Patterns of nail matrix and bed of longitudinal melanonychia by intraoperative dermatoscopy

Patterns of nail matrix and bed of longitudinal melanonychia by intraoperative dermatoscopy
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DOI:
10.1016/j.jaad.2010.06.009
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发表时间:
2011-08-01
影响因子:
13.8
通讯作者:
Tosti, Antonella
Tosti, Antonella
中科院分区:
医学1区
文献类型:
--
作者:
Hirata, Sergio Henrique;Yamada, Sergio;Tosti, Antonella

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背景:皮肤镜检查的指甲最近已被引入的评价色素指甲病变。然而,没有证据表明这种技术提高了原位黑色素瘤的诊断准确性。目的:建立和验证术中皮肤镜检查的指甲基质模式。方法:术中指甲基质皮肤镜检查在100个连续的纵向黑甲带中进行,这些带被切除并提交组织病理学检查。结果:我们确定了4种皮肤镜模式:规则灰度图(黑色素沉着症),规则棕色图案(良性黑素细胞增生),规则棕色图案伴小球或斑点(黑色素细胞痣)和不规则图案局限性:甲基质皮肤镜检查是一种侵入性的程序,不能在所有黑甲病例中常规进行。所描述的模式为术中鉴别诊断色素性指甲病变提供了高灵敏度和特异性。(《美国皮肤病学学会杂志》2011;65:297-303。)
Background: The dermatoscopic examination of the nail plate has been recently introduced for the evaluation of pigmented nail lesions. There is, however, no evidence that this technique improves diagnostic accuracy of in situ melanoma.Objective: To establish and validate patterns for intraoperative dermatoscopy of the nail matrix.Methods: Intraoperative nail matrix dermatoscopy was performed in 100 consecutive bands of longitudinal melanonychia that were excised and submitted to histopathologic examination.Results: We identified 4 dermatoscopic patterns: regular gray pattern (hypermelanosis), regular brown pattern (benign melanocytic hyperplasia), regular brown pattern with globules or blotch (melanocytic nevi), and irregular pattern (melanoma).Limitations: Nail matrix dermatoscopy is an invasive procedure that can not routinely be performed in all cases of melanonychia.Conclusion: The patterns described present high sensitivity and specificity for intraoperative differential diagnosis of pigmented nail lesions. (J Am Acad Dermatol 2011;65:297-303.)