Dermoscopic features of mucosal melanosis
Dermoscopic features of mucosal melanosis
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DOI：
10.1111/j.1524-4725.2004.30337.x
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发表时间：
2004-08-01
影响因子：
2.4
通讯作者：
Carli, P
中科院分区：
文献类型：
--
作者：
Mannone, F;De Giorgi, V;Carli, P
背景。黑素病是一种良性的粘膜色素病变，其特征是基底角化细胞色素沉着，黑素细胞数量正常或轻微增加。黑素病，尤其是发生在生殖器的黑素病，在临床上可以模拟粘膜黑色素瘤，从而引起患者和医生的关注。本研究分析了一系列临床模棱两可（n=11）或临床典型（n=10）的粘膜黑变的皮肤镜特征。对2002年5月1日至2002年6月30日在意大利佛罗伦萨大学妇产科外阴门诊连续就诊的妇女进行检查。三种主要的皮肤镜模式被确定：(1)一种“无结构”模式，主要见于临床模棱两可的外阴黑色素病，具有蓝色色调，与真皮上部噬黑细胞的存在有关，存在于大多数此类病变中；(2)“平行模式”，常见于临床典型的唇、阴茎黑素斑；(3)与临床上模棱两可的黑变有关的“网状”模式，发生在特殊部位，如乳晕（所有3例病例都发生在该部位）或很少发生在嘴唇。皮肤镜检查可以在无创的粘膜黑化分级中发挥作用。与黑色素瘤的错误分类的风险可能取决于病变所显示的皮肤镜模式。需要前瞻性研究，包括早期黑色素瘤，以建立皮肤镜对粘膜色素病变的诊断性能。
BACKGROUND. Melanosis (lentiginosis, labial melanotic macula) is a benign pigmented lesion of mucosa characterized by pigmentation of basal keratinocytes with melanocytic normal or slightly increased in number. Melanosis, particularly when occurring on genitalia, can clinically mimic mucosal melanoma thus creating concern in both the patient and the physician.OBJECTIVE. In this study dermoscopic features from a series of clinically equivocal (n=11) or clinically typical (n=10) mucosal melanosis were analyzed.METHODS. All the women consecutively seen at the Vulva Clinic of the Department of Obstetrics and Gynecology, University of Florence, Italy, from May 1, 2002 to June 30, 2002, were examined.RESULTS. Three major dermoscopic patterns were identified: (1) a "structureless" pattern, predominantly found in clinically equivocal vulvar melanosis, with a blue hue, associated with the presence of melanophages in the upper dermis, present in the majority of these lesions; (2) a "parallel pattern," often found in clinically typical melanotyc macules of the lips and penis; and (3) a "reticular-like" pattern associated with clinically equivocal melanosis occurring at peculiar sites such as the areola (all the three cases occurred at that site) or, rarely, on the lip.CONCLUSIONS. Dermoscopy can play a role in the noninvasive classification of mucosal melanosis. The risk of misclassification with melanoma is probably dependent on dermoscopy pattern shown by the lesion. Prospective studies including early melanomas are needed to establish diagnostic performance of dermoscopy in pigmented lesions of the mucosa.