Pigmentation in a scar: Use of dermoscopy in the management decision

Moscarella, Elvira; Argenziano, Giuseppe; Lallas, Aimilios; Longo, Caterina; Jalbout, Samer Al; Zalaudek, Iris

doi:10.1016/j.jaad.2013.03.008

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…Specifically, naevi typically recur quickly (up to 6 months after excision), and the recurring pigmentation is restricted within the scar of the previous excision. In contrast, melanoma usually recurs several months to years after excision and tends to expand beyond the borders of the scar onto the normal skin Sclerosing naevi with pseudomelanomatous features.…”

Section: False‐positive Tumoursmentioning

confidence: 99%

See 1 more Smart Citation

The limitations of dermoscopy: false‐positive and false‐negative tumours

Papageorgiou

Apalla

Sotiriou

et al. 2018

Acad Dermatol Venereol

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Dermoscopy has been documented to increase the diagnostic accuracy of clinicians evaluating skin tumours, improving their ability to detect skin cancer and better recognize benign moles. However, dermoscopically 'false-positive' and 'false-negative' tumours do exist. False-positive diagnosis usually leads to unnecessary excisions. False-negative diagnosis is much more dangerous, as it might result in overlooking a cancer, with severe undesirable consequences for the patient and the physician. Therefore, management strategies should mainly focus on addressing the risk of dermoscopically false-negative tumours. The most frequent benign tumours that might acquire dermatoscopic characteristics suggestive of malignancy are seborrhoeic keratosis (SK), including solar lentigo, melanoacanthoma, irritated, clonal and regressive SK, angioma (mainly thrombosed angioma and angiokeratoma), dermatofibroma, benign adnexal tumours and naevi (Clark, Spitz, recurrent, combined, sclerosing). The most useful clues to recognize these tumours are the following: solar lentigo - broad network; melanoacanthoma - sharp border; irritated SK - regularly distributed white perivascular halos; clonal SK - classic SK criteria; regressive SK - remnants of SK; targetoid haemosiderotic haemangioma - dark centre and reddish periphery; thrombosed angioma - sharp demarcation; angiokeratoma - dark lacunae; atypical dermatofibromas - palpation; follicular tumours - white colour; sebaceous tumours - yellow colour; Clark naevi - clinical context; Spitz/Reed naevi - age; combined naevi - blue central area; recurrent naevi - pigmentation within the scar; sclerosing naevi - age and location on the upper back; blue naevi - history. Malignant tumours that might mimic benign ones and escape detection are melanoma (in situ, nevoid, spitzoid, verrucous, regressive, amelanotic), squamous cell carcinoma (mainly well-differentiated variants) and rarely basal cell carcinoma (non-pigmented variants). The most useful clues to recognize the peculiar melanoma subtypes are as follows: melanoma in situ - irregular hyperpigmented areas; nevoid melanoma - history of growth; spitzoid melanoma - age; verrucous melanoma - blue-black sign; regressive melanoma - peppering or scar-like depigmentation; amelanotic melanoma - pink colour, linear irregular vessels, dotted vessels. In this article, we summarized the most frequent dermoscopic variations of common skin tumours that are often misinterpreted, aiming to assist clinicians to reduce the number of false diagnoses.

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Section: False‐positive Tumoursmentioning

confidence: 99%

“…In contrast, melanoma usually recurs several months to years after excision and tends to expand beyond the borders of the scar onto the normal skin. 24 • Sclerosing naevi with pseudomelanomatous features. This peculiar naevus subtype might clinically and histopathologically mimic regressive melanoma.…”

Section: Naevimentioning

confidence: 99%

The limitations of dermoscopy: false‐positive and false‐negative tumours

Papageorgiou

Apalla

Sotiriou

et al. 2018

Acad Dermatol Venereol

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“…The most frequently described dermoscopic features of reactive pigmentations includes: a homogeneous radial band-like and continuous brownish lines that perpendicularly to the scar [1]. This case report describes unusual dermoscopic characteristics of reactive pigmentation within a skin graft, resembling a recurrence of LM.…”

Section: Discussionmentioning

confidence: 82%

Reactive pigmentation of skin graft mimicking a lentigo maligna recurrence: A Case Report

Vera

Gárate

Vega

et al. 2022

Dermatol Pract Concept

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“…Our observation may be significant also because such cases should be differentiated clinically and dermoscopically with other situations characterized by newly developing pigmentation within a scar. According to Moscarella et al, 11 such a differentiation should include recurrent nevus, recurrent melanoma, and melanotic reactive pigmentation. Recurrent nevus is characterized by rapid development that is confined within the scar, and, dermoscopically, by irregular network, globules or streaks.…”

Section: Discussionmentioning

confidence: 99%