Abundance of the benign melanocytic universe: Dermoscopic–histopathological correlation in nevi

Woltsche, Nora; Schmid‐Zalaudek, Karin; Deinlein, Teresa; Rammel, Katrin; Hofmann‐Wellenhof, Rainer; Zalaudek, Iris

doi:10.1111/1346-8138.13808

Cited by 21 publications

(12 citation statements)

References 50 publications

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“…These initial melanomas may be incompletely developed melanomas [ 34 ]. Woltsche et al ., in a review, reanalysed melanocytic lesions and reaffirmed that there are lesions that cannot be classified using the clinical, dermatoscopic and histopathological criteria; such lesions would be termed atypical melanocytic proliferations of uncertain significance [ 35 ]. In this study, atypical melanocytic nevi were identified in 45.1% of the lesions.…”

Section: Discussionmentioning

confidence: 99%

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Campos-do-Carmo¹,

Nobre

Cuzzi

et al. 2021

PLoS ONE

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Early diagnosis when melanoma is still small and thin is essential for improving mortality and morbidity. However, the diagnosis of small size melanoma might be particularly difficult, not only clinically but also dermoscopically. This study aimed to define clinical and dermatoscopic parameters in the diagnosis of suspicious pigmented cutaneous lesions with a diameter of ≤ 6mm and determine the sensitivity, specificity, positive and negative predictive values as well as the accuracy of each clinical and dermatoscopic criterion. This is a transversal, descriptive and analytical study of dermatoscopic analysis with the gold standard being the pathologic examination obtained from the excisional biopsy of suspicious melanocytic lesions with a diameter of ≤ 6mm. Trunk and limb lesion data from a public health service and a private clinic were prospectively collected from 2011 to 2017 by a unique observer. In total, 481 melanocytic lesions were included, with 73.8% being ≤ 4mm in diameter. Overall, 123 were diagnosed as melanoma, 56.0% in situ and 22.0% as thin melanomas (Breslow index 0.1 to 1.0mm). Melanoma presented symmetry in 53.7% of cases, regular borders in 54.5% and a single color in 60.2%. Regarding evolution, 13.8% of melanomas versus 10.9% of benign lesions (p = 0.116) were new by comparing photos from baseline with photos from the follow-up. The majority of melanomas (65%) were found on the limbs compared to 37.2% of the benign lesions at this location (p<0.001). A multiple logistic regression model adjusted for age, gender and location was created. The independent variables associated with the diagnosis of melanoma ≤ 6mm, adjusted for age, gender and location, were: streaks (adjusted Odds Ratio [aOR] 2.5; 95% CI 1.3–4.7; p = 0.006), and the presence of a structureless area (aOR 2.2, 95% CI 1.2–4.0, p = 0.011). Conversely, a symmetric typical pigment network was a protection variable (aOR 0.4, 95% 0.7–0.9, p = 0.040). In conclusion, dermatoscopic criteria have been identified which help to diagnose cases of small size melanoma. These include streaks and structureless areas that can be taken, particularly in consideration for the diagnosis of this subset of small difficult melanomas.

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Section: Discussionmentioning

confidence: 99%

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Campos-do-Carmo¹,

Nobre

Cuzzi

et al. 2021

PLoS ONE

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“…In late adulthood, naevi become dermal or tend 62Á9 (53Á7-68Á4) Calendar year at first visit to disappear in elderly people, especially on areas other than the head and neck. 19 Genes involved in this senescence process are not well established, but BRAF, CDKN2A and telomere genes are likely to play a role 20 in addition to immune-related genes. 21,22 Previous studies on naevus counts have shown that genetic factors are important for naevus patterns.…”

Section: Discussionmentioning

confidence: 99%

Natural history of naevi: a two‐wave study

et al. 2021

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Summary Background Naevi number changes with age. Thus, a better understanding of naevus biology will shed more light on the genetic and environmental factors involved in melanoma development. Objectives To use a two‐wave study to better understand the evolution of naevi in healthy adults. Methods This study is a prospective two‐wave study based on adult twins from the TwinsUK registry (n = 414) who underwent total body naevus counts with an interval of at least 15 years. A negative binomial hierarchical model with two levels, the individual and the twin pair, was used to estimate expected changes in naevus count between the first and second visit, at any specific body site and on the whole body. The model was adjusted for age, calendar year at the first visit, height and skin type. Results The mean age of participants was 46 years at the first visit and 63 years at the second visit (the mean elapsed time between visits was 17 years). An increase in naevus count was observed in 235 (57%) participants and a decrease was observed in 166 (40%). The mean difference in total naevus count between the two visits was nine. The expected total body naevus count increased, on a logarithmic scale, by 0·28 [95% confidence interval (CI) 0·16–0·40] with a change in the incidence rate of total body naevus count of 32% (95% CI 17–49%). However, the observed increase in naevus count over time was observed only on the upper parts of the body, whereas there was no evidence of an increase on the lower parts. Conclusions Naevus counts increased slightly over time at older ages, but this was dependent on body site. The overall decrease in naevus counts previously reported in cross‐sectional studies has not been confirmed by this longitudinal study.

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“…Anatomically, the structure of facial skin has poor rete ridges, and instead, it has a large number of hair follicles. When pigmented cells exist in the epidermis, homogeneous pigmentation is disrupted by unpigmented follicular openings forming pseudonetwork 5 .…”

Section: Discussionmentioning

confidence: 99%

An intuitive explanation of dermoscopic structures by digitally reconstructed pathological horizontal top-down view images

Kasuya

Aoshima

Fukuchi

et al. 2019

Sci Rep

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Dermoscopy is a convenient tool to diagnose melanocytic lesions, especially nevus and melanoma. Various pigmented structures, including pigment network, dots and globules, and streaks, are observed in dermoscopy. Usually, 2D vertical images are used to explain the correlation of dermoscopy and histopathology. However, because the image of dermoscopy is horizontal, it is difficult for the horizontal view of dermoscopy to refer to the vertical view of histopathology. In our study, we digitally reconstructed 2D horizontal top-down view images and 3D aerial images from 50–100 serial 2D vertical sections by using high-speed scanner and 3D software in 6 cases of melanocytic lesion. Our new technology intuitively explained the histopathological structures corresponding to the dermoscopic structures. This technique could be used as a good educational tool for beginners.

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Abundance of the benign melanocytic universe: Dermoscopic–histopathological correlation in nevi

Cited by 21 publications

References 50 publications

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Natural history of naevi: a two‐wave study

An intuitive explanation of dermoscopic structures by digitally reconstructed pathological horizontal top-down view images

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