Eur J Dermatol. 2023 Apr 1;33(2):121-125. doi: 10.1684/ejd.2023.4454.
Dermoscopic features differentiating in situ nevus-associated melanoma (NAM) versus in situ de novo melanoma (DNM) are inconclusive.
The aim of the study was to investigate the dermoscopic features associated with in situ NAM versus DNM.
MATERIALS & METHODS: This was a retrospective observational study. All consecutive in situ melanomas diagnosed in adult patients were retrieved and stratified as NAM vs DNM, and clinical and dermoscopic data were compared between the two.
A total of 183 patients with in situ melanoma were collected, of whom 98 (54%) were male with a mean age of 64±14 years. For 129 patients, standardized dermoscopic images were collected (51 for NAM and 78 for de novo MM). The most common dermoscopic features were an atypical pigment network (85%), atypical globules (63%) and regression (42%). No significant differences were found except for regression, which was detected in 54.9% NAM vs 33.3% DNM (p=0.016). Multivariate logistic regression confirmed the association between dermoscopic regression and NAM (OR=2.34, 95% CI: 1.15-4.91).
Currently, the use of dermoscopy to determine whether a melanoma is associated with a nevus is unreliable, however, the presence of regression adjacent to atypical lesions may raise suspicion of in situ NAM.
鉴别原位痣相关黑色素瘤（NAM）与原位新发黑色素瘤（DNM）的皮肤镜特征尚无定论。
本研究旨在探讨与原位 NAM 与 DNM 相关的皮肤镜特征。
这是一项回顾性观察性研究。连续收集所有诊断为成人原位黑色素瘤的患者，并将其分为 NAM 与 DNM，比较两组间的临床及皮肤镜数据。
共收集到 183 例原位黑色素瘤患者，其中 98 例（54%）为男性，平均年龄 64±14 岁。129 例患者采集了标准化的皮肤镜图像（NAM 51 例，新发 MM 78 例）。最常见的皮肤镜特征为非典型色素网（85%）、非典型小球（63%）和退行性变（42%）。除退行性变外，两组间无显著差异，NAM 中退行性变的检出率为 54.9%，而 DNM 中为 33.3%（p=0.016）。多变量逻辑回归证实了皮肤镜下退行性变与 NAM 之间的关联（OR=2.34，95%CI：1.15-4.91）。
目前，皮肤镜检查用于确定黑色素瘤是否与痣相关并不可靠，然而，在非典型病变旁出现退行性变可能提示原位 NAM。
