Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy.
J Eur Acad Dermatol Venereol. 2021 Aug;35(8):1670-1677. doi: 10.1111/jdv.17313. Epub 2021 May 25.
Dermoscopy and Reflectance Confocal Microscopy (RCM) features of scalp melanoma according to lesion location and histopathology have not been fully investigated.
To reveal dermoscopic and RCM features of scalp melanoma according to lesion location and histopathology.
We retrospectively retrieved images of suspicious, atypical excised, flat melanocytic lesions of the scalp, assessed on dermoscopy and RCM at five centres, from June 2007 to April 2020. Lesions were classified according to histopathological diagnoses of nevi, lentigo maligna melanoma (LM/LMM) or superficial spreading melanoma (SSM). Clinical, dermoscopic and RCM images were evaluated; LM/LMM and SSM subtypes were compared through multivariate analysis.
Two hundred forty-seven lesions were included. In situ melanomas were mostly LM (81.3%), while invasive melanomas were mostly SSM (75.8%). Male sex, baldness and chronic sun-damaged skin were associated with all types of melanomas and in particular with LM/LMM. LMs were mostly located in the vertex area and SSM in the frontal (OR: 8.8; P < 0.05, CI 95%) and temporal (OR: 16.7; P < 0.005, CI 95%) areas. The dermoscopy presence of pseudo-network, pigmented rhomboidal structures, obliterated hair follicles and annular-granular pattern were associated with LM diagnoses, whereas bluish-white veil was more typical of SSM. Observations on RCM of atypical roundish and dendritic cells in the epidermis were associated with SSM (42.4%) and dendritic cells with LM (62.5%) diagnoses. Folliculotropism on RCM was confirmed as a typical sign of LM.
Flat scalp melanomas reveal specific dermoscopic and RCM features according to histopathologic type and scalp location.
根据病变位置和组织病理学，头皮黑素瘤的皮肤镜和反射共聚焦显微镜（RCM）特征尚未得到充分研究。
根据病变位置和组织病理学揭示头皮黑素瘤的皮肤镜和 RCM 特征。
我们回顾性地检索了 2007 年 6 月至 2020 年 4 月在五个中心进行的可疑、非典型切除的头皮扁平黑素细胞病变的皮肤镜和 RCM 图像，这些病变根据组织病理学诊断为痣、恶性雀斑样痣/原位黑素瘤（LM/LMM）或浅表扩散性黑素瘤（SSM）进行分类。评估临床、皮肤镜和 RCM 图像；通过多变量分析比较 LM/LMM 和 SSM 亚型。
共纳入 247 例病变。原位黑素瘤主要为 LM（81.3%），而侵袭性黑素瘤主要为 SSM（75.8%）。男性、秃顶和慢性日光损伤皮肤与所有类型的黑素瘤有关，尤其是与 LM/LMM 有关。LM 主要位于顶点区域，SSM 主要位于额（OR：8.8；P<0.05，95%CI）和颞（OR：16.7；P<0.005，95%CI）区域。皮肤镜下存在假网、色素性菱形结构、闭塞的毛囊和环状-颗粒状模式与 LM 诊断有关，而蓝白色面纱则更典型的 SSM。表皮中不规则圆形和树枝状细胞的 RCM 观察结果与 SSM（42.4%）和 LM（62.5%）诊断有关。RCM 上的滤泡嗜向性被证实为 LM 的典型特征。
扁平头皮黑素瘤根据组织病理学类型和头皮位置显示出特定的皮肤镜和 RCM 特征。
