Differentiation of atypical moles (dysplastic nevi) from early melanomas by dermoscopy

Differentiation of atypical moles (dysplastic nevi) from early melanomas by dermoscopy
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DOI:
10.1016/s0733-8635(05)70271-0
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发表时间:
2001-04-01
影响因子:
2.4
通讯作者:
Yadav, S
Yadav, S
中科院分区:
医学2区
文献类型:
--
作者:
Salopek, TG;Kopf, AW;Yadav, S

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一些皮肤镜特征已被确定为黑色素瘤的特征;然而,这些标准在区分早期黑色素瘤和非典型痣方面的可靠性尚未确定。作者发现以下皮肤镜特征在区分早期黑色素瘤和非典型痣方面是有用的(即高度特异性):突然中断的色素网;白色瘢痕样区域的存在;色素减退区域;以及白色薄纱样结构。尽管伪足、棕色小球和大小不一的黑点对黑色素瘤也具有特异性,但在早期黑色素瘤中很少见,因此在区分早期黑色素瘤和非典型痣方面作用不大。新发现的有助于区分非典型痣和早期黑色素瘤的皮肤镜特征包括:红色、蓝色、灰色或白色的存在;四种或更多颜色的存在;中度至重度边界不规则,以及多个大小不一的均匀区域的存在。这些特定特征的任何组合的存在都应提高对黑色素瘤的怀疑指数,并应促使进行活检以避免漏诊这种癌症。
Several dermoscopic features have been identified as characteristic for melanoma; however, the reliability of these criteria in differentiating early melanomas from atypical moles has yet to be determined. The authors found the following dermoscopic features to be useful (i.e., highly specific) in differentiating early melanoma from atypical moles: a pigment network that ends abruptly; the presence of white scar-like areas; depigmented areas; and whitish veil. Although pseudopods, brown globules, and black dots of variable size were also specific for melanoma, they were infrequently seen with early melanomas to be beneficial in distinguishing them from atypical moles. Newly identified dermoscopic features that were found to be helpful in differentiating atypical moles from early melanoma included: the presence of red, blue, gray, or white color; the presence of four or more colors; moderate to marked border irregularity, and the presence of multiple, variably sized homogeneous areas. The presence of any combination of these specific features should elevate the index of suspicion for melanoma and should prompt a biopsy to avoid missing this cancer.