Kawabata Y, Tamaki K
University of Tokyo, Faculty of Medicine, Department of Dermatology, Tokyo, Japan.
J Cutan Med Surg. 1998 Apr;2(4):199-204. doi: 10.1177/120347549800200404.
An acral lentiginous melanoma in situ on the sole is often difficult to differentiate with the naked eye from an acquired plantar melanocytic nevus. Recent technical advances in epiluminescence microscopy have contributed to the differentiation of these two pigmented skin lesions.
In this study, the correlation between dermatoscopic and histopathologic findings of acral lentiginous melanoma in situ on the sole are compared to those of acquired plantar melanocytic nevi.
Three acral lentiginous melanomas in situ on the sole, and two cases of acral lentiginous melanoma were compared with 50 acquired plantar melanocytic nevi by means of dermatoscopy and histopathology.
The dermatoscopic surface profiles of acquired melanocytic nevi were composed of linear pigmentation accentuated mainly on the sulcus superficialis. Histologically, some areas of the sulcus superficialis corresponded to rete ridges of the epidermis, and nests of nevus cells were also often located there. In contrast, the acral lentiginous melanomas in situ showed diffuse, irregularly shaped pigmentation distributed in a disorderly fashion over the entire surface. Histologically, isolated areas of proliferation and small nest formations of atypical melanocytes were irregularly distributed in the epidermis.
A distinctive dermatoscopic feature of acral lentiginous melanoma in situ is diffuse and irregular pigmentation over the entire surface of the lesion. This feature is helpful for differentiating acral lentiginous melanoma in situ from acquired plantar melanocytic nevi.
足底原位肢端雀斑样痣黑色素瘤通常很难用肉眼与后天性足底黑素细胞痣区分开来。皮肤镜检查技术的最新进展有助于区分这两种色素性皮肤病变。
在本研究中，比较足底原位肢端雀斑样痣黑色素瘤的皮肤镜和组织病理学表现与后天性足底黑素细胞痣的相关性。
通过皮肤镜检查和组织病理学，将3例足底原位肢端雀斑样痣黑色素瘤和2例肢端雀斑样痣黑色素瘤与50例后天性足底黑素细胞痣进行比较。
后天性黑素细胞痣的皮肤镜表面特征由主要在浅表沟处加重的线性色素沉着组成。组织学上，浅表沟的一些区域对应于表皮的 rete 嵴，痣细胞巢也常位于此处。相比之下，原位肢端雀斑样痣黑色素瘤表现为弥漫性、形状不规则的色素沉着，以无序方式分布于整个表面。组织学上，非典型黑素细胞的孤立增殖区域和小巢状形成不规则地分布在表皮中。
原位肢端雀斑样痣黑色素瘤独特的皮肤镜特征是病变整个表面弥漫性和不规则色素沉着。这一特征有助于将原位肢端雀斑样痣黑色素瘤与后天性足底黑素细胞痣区分开来。
