Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma

Dika, Emi; Lambertini, Martina; Patrizi, Annalisa; Misciali, Cosimo; Scarfì, Federica; Pellacani, Giovanni; Mandel, Victor Desmond; Tullio, Francesca Di; Stanganelli, Ignazio; Chester, Johanna; Kaleci, Shaniko; Massi, Daniela; Giorgi, Vincenzo De; Cinotti, Élisa; Rubegni, Pietro; Perrot, Jean; Farnetani, Francesca

doi:10.1111/ddg.14311

Cited by 12 publications

(18 citation statements)

References 38 publications

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“…Folliculotropism, already described as a specific feature of facial LM/LMM, was also found to be specific for LM/LMM scalp lesions. 34 , 38 , 48 , 49 Further, medusae‐like structures, an RCM feature suggestive of folluculotropism, 38 were associated with malignancy and observed in 14% of LM/LMM and 12% of SSM.…”

Section: Discussionmentioning

confidence: 95%

Flat scalp melanoma dermoscopic and reflectance confocal microscopy features correspond to histopathologic type and lesion location

Garbarino

Pampena

Lai

et al. 2021

Acad Dermatol Venereol

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Background Dermoscopy and Reflectance Confocal Microscopy (RCM) features of scalp melanoma according to lesion location and histopathology have not been fully investigated.Objectives To reveal dermoscopic and RCM features of scalp melanoma according to lesion location and histopathology. MethodsWe retrospectively retrieved images of suspicious, atypical excised, flat melanocytic lesions of the scalp, assessed on dermoscopy and RCM at five centres, from June 2007 to April 2020. Lesions were classified according to histopathological diagnoses of nevi, lentigo maligna melanoma (LM/LMM) or superficial spreading melanoma (SSM). Clinical, dermoscopic and RCM images were evaluated; LM/LMM and SSM subtypes were compared through multivariate analysis.Results Two hundred forty-seven lesions were included. In situ melanomas were mostly LM (81.3%), while invasive melanomas were mostly SSM (75.8%). Male sex, baldness and chronic sun-damaged skin were associated with all types of melanomas and in particular with LM/LMM. LMs were mostly located in the vertex area and SSM in the frontal (OR: 8.8; P < 0.05, CI 95%) and temporal (OR: 16.7; P < 0.005, CI 95%) areas. The dermoscopy presence of pseudonetwork, pigmented rhomboidal structures, obliterated hair follicles and annular-granular pattern were associated with LM diagnoses, whereas bluish-white veil was more typical of SSM. Observations on RCM of atypical roundish and dendritic cells in the epidermis were associated with SSM (42.4%) and dendritic cells with LM (62.5%) diagnoses. Folliculotropism on RCM was confirmed as a typical sign of LM.Conclusions Flat scalp melanomas reveal specific dermoscopic and RCM features according to histopathologic type and scalp location.

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Section: Discussionmentioning

confidence: 95%

Flat scalp melanoma dermoscopic and reflectance confocal microscopy features correspond to histopathologic type and lesion location

Garbarino

Pampena

Lai

et al. 2021

Acad Dermatol Venereol

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“…None of the benign lesions showed the intrafollicular disposition of dark cells. In dermatoscopy, this folliculotropism can correspond to the presence of annular‐granular grey dots that aggregated asymmetrically around the follicular openings 25,26 . The importance of these findings is also highlighted by a parallel with other, more accurate, accredited and diagnostic imaging techniques 27,28 .…”

Section: Discussionmentioning

confidence: 98%

Fluorescence‐advanced videodermatoscopy (FAV) for the differential diagnosis of suspicious facial lesions: A single‐centre experience with pattern analysis and histopathological correlation

