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- Title
Reinterpreting dermoscopic pigment network with reflectance confocal microscopy for identification of melanoma‐specific features.
- Authors
De Pace, B.; Farnetani, F.; Losi, A.; Ciardo, S.; De Carvalho, N.; Cesinaro, A. M.; Reggiani Bonetti, L.; Chester, J.; Kaleci, S.; Del Duca, E.; Nisticò, S. P.; Longo, C.; Pellacani, G.
- Abstract
Abstract: Background: Pigment network is an important dermoscopic feature for melanocytic lesions, but alterations in grid line thickness are also observed in melanomas. Objective: To investigate features of thick, thin and mixed pigment networks at dermoscopy and their respective features at reflectance confocal microscopy (RCM) for differential diagnosis, correlated with histology. Methods: All melanocytic lesions with histological diagnosis, evaluated between January 2010 and May 2014, were enrolled and classified according to dermoscopy evaluation of the pigment networks: thin, thick and mixed. Results: Thin network in melanoma was characterized by a honeycombed pattern (P < 0.001), dendritic cells (P < 0.001), atypical ringed pattern (P = 0.035) and structureless area (P = 0.012), whereas round cells (P < 0.001), dendritic cells (P < 0.001) and atypical meshwork pattern (<0.001) characterized thick network in melanoma. Mixed network type in melanoma shared honeycombed (P = 0.049) and typical ringed patterns (P = 0.045) in the thin area and round cells (P < 0.001) and atypical meshwork pattern (P < 0.001) in the thick area. Thin network in nevi was characterized by cobblestone (P < 0.001) and typical ringed patterns (P = 0.035), whereas thick network in nevi showed a typical meshwork pattern (P < 0.001). Mixed nevi shared the same features and patterns, but more frequently with inflammatory infiltrate (P = 0.047). Conclusion: Differential diagnosis between melanocytic lesions (nevi or melanoma) in thin, thick and mixed pigment networks observed at dermoscopy can be assisted by RCM to improve diagnostic accuracy.
- Subjects
CONFOCAL microscopy; PIGMENT analysis; MELANOMA diagnosis; MELANOMA treatment; DIFFERENTIAL diagnosis
- Publication
Journal of the European Academy of Dermatology & Venereology, 2018, Vol 32, Issue 6, p947
- ISSN
0926-9959
- Publication type
Article
- DOI
10.1111/jdv.14675