Reflectance confocal microscopy and dermoscopy aid in evaluating repigmentation within or adjacent to lentigo maligna melanoma surgical scars.
Reflectance confocal microscopy and dermoscopy aid in evaluating repigmentation within or adjacent to lentigo maligna melanoma surgical scars.
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DOI：
10.1111/jdv.15819
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Nehal KS
中科院分区：
文献类型：
--
作者：
Navarrete-Dechent C;Cordova M;Liopyris K;Rishpon A;Aleissa S;Rossi AM;Lee E;Chen CJ;Busam KJ;Marghoob AA;Nehal KS
确定恶性雀斑或恶性雀斑(LM/LMM)疤痕内或附近的重新色素沉着是否代表黑色素瘤复发是一项具有挑战性的工作。使用反射共聚焦显微镜(RCM)和皮肤镜检查可能有助于区分真正的黑色素瘤复发和其他原因的色素沉着。描述在RCM和皮肤镜下可观察到的LM/LMM瘢痕内或邻近部位的重新色素沉着的特征。我们回顾分析了2014年1月至2018年12月手术治疗的LM/LMM瘢痕内或瘢痕附近出现新的色素沉着的患者。记录临床和人口学特征以及复发时间。在活检前用RCM评估色素沉着的区域。如果有的话，对皮肤镜图像进行评估。总体而言，29名患者的30项共聚焦研究纳入研究队列。21例患者经活检证实为复发的LM/LMM；其余患者为色素沉着光化性角化病(n=4)或色素沉着/日光性雀斑(n=5)。RCM的敏感性为95.24%(95%CI，76.18%~99.88%)，特异性为77.7%(95%CI，39.99%~97.19%)，阳性预测值为90.91%(95%CI，74.58%~97.15%)，阴性预测值为87.5%(95%CI，50.04%~98.0%)。在复发的LM/LMM患者中，最常见的皮肤镜特征是局灶性均匀或无结构的浅褐色色素沉着(92.8%对37.5%，在其他诊断的患者中；P=0.009)。在复发的LM/LMM患者中，只有28.5%的患者有LM特异性皮肤镜检查标准。RCM和皮肤镜检查是全面评估LM瘢痕内或邻近的复色素沉着的有价值的工具。
Determining whether repigmentation within or adjacent to lentigo maligna or lentigo maligna melanoma (LM/LMM) scars represents recurrence of melanoma is challenging. The use of reflectance confocal microscopy (RCM) and dermoscopy may aid in differentiating true melanoma recurrence from other causes of repigmentation. To describe the characteristics of repigmentation within or adjacent to LM/LMM scars observable on RCM and dermoscopy. We retrospectively analysed patients who presented with new pigmentation within or adjacent to scars from surgically treated LM/LMM between January 2014 and December 2018. Clinical and demographic characteristics and time to recurrence were recorded. RCM was used to evaluate areas of pigmentation before biopsy. If available, dermoscopic images were evaluated. In total, 30 confocal studies in 29 patients were included in the study cohort. Twenty-one patients had biopsy-confirmed recurrent LM/LMM; the remainder had pigmented actinic keratosis (n=4) or hyperpigmentation/solar lentigo (n=5). RCM had sensitivity of 95.24% (95% CI, 76.18%-99.88%), specificity of 77.7% (95% CI, 39.99%-97.19%), positive predictive value of 90.91% (95% CI, 74.58%-97.15%), and negative predictive value of 87.5% (95% CI, 50.04%-98.0%). The most common dermoscopic feature observed among patients with recurrent LM/LMM was focal homogeneous or structureless areas of light-brown pigmentation (92.8% vs 37.5% in patients with other diagnoses; P=0.009). LM-specific dermoscopic criteria were present in only 28.5% of patients with recurrent LM/LMM. RCM and dermoscopy are valuable tools for the comprehensive evaluation of repigmentation within or adjacent to LM scars.
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影响因子：
13.8
作者：
Connolly, Karen L.;Giordano, Cerrene;Nehal, Kishwer
通讯作者：
Nehal, Kishwer
影响因子：
13.8
作者：
Kittler H;Marghoob AA;Argenziano G;Carrera C;Curiel-Lewandrowski C;Hofmann-Wellenhof R;Malvehy J;Menzies S;Puig S;Rabinovitz H;Stolz W;Saida T;Soyer HP;Siegel E;Stoecker WV;Scope A;Tanaka M;Thomas L;Tschandl P;Zalaudek I;Halpern A
通讯作者：
Halpern A
影响因子：
6.5
作者：
Guitera, Pascale;Pellacani, Giovanni;Menzies, Scott W.
通讯作者：
Menzies, Scott W.
影响因子：
6.5
作者：
Guitera, Pascale;Menzies, Scott W.;Pellacani, Giovanni
通讯作者：
Pellacani, Giovanni
影响因子：
3.6
作者：
Persechino, Flavia;De Carvalho, Nathalie;Pellacani, Giovanni
通讯作者：
Pellacani, Giovanni