This study showed a correlation between BRAF and NRAS status and dermoscopic findings of 'peppering' as an expression of regression and melanophages in the dermis, suggesting a morphological consequence of immune behaviour in BRAF-mutated melanomas.
The rosette structure is a dermoscopic sign visible under polarized light, characterized by 4 white points arranged as a 4-leaf clover. It has been mainly described in facial sun-damaged skin and actinic keratosis, although it has also been found in squamous and basal cell carcinomas, and in 2 cases of hypomelanotic melanomas. We describe 2 different cases of pigmented incipient melanomas with the presence of multiple rosettes and shiny white structures on dermoscopy. In the reflectance confocal microscope they exhibit a disarranged epidermal architecture with atypical and dendritic cells. Histological examination showed focal hyperkeratosis and a normal corneal layer presented alternatively. To our knowledge this is the first description of rosette structures in pigmented melanomas. Based on a proper dermoscopic- confocal-histopathological correlation, we hypothesize that rosettes could correspond to optic phenomena due to changes in the superficial epidermal reaction and in the acrosyringia.
Dermoscopy allowed a more precise prediction of SLN status. If a combined SCOREBRESEX was used to select patients for SLNB, 41·5% of procedures might be avoided.
Paciente de sexo femenino, de 11 años, estudiante de bachillerato, sin antecedentes de importancia. Consulta por lesión pigmentada de dos años de evolución, que ha presentado crecimiento progresivo en los últimos meses y se asocia a descamación y prurito, sin ulceración ni sangrado. Al examen físico presenta placa negra brillante de aproximadamente 10 mm × 9 mm en la zona medial de la pierna derecha, simétrica, de bordes bien delimitados. A la dermatoscopia se observa presencia de velo azul-gris con líneas blanco-brillantes, de predominio central.
El nevo de Spitz es una lesión melanocítica benigna poco común, compuesta de células epitelioides y/o fusiformes grandes, que usualmente se presenta en la infancia. Clínicamente son lesiones pequeñas, generalmente de menos de 6 mm de diámetro, con características histológicas benignas (arquitectura regular, escasas o nulas mitosis y ausencia de atipia celular). El patrón en estallido de estrella y el patrón vascular punteado son los patrones dermatoscópicos más frecuentes. El manejo puede ser expectante o excisional dependiendo de las caracter ísticas clínicas y la edad del paciente.
Paciente de 74 años, ama de casa, residente de Bello, Antioquia, Colombia. Consultó por un cuadro clínico de lesión única en la mejilla derecha, de crecimiento lento y asintomática. Solamente ha usado antisolar como tratamiento. No tiene compromiso de otras zonas.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.