Dermatology Department, Hospital Fundación Alcorcón, Madrid, Spain
Pathology Department, Hospital Fundación Alcorcón, Madrid, Spain
Eur J Dermatol. 2022 Jul 1;32(4):516-521. doi: 10.1684/ejd.2022.4302.
Diagnosis of non-facial melanomas on sun-damaged skin or extrafacial lentigo maligna is challenging.
To identify the evolutionary dermoscopic signs, characteristic of this type of non-facial melanoma on sun-damaged skin.
MATERIALS & METHODS: This retrospective descriptive observational study included 90 dermoscopic follow-up images of 22 non-facial melanomas on sun-damaged skin from 17 high-risk melanoma patients, followed with digital dermoscopy and diagnosed between January 2016 and October 2020. We recorded dermoscopic changes by comparing each dermoscopic image with the previous one (mean dermoscopic follow-up of the excised lesions was 3.6 years). Confocal microscopy images were taken at diagnosis.
In total, 51.5% (95% CI: 39-64) showed an appearance or increase in featureless areas with surrounding small round or triangular dark brown-blue structures, 23% (95% CI: 23-46) showed an increase in other geometric structures (angulated lines, zig-zag lines and polycyclic structures), 5.9% (95% CI: 2-14) showed an appearance or increase in bright white lines and atypical vascularization, 26.5% (95% CI: 17-39) showed an appearance or increase in follicular pigmentation structures or follicular radial lines, and 39.7% (95% CI: 28-52) showed focal islands of pigmentation in these areas. Of the changes, 54% occurred at the last and diagnostic visit. There was an increase in size in only 20.6% (95% CI: 12-32). Also, 81.8% showed pagetoid cells in the epidermis, 95.5% atypical cells at the dermoepidermal junction by reflectance confocal microscopy, and 95.5% showed non-edged or edged and non-edged papillae.
This study identifies the dermoscopic evolutionary changes associated with extrafacial lentigo maligna.
在日光损伤皮肤或非面部恶性雀斑样痣上诊断非面部黑色素瘤具有挑战性。
确定日光损伤皮肤中非面部黑色素瘤的这种类型的特征性进化性皮肤镜特征。
这是一项回顾性描述性观察研究，纳入了 17 例高危黑色素瘤患者的 22 例非面部日光损伤皮肤黑色素瘤的 90 个皮肤镜随访图像，这些患者在 2016 年 1 月至 2020 年 10 月期间进行了数字皮肤镜检查和诊断。我们通过比较每个皮肤镜图像与前一个图像（切除病变的平均皮肤镜随访时间为 3.6 年）来记录皮肤镜变化。在诊断时拍摄共焦显微镜图像。
总共，51.5%（95%CI：39-64）显示无特征区域的外观或增加，伴有周围小圆形或三角形深棕色-蓝色结构，23%（95%CI：23-46）显示其他几何结构（成角线、锯齿线和多环结构）增加，5.9%（95%CI：2-14）显示亮白线和非典型血管化的外观或增加，26.5%（95%CI：17-39）显示滤泡色素结构或滤泡放射状线的外观或增加，39.7%（95%CI：28-52）显示这些区域的局灶性色素岛。这些变化中有 54%发生在最后一次也是诊断性就诊时。仅 20.6%（95%CI：12-32）的病变大小增加。此外，81.8%的表皮中存在派杰样细胞，95.5%的反射共聚焦显微镜下的真皮表皮交界处存在非典型细胞，95.5%显示非边缘或边缘和非边缘乳头。
本研究确定了与非面部恶性雀斑样痣相关的皮肤镜进化性变化。
