Use of digital epiluminescence microscopy to help define the edge of lentigo maligna
Use of digital epiluminescence microscopy to help define the edge of lentigo maligna
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DOI：
10.1001/archderm.140.9.1095
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发表时间：
2004-09-01
影响因子：
--
通讯作者：
Robinson, JK
中科院分区：
文献类型：
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作者：
Robinson, JK
目的：比较识别的边界的恶性雀斑（LM）与数字荧光显微镜（DELM）与临床和木材光assessment.Design：临床确定的木材光，与DELM，并切除后Molis显微手术的病变的边界追踪到塑料片。比较描记图上定义的边界的一致性和平均表面积。设置：Cardinal Bernardin癌症皮肤癌中心，Loyola大学卫生系统，Maywood，III。患者：26名连续的头颈部LM患者。主要结果测量：4种方法确定的边界轮廓和平均表面积的比较结果。结果：临床检查确定的边界小于Wood灯或DELM确定的边界。大多数病变在DELM清除边界外5 mm处进行了额外切除。具有不对称滤泡开口和深棕色菱形结构的LM的DELM模式在外周发生变化，并变为与原位黑色素瘤的组织病理学特征相关的着色薄网格。从LM延伸的更均匀的色素沉着区域与黑素细胞增生的病理特征相关。结论：通过DELM（皮肤镜）可视化LM有助于指导切除。因为LM发生于日光损伤的皮肤，伴有黑素细胞增生，确定无肿瘤边缘需要有经验的医生的判断。
Objective: To compare identification of the border of lentigo maligna (LM) with digital epiluminescence microscopy (DELM) with clinical and Wood light assessment.Design: The borders of lesions identified clinically with the Wood light, with DELM, and after excision by Molis micrographic surgery were traced onto plastic sheets. The borders defined on the tracings were compared for congruence and mean surface area.Setting: Cardinal Bernardin Cancer Center for Skin Cancer, Loyola University Health System, Maywood, III.Patients: Twenty-six consecutive patients with LM of the head and neck.Main Outcome Measures: Results of the comparison of the outlines of the borders and the mean surface area identified by the 4 methods.Results: The border determined by clinical examination was smaller than that determined with the Wood lamp or by DELM. Most lesions underwent an additional excision 5 mm beyond the DELM-clefined border. The DELM pattern of LM with asymmetric follicular openings and dark brown rhomboidal structures changed at the periphery and became a pigmented thin mesh that was associated with the histopathological features of melanoma in situ. More homogeneous pigmented areas extending from the LM were associated with the pathologic features of melanocytic hyperplasia.Conclusions: Visualization of LM by DELM (dermoscopy) helps to guide resection. Because LM arises in sundamaged skin with melanocytic hyperplasia, determining the tumor-free margin requires the judgment of an experienced physician.