Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Exp Dermatol. 2024 Oct;33(10):e15188. doi: 10.1111/exd.15188.
External ear lentigo maligna/lentigo melanoma (LM/LMM) represents approximately 1%-4% of all primary cutaneous melanomas. Over the past 20 years, dermoscopy has proven highly effective in early detection of LM/LMM, with recent studies identifying perifollicular linear projections (PLP) as a specific diagnostic criterion for early LM. However, in clinical practice, LM and LMM turn out to be very difficult to distinguish based on dermoscopic findings. Therefore, our retrospective monocentric study aimed to investigate dermoscopic characteristics, as well as the epidemiological and clinical data of 19 patients diagnosed with the external ear (EE) LM/LMM at the Oncologic Dermatology Unit in Bologna. Dermoscopic images were obtained using the FotoFinder Medicam 800HD, and specific criteria validated by the International Dermoscopy Society (IDS) for atypical pigmented facial lesions were assessed. Fisher's exact test was primarily used for statistical comparisons. As results, most of the patients were male (74%) with an average age (± SD) at diagnosis of 69.8 (± 15.1) years old. LMM appeared more commonly observed in elderly patients as compared to LM (mean 71.6 vs. 66.7, p = 0.514), presenting as pigmented macule (89.5%) of the ear lobule (23.9%). A statistically significant difference (p = 0.01) of tumour' diameter between LMM and LM was reported with the first resulting more than twice the size of the latter. Concerning dermoscopic findings, asymmetric pigmented follicles, obliteration of the follicular openings and grey circles were more frequently observed in LMM compared to LM (63.2% vs. 31.6%; 63.2% vs. 26.3%; 47.4% vs. 15.8%, respectively).
外耳恶性雀斑痣/黑素瘤（LM/LMM）约占所有原发性皮肤黑素瘤的 1%-4%。在过去的 20 年中，皮肤镜检查已被证明在 LM/LMM 的早期检测中非常有效，最近的研究确定了毛囊周围线性突起（PLP）是早期 LM 的特定诊断标准。然而，在临床实践中，根据皮肤镜检查结果，LM 和 LMM 非常难以区分。因此，我们的回顾性单中心研究旨在调查在博洛尼亚肿瘤皮肤科诊断为外耳（EE）LM/LMM 的 19 名患者的皮肤镜特征，以及流行病学和临床数据。使用 FotoFinder Medicam 800HD 获取皮肤镜图像，并评估了国际皮肤镜学会（IDS）为非典型色素性面部病变验证的特定标准。Fisher 精确检验主要用于统计比较。结果，大多数患者为男性（74%），诊断时的平均年龄（±SD）为 69.8（±15.1）岁。与 LM 相比，LMM 更常见于老年患者（平均 71.6 岁 vs. 66.7 岁，p=0.514），表现为耳叶的色素性斑（23.9%）。LMM 和 LM 的肿瘤直径存在统计学显著差异（p=0.01），前者的直径是后者的两倍多。关于皮肤镜检查结果，不对称性色素性毛囊、毛囊开口闭塞和灰色环在 LMM 中比 LM 更常见（63.2% vs. 31.6%；63.2% vs. 26.3%；47.4% vs. 15.8%）。
