Ambiguous melanocytic lesions: A retrospective cohort study of incidence and outcome of melanocytic tumor of uncertain malignant potential (MELTUMP) and superficial atypical melanocytic proliferation of uncertain significance (SAMPUS) in the Netherlands

Vermariën-Wang, Jiahe; Doeleman, Thom; Doorn, Remco van; Mooyaart, Antien L.; Blokx, Willeke A.M.; Schrader, Anne M.R.

doi:10.1016/j.jaad.2022.11.019

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…The ability of these atypical melanocytic proliferations to evolve and spread locally or metastasize is largely unknown. Vermariëen-Wang et al 16 have presented evidence that the atypical superficial melanocytic proliferations of uncertain significance do not metastasize. While reassuring, we feel that it would be prudent to repeat AI screening after an interval of 6 months or sooner if the patient notices a change in a lesion.…”

Section: Discussionmentioning

confidence: 99%

Using Artificial Intelligence as a Melanoma Screening Tool in Self-Referred Patients

Crawford,

Kamali,

Dorey

et al. 2023

J Cutan Med Surg

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Introduction: Early detection of melanoma requires timely access to medical care. In this study, we examined the feasibility of using artificial intelligence (AI) to flag possible melanomas in self-referred patients concerned that a skin lesion might be cancerous. Methods: Patients were recruited for the study through advertisements in 2 hospitals in Halifax, Nova Scotia, Canada. Lesions of concern were initially examined by a trained medical student and if the study criteria were met, the lesions were then scanned using the FotoFinder System®. The images were analyzed using their proprietary computer software. Macroscopic and dermoscopic images were evaluated by 3 experienced dermatologists and a senior dermatology resident, all blinded to the AI results. Suspicious lesions identified by the AI or any of the 3 dermatologists were then excised. Results: Seventeen confirmed malignancies were found, including 10 melanomas. Six melanomas were not flagged by the AI. These lesions showed ambiguous atypical melanocytic proliferations, and all were diagnostically challenging to the dermatologists and to the dermatopathologists. Eight malignancies were seen in patients with a family history of melanoma. The AI’s ability to diagnose malignancy is not inferior to the dermatologists examining dermoscopic images. Conclusion: AI, used in this study, may serve as a practical skin cancer screening aid. While it does have technical and diagnostic limitations, its inclusion in a melanoma screening program, directed at those with a concern about a particular lesion would be valuable in providing timely access to the diagnosis of skin cancer.

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Section: Discussionmentioning

confidence: 99%

Using Artificial Intelligence as a Melanoma Screening Tool in Self-Referred Patients

Crawford,

Kamali,

Dorey

et al. 2023

J Cutan Med Surg

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“…Before the immunohistochemical analysis, the H&E-stained sections of melanocytic lesions were independently and blindly reviewed by 2 dermatopathologists. The following diagnoses were made: CM, superficial atypical melanocytic proliferation of uncertain significance (SAMPUS), 12 and benign. All melanocytic lesions had been excised with adjacent skin.…”

Section: Methodsmentioning

confidence: 99%

The Expression of PRAME as an Aid for Diagnosis and Evaluation of Histologic Margins of Intraepidermal Cutaneous Melanoma in Xeroderma Pigmentosum Patients

Ferreira,

Kim,

Stelini

et al. 2024

Applied Immunohistochemistry &Amp; Molecular Morphology

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Xeroderma Pigmentosum (XP) is a genetic disorder characterized by photosensitivity, dyschromia, and high risk of skin cancer. From a clinical and histologic view, it can be difficult to diagnose cutaneous melanoma (CM) in XP patients and to define its resection margins. We aimed to study the role of PRAME (PReferentially Expressed Antigen in MElanoma) in differentiating intraepidermal CM from superficial atypical melanocytic proliferation of uncertain significance (SAMPUS) and evaluating the histological margins of CMs. We included XP patients. melanocitic and nonmelanocytic lesions with adjacent skin, and, as control groups, sun-damaged skin from non-XP individuals. Melanocytic lesions with a consensus diagnosis were grouped into CM, SAMPUS, or benign. The selected samples were PRAME-immunoshistochemically stained, and the ratio between immuno-positive cells/mm was recorded, according to Olds and colleagues for intraepidermal lesions. Lezcano and colleagues' method was used for intradermal lesions. Clinical data from XP patients were reviewed. All 9 patients were alive and well at the study closure, even those who developed melanoma metastases. Positive/diffuse PRAME expression was found in 29% (7/24) of intraepidermal CMs and 20% (1/5) SAMPUS samples. All 103 XP control samples and 24 adjacent lesions skin of non-XP patients were PRAME negative. This was a single-center and retrospective study, using a relatively small sample, limiting our conclusions. In XP patients’ lesions, PRAME expression could help in the setting of challenging melanocytic tumors and surgical margins evaluation. It is also possible that the method can avoid overdiagnosis and, consequently, more aggressive treatment recommendation in unequivocal CM cases.

