Histopathologic tissue correlations of dermoscopic structures

Braun, Ralph; Scope, Alon; Marghoob, Ashfaq A.; Kerl, Katrin; Rabinovitz, Harold; Malvehy, Josep

doi:10.3109/9781841847627.003

Cited by 11 publications

(16 citation statements)

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“…By their very nature they do not demonstrate many of the classical dermatoscopic features of melanoma: brown and black dots require pagetoid spread; thick lines reticular require preservation of rete ridges as well as bridging of rete ridges; pseudopods and radial lines require cords of cells to form [ 15 , 16 ]. When in situ, they will not exhibit a large range of colors.…”

Section: Discussionmentioning

confidence: 99%

Dermatoscopic features of cutaneous non-facial and non-acral lentiginous growth pattern melanomas

Keir

2014

Dermatol Pract Concept

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Background:The dermatoscopic features of facial lentigo maligna (LM), facial lentigo maligna melanoma (LMM) and acral lentiginous melanoma (ALM) have been well described. This is the first description of the dermatoscopic appearance of a clinical series of cutaneous non-facial non-acral lentiginous growth pattern melanomas.Objective:To describe the dermatoscopic features of a series of cutaneous non-facial non-acral lentiginous growth pattern melanomas in an Australian skin cancer practice.Method:Single observer retrospective analysis of dermatoscopic images of a one-year series of cutaneous non-facial, non-acral melanomas reported as having a lentiginous growth pattern detected in an open access primary care skin cancer clinic in Australia. Lesions were scored for presence of classical criteria for facial LM; modified pattern analysis (“Chaos and Clues”) criteria; and the presence of two novel criteria: a lentigo-like pigment pattern lacking a lentigo-like border, and large polygons.Results:20 melanomas occurring in 14 female and 6 male patients were included. Average patient age was 64 years (range: 44–83). Lesion distribution was: trunk 35%; upper limb 40%; and lower limb 25%. The incidences of criteria identified were: asymmetry of color or pattern (100%); lentigo-like pigment pattern lacking a lentigo-like border (90%); asymmetrically pigmented follicular openings (APFO’s) (70%); grey blue structures (70%); large polygons (45%); eccentric structureless area (15%); bright white lines (5%). 20% of the lesions had only the novel criteria and/or APFO’s.Limitations:Single observer, single center retrospective study.Conclusions:Cutaneous non-facial non-acral melanomas with a lentiginous growth pattern may have none or very few traditional criteria for the diagnosis of melanoma. Criteria that are logically expected in lesions with a lentiginous growth pattern (lentigo-like pigment pattern lacking a lentigo-like border, APFO’s) and the novel criterion of large polygons may be useful in increasing sensitivity and specificity of diagnosis of these lesions. Further study is required to establish the significance of these observations.

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Section: Discussionmentioning

confidence: 99%

Dermatoscopic features of cutaneous non-facial and non-acral lentiginous growth pattern melanomas

Keir

2014

Dermatol Pract Concept

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“…4 The role of the pathologist Dermatopathologists routinely evaluate full-thickness skin sections in the vertical plane of a small percentage of the entire specimens volume, whereas dermoscopists evaluate the entire lesion in the horizontal plane but only to a maximum depth of the papillary dermis. 45 Therefore, both techniques are complementary and can be used in the laboratory to improve grossing.…”

Section: Accepted Manuscript 11mentioning

confidence: 99%

Usefulness of dermoscopy to improve the clinical and histopathologic diagnosis of skin cancers

Yélamos

Braun

Liopyris

et al. 2019

Journal of the American Academy of Dermatology

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Multiple studies have shown that dermoscopy increases the sensitivity and specificity for the detection of skin cancers compared to naked-eye examination. Dermoscopy can also lead to the detection of thinner and smaller cancers. Furthermore, dermoscopy leads to more precise selection of lesions requiring excision. In essence, dermoscopy helps clinicians differentiate benign from malignant lesions through the presence or absence of specific dermoscopic structures. Therefore, since most dermoscopic structures have direct histopathologic correlates, dermoscopy can allow the prediction of certain histologic findings present in skin cancers, thus helping select management and treatment options for select types of skin cancers. Visualizing dermoscopic structures in the ex vivo specimens can also be beneficial. It can improve the histologic diagnostic accuracy by targeted step-sectioning in areas of concern, which can be marked by the clinician before sending the specimen to the pathologist, or by the pathologist on the excised specimen in the laboratory. In addition, ex vivo dermoscopy can also be used to select tumor areas with genetic importance since some dermoscopic structures have been related to mutations with theragnostic relevance. In the second article of this continuing medical education series we review the impact of dermoscopy on the diagnostic accuracy of skin cancer, how can dermoscopy affect the histopathologic examination, and which dermoscopic features may be more relevant in terms of histological and genetic prediction.