Scarfì

Trane

Maio

et al. 2021

Photoderm Photoimm Photomed

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Background: Fluorescence-advanced videodermatoscopy (FAV) is a new non-invasive high-resolution skin imaging technique to assess pigmented lesions in conjunction with the clinical examination and dermatoscopy.Objectives: This is the first prospective study to identify morphologic descriptors and standardized terminology to examine facial pigmented lesions using FAV. The objectives were to identify FAV indicators, which can assist physicians in diagnosing suspicious flat facial pigmented lesions.Methods: Consecutive equivocal pigmented lesions were retrospective analysed.Histopathological examination was performed for all the lesions. The main cytomorphological and cytoarchitectural FAV features were described and correlated with histopathological characteristics.Results: From January to October 2020, 21 consecutive clinically suspected pigmented lesions in 20 patients were analysed using dermatoscopy and FAV and then surgically excised. Histopathological examination identified lentigo maligna (LM), lentigo maligna melanoma (LMM), solar lentigo (SL), flat seborrheic keratosis (SK) and pigmented actinic keratosis (PAK). Thirteen malignant melanocytic lesions were removed (11 LM, 2 LMM), two were diagnosed as PAK, and the remaining six pigmented lesions were SL-SKs. With FAV, large ovoid pleomorphic and dendritic cells arranged in the intrafollicular disposition, are typical of most malignant melanocytic lesions (12/13, 92.3%). No benign lesions displayed these features. In dermatoscopy, this folliculotropism corresponded to the presence of an annular-granular pattern with slate grey dots that were aggregated asymmetrically around follicular openings.Conclusions: FAV features can provide an improved diagnostic approach in the differential diagnosis of flat pigmented facial lesions.

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“…This presents in the form of gray rhomboid structures or gray circles. Gray circles represent deeper involvement of the hair follicle infundibula [16].…”

Section: Clinical and Dermoscopic Features Of Pak Pbd And Piecmentioning

confidence: 99%

“…Pagetoid spread may be minimal or absent. In contrast, LMM displays atypical melanocytes in single cells and nests within the dermis [16]. The diagnosis of LM and LMM can be challenging due to the extent of ultraviolet damage and/or prior therapeutic intervention like cryosurgery or topical treatments [11].…”

Section: Introductionmentioning

confidence: 99%

Pigmented macules on the head and neck

Gouda

Pyne

Dicker

2022

Dermatol Pract Concept

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Introduction: Differentiating early melanoma from other flat pigmented lesions on the head and neck is challenging both clinically and dermoscopically, partly due to the wide differential diagnosis and the lack of specific diagnostic algorithms. Objectives: To review publications covering the dermoscopic features of pigmented macules on the head and neck. Methods: Embase and PubMed (Medline) database from Jan 2015 to Jan 2021 were searched using a four-step search. Keywords used were dermoscopy/dermatoscopy or epiluminescence microscopy, lentigo maligna (LM), lentigo maligna melanoma (LMM), lichen-planus-like-keratosis (LPLK), solar lentigo (SL), seborrhoeic keratosis (SK), pigmented actinic keratosis (PAK), pigmented Bowen’s disease (pBD), pigmented intraepidermal carcinoma (pIEC) and head and neck. Results: The commonest reported dermoscopic features of facial melanoma were irregular dots, atypical dots/globules, asymmetric pigmented follicular openings (APFO), rhomboid grey/ black structures, increased vascular network, brown globules/dots and a pattern of circles. Pseudopods, radial streaming, blue white veil, irregular blotches, scar-like depigmentation and atypical pigment network were recorded in low frequencies. For PAK, pBD and pIEC perifollicular erythema, white/yellow surface scale, linear wavy vessels around hair follicles, hair follicular openings surrounded by a white halo, evident follicles or follicular or keratotic plugs, rosette sign and sharply demarcated borders were the salient features. Conclusions: Further studies are needed to determine the dermoscopic criteria for pigmented melanocytic and non-melanocytic lesions on the head and neck. Furthermore, there is a gap in the knowledge of site-specific dermoscopic features on specific sites, namely ears, nose, cheeks, scalp and neck which will also benefit from further studies.

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Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma

Cited by 12 publications

References 38 publications

Flat scalp melanoma dermoscopic and reflectance confocal microscopy features correspond to histopathologic type and lesion location

Flat scalp melanoma dermoscopic and reflectance confocal microscopy features correspond to histopathologic type and lesion location

Fluorescence‐advanced videodermatoscopy (FAV) for the differential diagnosis of suspicious facial lesions: A single‐centre experience with pattern analysis and histopathological correlation

Pigmented macules on the head and neck

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