanoma thickness, in a relatively large cohort of patients.
A cross-sectional study of all melanomas biopsied between 2004 and 2019 at a large cancer centre. Lesions were categorized as in situ and invasive NAM or DNM. Dermoscopic images were reviewed and annotated. Associations between melanoma subtype and dermoscopic features were analysed via logistic regression modelling. Bivariate analyses were conducted using non-parametric bootstrap and chi-squared methods.
The study included 160 NAM (86 in situ and 74 invasive) and 218 DNM (109 in situ and 109 invasive). NAM were associated with younger age, greater likelihood of being present on the torso, and thinner Breslow thickness. NAM were 2.5 times more likely to show a negative pigment network than DNM. In situ NAM were 2.1 and two times more likely to display dermoscopic area without definable structures and tan structureless areas than DNM, respectively. In situ melanomas were more likely to present a pigment network, and invasive melanomas more commonly presented scar-like depigmentation and shiny white structures. Streaks, blotches and shiny white structures were associated with deeper Breslow depth.
Even though the nevus component of NAM could not be identified dermoscopically in the current series, negative pigment network, tan structureless areas and areas without definable structures are dermoscopic clues for NAM.
痣相关黑色素瘤（NAM）占所有黑色素瘤的30%，与较年轻的年龄和较薄的Breslow厚度相关。先前关于NAM皮肤镜检查的研究结果相互矛盾。
在一个相对较大的患者队列中，比较按黑色素瘤厚度分层的NAM和新发黑色素瘤（DNM）的临床和皮肤镜特征。
对2004年至2019年在一家大型癌症中心活检的所有黑色素瘤进行横断面研究。病变分为原位和侵袭性NAM或DNM。对皮肤镜图像进行回顾和注释。通过逻辑回归模型分析黑色素瘤亚型与皮肤镜特征之间的关联。使用非参数自助法和卡方方法进行双变量分析。
该研究包括160例NAM（86例原位和74例侵袭性）和218例DNM（109例原位和109例侵袭性）。NAM与较年轻的年龄、出现在躯干上的可能性更大以及较薄的Breslow厚度相关。NAM显示阴性色素网络的可能性是DNM的2.5倍。原位NAM显示无明确结构的皮肤镜区域和棕褐色无结构区域的可能性分别是DNM的2.1倍和2倍。原位黑色素瘤更有可能呈现色素网络，而侵袭性黑色素瘤更常见的表现是瘢痕样色素脱失和亮白色结构。条纹、斑片和亮白色结构与更深的Breslow深度相关。
尽管在本系列中无法通过皮肤镜识别NAM的痣成分，但阴性色素网络、棕褐色无结构区域和无明确结构的区域是NAM的皮肤镜线索。