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“…However, the precise tissue correlates of NPN have been elusive . It had been suggested that NPN corresponds with a histopathological pattern showing elongated non‐pigmented rete ridges and intervening widened dermal papillae (DP) with large pigmented nests of melanocytes . Botella‐Estrada et al .…”

Section: Introductionmentioning

confidence: 99%

“…8 It had been suggested that NPN corresponds with a histopathological pattern showing elongated non-pigmented rete ridges and intervening widened dermal papillae (DP) with large pigmented nests of melanocytes. 2 Botella-Estrada et al 9 hypothesized that NPN correlates with increased collagen in the dermis. In contrast, Pizzichetta et al 3 conducted a systematic correlative study of 7 melanomas and 26 naevi and ascertained that NPN was not associated with fibrosis; however, a specific tissue correlate of NPN could not be identified.…”

Section: Introductionmentioning

confidence: 99%

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A comparative dermoscopic and reflectance confocal microscopy study of naevi and melanoma with negative pigment network

Farnetani

Scope

Mazzoni

et al. 2019

Acad Dermatol Venereol

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Background Negative pigment network (NPN) is a dermoscopic structure observed more frequently among melanomas than naevi. Precise tissue correlates of NPN are still elusive. Objective To describe the reflectance confocal microscopy (RCM) findings underlying NPN in melanocytic neoplasms. Methods We retrospectively identified all melanocytic neoplasms displaying dermoscopic NPN that were imaged with RCM and subsequently biopsied between 2011 and 2015. Images from study lesions (n = 50) were evaluated for dermoscopic and RCM Criteria. Histopathological correlational study was performed in a subset of cases (n = 15). Results The study data set consisted of 21 melanomas (42%) and 29 naevi (58%). Melanomas showed more frequently irregularly shaped globules than naevi (62% vs. 28%, P = 0.03); NPN also tended to be more asymmetrically located among melanomas (86%) than naevi (62%), albeit not significant (P = 0.06). Under RCM, we observed three patterns of dermal papillae (DP): (i) ‘Dark DP’ – whereby DP were devoid of nests and often surrounded by a junctional proliferation as thick‐Rings – this pattern was less common among melanomas (n = 10, 48%) than naevi (n = 23, 79%, P = 0.02); (ii) ‘Bulging DP’ – whereby junctional nests of melanocytes protrude into the DP, often in association with junctional proliferation as Meshwork – with comparable frequency among melanomas (n = 12, 57%) and naevi (n = 23, 79%, P = 0.09) and (iii) ‘Expanded DP’ – whereby junctional and/or dermal nests filled and expanded the DP, often in association with dermal–epidermal junction (DEJ) Clod pattern – seen more commonly among melanomas (n = 15, 71%) than naevi (n = 6, 21%, P < 0.001). Dermoscopy–RCM correlation and comparison to histopathological findings show that the hypo‐pigmented lines of NPN correlate with broadened epidermal retes, which often show overlying surface dells and wedge‐shaped hypergranulosis, while the pigmented globules of NPN correlate with a predominantly‐junctiona of melanocytes along and between the elongated retes. Conclusions Dermoscopic NPN correlates with three DEJ RCM patterns with differing frequency between naevi and melanomas.

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Histopathologic tissue correlations of dermoscopic structures

Cited by 11 publications

References 50 publications

Dermatoscopic features of cutaneous non-facial and non-acral lentiginous growth pattern melanomas

Dermatoscopic features of cutaneous non-facial and non-acral lentiginous growth pattern melanomas

Usefulness of dermoscopy to improve the clinical and histopathologic diagnosis of skin cancers

A comparative dermoscopic and reflectance confocal microscopy study of naevi and melanoma with negative pigment network

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