An atypical pigmented lesion
نویسندگان
چکیده
BACKGROUND The dermatoscopic features of facial lentigo maligna (LM), facial lentigo maligna melanoma (LMM) and acral lentiginous melanoma (ALM) have been well described. This is the first description of the dermatoscopic appearance of a clinical series of cutaneous non-facial non-acral lentiginous growth pattern melanomas. OBJECTIVE To describe the dermatoscopic features of a series of cutaneous non-facial non-acral lentiginous growth pattern melanomas in an Australian skin cancer practice. METHOD Single observer retrospective analysis of dermatoscopic images of a one-year series of cutaneous non-facial, non-acral melanomas reported as having a lentiginous growth pattern detected in an open access primary care skin cancer clinic in Australia. Lesions were scored for presence of classical criteria for facial LM; modified pattern analysis ("Chaos and Clues") criteria; and the presence of two novel criteria: a lentigo-like pigment pattern lacking a lentigo-like border, and large polygons. RESULTS 20 melanomas occurring in 14 female and 6 male patients were included. Average patient age was 64 years (range: 44-83). Lesion distribution was: trunk 35%; upper limb 40%; and lower limb 25%. The incidences of criteria identified were: asymmetry of color or pattern (100%); lentigo-like pigment pattern lacking a lentigo-like border (90%); asymmetrically pigmented follicular openings (APFO's) (70%); grey blue structures (70%); large polygons (45%); eccentric structureless area (15%); bright white lines (5%). 20% of the lesions had only the novel criteria and/or APFO's. LIMITATIONS Single observer, single center retrospective study. CONCLUSIONS Cutaneous non-facial non-acral melanomas with a lentiginous growth pattern may have none or very few traditional criteria for the diagnosis of melanoma. Criteria that are logically expected in lesions with a lentiginous growth pattern (lentigo-like pigment pattern lacking a lentigo-like border, APFO's) and the novel criterion of large polygons may be useful in increasing sensitivity and specificity of diagnosis of these lesions. Further study is required to establish the significance of these observations.
منابع مشابه
An irregular pigmented lesion on the back
An 87-year-old woman with a history of multiple basal cell carcinomas presented to a follow-up visit referring a pigmented, slowly growing lesion on her right scapula that had been present for one year. Physical examination revealed an irregular 12 x 5 mm well circumscribed pigmented lesion with an elevated keratotic surface (Figure 1). The dermoscopic evaluation revealed a multicomponent patte...
متن کاملPigmented or Hemosiderotic Atypical Fibroxanthoma
Manuscript accepted for publication July 21, 2008. Abstract. Pigmented atypical fibroxanthoma is a rare variant of atypical fibroxanthoma and is characterized by extensive areas of hemorrhage, erythrophagocytosis, and hemosiderin accumulation in the cytoplasm of the neoplastic cells. It affects elderly individuals and presents as irregularly pigmented, dome-shaped nodules or plaques on areas of...
متن کاملAn atypical pigmented lesion of the nose
A 56-year-old Caucasian woman, with skin phototype III, presented with an asymptomatic, slow-growing, gray-black plaque on her nose. The lesion had appeared almost 6 months prior, was 10 × 5 mm in size and presented with a paler, raised and scaly central area (Figure 1). This area could be hardly differentiated from ulceration, however, that was excluded on histology. Dermatoscopy with a non-co...
متن کاملAtypical Presentation of a Pigmented Oncocytoma of the Caruncle: A Case Report
We report an unusual case of a pigmented oncocytoma of the caruncle. The lesion presented the following atypical features: a well-circumscribed, partially pigmented, and lobulated mass that macroscopically resembled a caruncular nevus. However, an excision biopsy revealed an oncocytoma instead. Thus, although nevi are the most common lesions found in the caruncle, oncocytoma should also be cons...
متن کاملAn atypical pigmented lesion on the nose—Answer
PCSCC is a variant of invasive squamous cell carcinoma, with less than 20 cases reported, to our knowledge, in the English literature [1,2]. PCSCC had been more often reported to occur in the oral mucosa and conjunctiva [3]. Pigmentation is probably due to cytokines secreted by tumoral cells that stimulate melanocytes to produce melanin [4]. In some cases, PCSCC may be the malignant progression...
متن کامل