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“…The dermoscopic structures assessed for their presence or absence are outlined in Table 1 . The selection of dermoscopic features was based on the available literature [ 15 , 16 , 17 , 18 , 19 ], ensuring a comprehensive analysis of the lesions in the study. Given the ongoing debates in the current literature regarding the standardization of dermatoscopic structure terminology, with some authors using descriptive terms and others employing metaphoric terms, we sought to minimize interpretational subjectivity among the authors.…”

Section: Methodsmentioning

confidence: 99%

“…Lesions located on the acral site, scalp, nails, and mucosae were excluded from the study. Also, lesions with equivocal histopathological diagnosis, such as collision tumors, SAMPUS (Superficial Atypical Melanocytic Proliferations of Unknown Significance), MELTUMP (Melanocytic Tumors of Uncertain Melanocytic Potential) [ 17 ], Atypical Spitz Tumor were excluded from the analysis.…”

Section: Methodsmentioning

confidence: 99%

Exploring Small-Diameter Melanomas: A Retrospective Study on Clinical and Dermoscopic Features

Hunziker,

Abdalla,

Brandão

et al. 2023

Life

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Background: Early melanoma detection allows for timely intervention and treatment, significantly improving the chances of favorable outcomes for patients. Small-diameter melanoma (SDM) typically represents an initial growth phase of cutaneous melanoma. One of the challenges in detecting melanoma in their early stage lies in the fact that dermoscopy criteria have been primarily designed for fully developed lesions. Early-stage melanomas may be difficult to detect and possibly even be overlooked or misinterpreted during examinations. Methods: The primary aim of this study was to identify valuable clinical and dermoscopic clues to enhance the detection of SDMs. To achieve this objective, we conducted a comprehensive retrospective analysis, including forty SDMs with a diameter of 5 mm or less. These cases were diagnosed over an 8-year period and were collected from five referral centers across Brazil. Seven experienced dermatologists independently assessed the dermoscopic features of each lesion. Additionally, this study includes demographic and histological information. Results: The study encompassed a total of 28 patients, of which 16 were females, accounting for 58% of the participants, with an average age of 43.6 years. Among the small-diameter melanomas (SDMs) under investigation, the majority, constituting 27 cases (69.2%), were identified as “de novo” lesions, i.e., not associated with a nevus. Additionally, eight SDMs (20%) exhibited invasive characteristics, with Breslow index measurements ranging between 0.2 to 0.4 mm, suggesting an early stage of malignancy. During dermoscopic examinations, the most prevalent features observed were irregular dots and globules, present in 95% and 87.5% of cases, respectively. Moreover, brown structureless areas were identified in 70% of lesions, followed by atypical network (67.5%), pseudopods (55%), dotted vessels (47.5%), flat structureless blue-gray areas (42.5%), and irregular blotches (40%). Notably, all SDM were diagnosed in patients under surveillance through total body skin photography (TBSP) and Digital Dermoscopy (DD). Conclusions: Dermoscopy significantly enhances the diagnostic accuracy of melanoma, even in its early stages. Particularly for high-risk patients with numerous nevi, the identification of a new lesion or subtle changes on dermoscopy during follow-up may serve as the sole clue for an early diagnosis. This emphasizes the critical role of dermoscopy in SDM detection and reinforces the importance of surveillance in high-risk patients for timely and effective management.

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Ambiguous melanocytic lesions: A retrospective cohort study of incidence and outcome of melanocytic tumor of uncertain malignant potential (MELTUMP) and superficial atypical melanocytic proliferation of uncertain significance (SAMPUS) in the Netherlands

Cited by 4 publications

References 11 publications

Using Artificial Intelligence as a Melanoma Screening Tool in Self-Referred Patients

Using Artificial Intelligence as a Melanoma Screening Tool in Self-Referred Patients

The Expression of PRAME as an Aid for Diagnosis and Evaluation of Histologic Margins of Intraepidermal Cutaneous Melanoma in Xeroderma Pigmentosum Patients

Exploring Small-Diameter Melanomas: A Retrospective Study on Clinical and Dermoscopic Features

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