Shiny white streaks: An additional dermoscopic finding in melanomas viewed using contact polarised dermoscopy

Stefani, Alessandro; Campbell, Terri M.; Malvehy, Josep; Massone, Cesare; Soyer, H. Peter; Hofmann‐Wellenhof, Rainer

doi:10.1111/j.1440-0960.2010.00672.x

Cited by 38 publications

(35 citation statements)

References 18 publications

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“…As an example of structures seen only under PD, SWS were described in a variety of lesions including melanomas, BCCs, dermatofibromas, biopsy scars and melanocytic naevi (22)(23)(24)(25). SWS has been suggested to represent dermal fibroplasia seen in benign lesions such as dermatofibromas and scars, and in malignant lesions, due to tumour-induced stromal reaction and extracellular matrix changes (21).…”

Section: Discussionmentioning

confidence: 99%

“…Shiny white streaks (SWS) (also named chrysalis or, as recently proposed, crystalline structures) were described as shiny, bright, often orthogonal, linear streaks, seen only under PD, in dermatofibromas, scars, melanomas, BCCs (21)(22)(23)(24) and, more recently, melanocytic naevi, mainly Spitz naevi (25). recently, a classification of SWS types has been proposed according to different diagnoses (26).…”

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confidence: 99%

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Shiny White Streaks: A Sign of Malignancy at Dermoscopy of Pigmented Skin Lesions

Shitara¹,

Ishioka²,

Alonso-Pinedo³

et al. 2014

Acta Derm Venerol

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The aim of this study was to evaluate the practical importance of the presence of shiny white streaks (SWS) (chrysalis or crystalline structures in polarized dermoscopy) for suspicion of malignancy, diagnosis of melanoma, and pre-operative estimation of Breslow thickness and its correlation with total dermoscopy score (TDS). SWS were present in 13.6% of 800 consecutive excised lesions. The presence of SWS was associated with malignancy (odds ratio (OR) 10.534, 95% confidence interval (95% CI) 6.357-17.455, p < 0.0005) in the context of melanocytic lesions with invasive melanoma (OR 10.333, 95% CI 3.812-28.014) and melanomas with high TDS (OR 6.286, 95% CI 1.673-23.619), but was also a factor in the diagnosis of featureless and some thin melanomas. These results corroborate the clinical applicability of SWS in aiding the diagnosis of malignancy and helping to raise the general dermatologist's awareness in cases of doubt and featureless lesions.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Shiny White Streaks: A Sign of Malignancy at Dermoscopy of Pigmented Skin Lesions

Shitara¹,

Ishioka²,

Alonso-Pinedo³

et al. 2014

Acta Derm Venerol

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“…Indeed, these findings are in line with those of a recent study that demonstrated a statistically significant correlation between the presence of CS and increased depth of invasion. 16 Superficial spreading melanoma begins as in situ melanoma and progresses by dermal invasion with subsequent metastases. The functional interaction of melanoma cells with surrounding neoplastic cells, tumoral stoma, inflammatory milieu, and growth factors is critical, and fibroblasts serve as the major source of extracellular matrix and contribute to melanoma progression.…”

Section: Discussionmentioning

confidence: 99%

The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions

Balagula¹,

Braun²,

Rabinovitz³

et al. 2012

Journal of the American Academy of Dermatology

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BACKGROUND: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy. OBJECTIVES: We sought to estimate the prevalence and assess the clinical significance of CS in melanocytic and nonmelanocytic lesions. METHODS: This was a prospective observational study in which dermatoscopic assessment of lesions was recorded in consecutive patients examined during a 6-month period. In addition, a data set of biopsy-proven melanomas was retrospectively analyzed. RESULTS: In all, 11,225 lesions in 881 patients were prospectively examined. Retrospectively, 229 melanomas imaged with polarized dermatoscopy were analyzed. In the prospective data set, a median of 12.7 lesions (range, 1-54) were evaluated per patient. None of clinically diagnosed Clark nevi (n = 9750, 86.8%) demonstrated CS. Overall, CS were observed in 206 (1.8%) lesions, most commonly dermatofibromas and scars among nonbiopsied lesions. A total of 265 (2.4%) lesions were biopsied, including 20 melanomas and 36 nevi. Among biopsied malignant lesions, CS were most commonly observed in basal cell carcinoma (47.6%) and invasive melanomas (84.6%). Melanomas were more likely to have CS than biopsied nevi (odds ratio = 9.7, 95% confidence interval 2.7-34.1). In the retrospective data set, CS were more commonly observed among invasive melanomas (41%) compared with in situ melanomas (17%) (odds ratio = 3.4, 95% confidence interval 1.9-6.3, P < .001). The prevalence of CS correlated with increased melanoma thickness (P = .001). LIMITATIONS: Biopsied lesions represent a small percentage of the total number of lesions evaluated. CONCLUSION: Among biopsied malignant lesions, CS are most commonly observed in basal cell carcinoma and invasive melanomas and rarely seen in nevi. In melanoma, CS may reflect increased tumor thickness and progression. (2) Background: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy.

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“…8 The differential diagnoses may also include shiny white streaks, metaphorically termed ''chrysalis structures,'' that were defined as thick, short, bright-whitish linear structures, often oriented in an approximately orthogonal or stellate fashion. [12][13][14] These structures can only be seen with polarized dermoscopy and probably correspond to changes in the composition and orientation of the collagen that can also be found in dermatofibroma, basal cell carcinoma, melanoma, and Spitz nevus. 15 When shiny white streaks are orientated in an orthogonal fashion they can simulate a NPN; however, shiny white streaks can be differentiated from NPN because of thick, short, bright-white (not relatively light), straight lines at right angles (not serpiginous) (Fig 3).…”

Section: Preliminary Phase Of the Studymentioning

confidence: 99%

Negative pigment network: An additional dermoscopic feature for the diagnosis of melanoma

Pizzichetta

Talamini

Marghoob

et al. 2013

Journal of the American Academy of Dermatology

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Shiny white streaks: An additional dermoscopic finding in melanomas viewed using contact polarised dermoscopy

Cited by 38 publications

References 18 publications

Shiny White Streaks: A Sign of Malignancy at Dermoscopy of Pigmented Skin Lesions

Shiny White Streaks: A Sign of Malignancy at Dermoscopy of Pigmented Skin Lesions

The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions

Negative pigment network: An additional dermoscopic feature for the diagnosis of melanoma

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