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- Title
Claves dermatoscópicas del melanoma acral lentiginoso.
- Authors
Ortega, Blanca Carlos; Ángeles Garay, Ulises; Gómez, Guillermo
- Abstract
Background: The most frequent type of melanoma in Mexico is acral lentiginous melanoma and affects subungueal, palm and plantar skin, zones which are little exposed to solar light and are protected by a thick layer of corneus stratum. Objective: To identify the most common dermoscopic findings in acral lentiginous melanoma. Material and methods: From 2000 to 2010 it was carried out an analysis of case reports in the Department of Dermatology, Tumor Clinic of National Medical Center La Raza, Mexico City. All lesions were photographed with polarized light and the images were stored on the computer. The algorithm applied in all lesions was the pattern of analysis. The variables studied were: age, sex, topography, time of evolution and dermoscopic findings, of these, we evaluated the crest parallel pattern, irregular diffuse pigmentation and other classic findings of acral melanoma with another topography, as homogeneous pattern, globules, blue veil, pepper-like grains and abrupt termination of the pigment. In the nail apparatus dermoscopic criteria assessed were loss of parallelism, irregular diffuse pigmentation, ulcer, vessels and blue veil. Results: The study included 142 cases of melanoma: 92 women and 50 men. Melanoma most often affected soles, hands and nails. The predominant skin phototype was type III, and we found no relationship between time of evolution and tumor size. We analyzed 12 dermoscopic structures: the crest parallel pattern in 47 tumors, irregular distribution of pigment in 32, ulcers in 25, blue veil in 15, globules in 11, vascular pattern in 11, pepper-like grains in eight, loss of parallelism in six, regression in two, abrupt termination of the pigment in one, homogeneous pattern in one and groove parallel pattern in one. Only two tumors exhibited classic dermoscopic findings (abrupt termination of the pigment and homogeneous blue pattern), which are observed in non-palmoplantar melanomas. In the 13 subungual cases the most frequent dermoscopic findings were loss of parallelism, ulcer and areas of bleeding. Conclusion: In palmoplantar melanoma the most common dermatoscopic findings (crest parallel pattern [CPP] and irregular diffuse pigmentation [IDP]) differ from the findings in other topographies. The CPP and IDP are highly suggestive of malignancy, so its presence indicates that a biopsy should be taken. It should also be noted that the CPP can be found in benign conditions, such as Peutz-Jeghers syndrome and Laugier-Hunziker syndrome, in plantar and cancer drugs-induced warts, among others. Acral lentiginous melanoma can be detected in early stages when using dermoscopy as a diagnostic method.
- Subjects
MELANOMA; MICROSCOPY; DISEASES; SCALP; DERMATOLOGY; HUMAN skin color; BIOPSY
- Publication
Dermatología Revista Mexicana, 2012, Vol 56, Issue 3, p180
- ISSN
0185-4038
- Publication type
Article