Navarrete-Dechent Cristian, Jaimes Natalia, Dusza Stephen W, Liopyris Konstantinos, Marchetti Michael A, Cordova Miguel, Oliviero Margaret, Villaseca Miguel A, Pulitzer Melissa, Busam Klaus J, Rossi Anthony M, Rabinovitz Harold S, Nehal Kishwer S, Scope Alon, Marghoob Ashfaq A
Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
J Am Acad Dermatol. 2024 Jan;90(1):52-57. doi: 10.1016/j.jaad.2023.07.1036. Epub 2023 Aug 25.
Lentigo maligna (LM) can mimic benign, flat, pigmented lesions and can be challenging to diagnose.
To describe a new dermatoscopic feature termed "perifollicular linear projections (PLP)" as a diagnostic criterion for LM on the face.
Retrospective study on reflectance confocal microscopy and dermatoscopy images of flat facial pigmented lesions originating from 2 databases. PLP were defined as short, linear, pigmented projections emanating from hair follicles. Dermatoscopy readers were blinded to the final histopathologic diagnosis.
From 83 consecutive LMs, 21/83 (25.3%) displayed "bulging of hair follicles" on reflectance confocal microscopy and 18 of these 21 (85.7%), displayed PLP on dermatoscopy. From a database of 2873 consecutively imaged and biopsied lesions, 252 flat-pigmented facial lesions were included. PLP was seen in 47/76 melanomas (61.8%), compared with 7/176 lesions (3.9%) with other diagnosis (P < .001). The sensitivity was 61.8% (95% CI, 49.9%-72.7%), specificity 96.0% (95% CI, 92.9%-98.4%). PLP was independently associated with LM diagnosis on multivariate analysis (OR 26.1 [95% CI, 9.6%-71.0]).
Retrospective study.
PLP is a newly described dermatoscopic criterion that may add specificity and sensitivity to the early diagnosis of LM located on the face. We postulate that PLP constitutes an intermediary step in the LM progression model.
恶性雀斑样痣（LM）可类似良性扁平色素沉着病变，诊断具有挑战性。
描述一种称为“毛囊周围线性突起（PLP）”的新皮肤镜特征，作为面部LM的诊断标准。
对来自2个数据库的面部扁平色素沉着病变的反射式共聚焦显微镜和皮肤镜图像进行回顾性研究。PLP定义为从毛囊发出的短的、线性的、色素沉着的突起。皮肤镜检查者对最终的组织病理学诊断不知情。
在83例连续的LM中，21/83（25.3%）在反射式共聚焦显微镜下显示“毛囊隆起”，这21例中的18例（85.7%）在皮肤镜下显示PLP。在一个包含2873例连续成像和活检病变的数据库中，纳入了252例面部扁平色素沉着病变。47/76例黑色素瘤（61.8%）可见PLP，而其他诊断的病变中7/176例（3.9%）可见PLP（P <.001）。敏感性为61.8%（95%CI，49.9%-72.7%），特异性为96.0%（95%CI，92.9%-98.4%）。多变量分析显示PLP与LM诊断独立相关（OR 26.1[95%CI，9.6%-71.0]）。
回顾性研究。
PLP是一种新描述的皮肤镜标准，可能会增加对面部LM早期诊断的特异性和敏感性。我们推测PLP构成了LM进展模型中的一个中间步骤。
