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Amelanotic/hypomelanotic lentigo maligna: Dermoscopic and confocal features predicting diagnosis

Title: Amelanotic/hypomelanotic lentigo maligna: Dermoscopic and confocal features predicting diagnosis
Authors: Pizzichetta, Maria A; Polesel, Jerry; Perrot, Jean L; Rubegni, Pietro; Fiorani, Diletta; Rizzo, Arianna; Stanganelli, Ignazio; Magi, Serena; Mazzoni, Laura; Medri, Matelda; Dominici, Michele M; Toffolutti, Federica; Farnetani, Francesca; Lippolis, Nicola; Pedroni, Gioia; Ciardo, Silvana; Condorelli, Alessandra G; Conforti, Claudio; Pellacani, Giovanni; Zalaudek, Iris; Puglisi, Fabio; Cinotti, Elisa
Contributors: Pizzichetta, Maria A; Polesel, Jerry; Perrot, Jean L; Rubegni, Pietro; Fiorani, Diletta; Rizzo, Arianna; Stanganelli, Ignazio; Magi, Serena; Mazzoni, Laura; Medri, Matelda; Dominici, Michele M; Toffolutti, Federica; Farnetani, Francesca; Lippolis, Nicola; Pedroni, Gioia; Ciardo, Silvana; Condorelli, Alessandra G; Conforti, Claudio; Pellacani, Giovanni; Zalaudek, Iri; Puglisi, Fabio; Cinotti, Elisa
Publication Year: 2023
Collection: Università degli studi di Trieste: ArTS (Archivio della ricerca di Trieste)
Subject Terms: lentigo maligna; amelanotic melanoma; dermatoscopy; reflectance confocal microscopy; melanocytic skin lesion; nonmelanocytic skin lesions
Description: Background Amelanotic/hypomelanotic lentigo maligna and lentigo maligna melanoma (AHLM/LMM) may be very difficult to diagnose at an early stage. Objectives To quantify the predictive value of dermoscopic and reflectance confocal microscopy (RCM) features for AHLM/LMM. Methods Dermoscopic and RCM images of histopathologically diagnosed AHLM/LMM, amelanotic/hypomelanotic benign lesions (AHBL), and amelanotic/hypomelanotic basal and squamous cell carcinomas (AHBCC/AHSCC) of the head and neck from consecutive patients were retrospectively collected and blindly evaluated by three observers to assess presence or absence of dermoscopic and RCM criteria. Results Overall, 224 lesions in 216 patients including LM/LMM (n = 55, 24.6%), AHBL (n = 107, 47.8%) and AHBCC/AHSCC (n = 62, 27.7%) were analysed. Multivariable analysis showed that milky-red areas (OR = 5.46; 95% CI: 1.51-19.75), peripheral light brown structureless areas (OR = 19.10; 4.45-81.96), linear irregular vessels (OR = 5.44; 1.45-20.40), and asymmetric pigmented follicles (OR = 14.45; 2.77-75.44) at dermoscopy, and >= 3 atypical cells in five fields (OR = 10.12; 3.00-34.12) and focal follicular localization of atypical cells at dermo-epidermal junction (DEJ) (OR = 10.48; 1.10-99.81) at RCM were significantly independent diagnostic factors for AHLM/LMM vs. AHBL. In comparison with AHBCC/AHSCC, peripheral light brown structureless area (OR = 7.11; 1.53-32.96), pseudonetwork around hair follicles (OR = 16.69; 2.73-102.07), and annular granular structures (OR = 42.36; 3.51-511.16) at dermoscopy and large dendritic (OR = 6.86; 3.15-38.28) and round pagetoid cells (OR = 26.78; 3.15-227.98) at RCM led to a significantly increased risk of diagnosing AHLM/LMM. Conclusions Amelanotic/hypomelanotic lentigo maligna and lentigo maligna melanoma may have the same dermoscopic features of AHM on other body sites, such as milky red areas, peripheral light brown structureless areas and linear irregular vessels. These features, asymmetric pigmented follicles and at RCM >= ...
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36196781; info:eu-repo/semantics/altIdentifier/wos/WOS:000868697200001; volume:37; issue:2; firstpage:303; lastpage:310; numberofpages:8; journal:JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY; https://hdl.handle.net/11368/3034298
DOI: 10.1111/jdv.18636
Availability: https://hdl.handle.net/11368/3034298; https://doi.org/10.1111/jdv.18636; https://onlinelibrary.wiley.com/doi/10.1111/jdv.18636
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.6B075A18
Database: BASE