Reflectance Confocal Microscopy in Lentigo Maligna

Gamo, R. Scott; Pampín, A.; Floristán, Uxúa

doi:10.1016/j.adengl.2016.09.014

Cited by 12 publications

(16 citation statements)

References 20 publications

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“…Imaging showed an irregular honeycomb pattern of keratinocytes, the presence of non‐edged papillae, bright round pagetoid cells and numerous atypical cells at the dermal‐epidermal junction (DEJ) (Figure C). These RCM features were strongly suggestive of lentigo maligna . Complete surgical excision was performed with a 1 cm margin and there was no evidence of recurrence.…”

Section: Lm Scoring System For Rcm Diagnosis (Adapted From Guitera Pmentioning

confidence: 94%

Bedside diagnosis of lentigo maligna with reflectance confocal microscopy

2018

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Section: Lm Scoring System For Rcm Diagnosis (Adapted From Guitera Pmentioning

confidence: 94%

Bedside diagnosis of lentigo maligna with reflectance confocal microscopy

2018

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“…The epidermis shows the presence of atypical, folliculotropic cells, most of them with dendritic morphology. Atypical junctional thickening, caused by atypical cells arranged around the follicles, is observed at the dermoepidermal junction (Fig. ).…”

Section: Introductionmentioning

confidence: 99%

Key dermoscopic signs in the diagnosis and progression of extrafacial lentigo maligna: Evaluation of a series of 41 cases

et al. 2019

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Background/Objectives: Lentigo maligna is usually located on the face. Extrafacial lentigo maligna is less common, and diagnosis of early forms is very difficult. Confocal microscopy of facial and extrafacial lentigo maligna shares the same features (abundant dendritic cells and generalised atypical junctional thickenings) and helps us to identify the dermoscopic features of extrafacial lentigo maligna. Methods:We analysed dermoscopic and clinical features of 41 lesions diagnosed by confocal microscopy of extrafacial lentigo maligna confirmed on histology to identify dermoscopic signs of early lesions.Results: Erased areas on dermoscopy were the clue to diagnose early lesions. At the borders of these areas, very small, round or triangular structures were found. At the lesion periphery, dermoscopy revealed a fine reticular pattern that helped to identify them as a melanocytic lesion. A progressive increase of the number and size of erased areas was accompanied by the appearance of various angulated structures around them (angulated lines, zigzag structures or polygonal structures). Analysis of invasive lesions revealed very large erased areas containing white lines and atypical vascularisation. Conclusions:We have identified the dermoscopic early features and signs of progression by examining the dermoscopic and reflectance confocal microscopy findings of early and invasive extrafacial lentigo maligna.

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“…Presence of dendritic and/or roundish cells has been established as a highly specific RCM pattern for LM/LMM diagnosis . However, Nascimento et al recently showed that dendritic cells in the epidermal layer around the hair follicle are frequently present in PAK.…”

Section: Introductionmentioning

confidence: 99%

Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy

Persechino

Carvalho

Ciardo

et al. 2018

Experimental Dermatology

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Pigmented facial macules are common on sun damage skin. The diagnosis of early stage lentigo maligna (LM) and lentigo maligna melanoma (LMM) is challenging. Reflectance confocal microscopy (RCM) has been proven to increase diagnostic accuracy of facial lesions. A total of 154 pigmented facial macules, retrospectively collected, were evaluated for the presence of already‐described RCM features and new parameters depicting aspects of the follicle. Melanocytic nests, roundish pagetoid cells, follicular infiltration, bulgings from the follicles and many bright dendrites and infiltration of the hair follicle (ie, folliculotropism) were found to be indicative of LM/LMM compared to non‐melanocytic skin neoplasms (NMSNs), with an overall sensitivity of 96% and specificity of 83%. Concerning NMSNs, solar lentigo and lichen planus‐like keratosis resulted better distinguishable from LM/LMM because usually lacking malignant features and presenting characteristic diagnostic parameters, such as epidermal cobblestone pattern and polycyclic papillary contours. On the other hand, distinction of pigmented actinic keratosis (PAK) resulted more difficult, and needing evaluation of hair follicle infiltration and bulging structures, due to the frequent observation of few bright dendrites in the epidermis, but predominantly not infiltrating the hair follicle (estimated specificity for PAK 53%). A detailed evaluation of the components of the folliculotropism may help to improve the diagnostic accuracy. The classification of the type, distribution and amount of cells, and the presence of bulging around the follicles seem to represent important tools for the differentiation between PAK and LM/LMM at RCM analysis.

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Reflectance Confocal Microscopy in Lentigo Maligna

Cited by 12 publications

References 20 publications

Bedside diagnosis of lentigo maligna with reflectance confocal microscopy

Bedside diagnosis of lentigo maligna with reflectance confocal microscopy

Key dermoscopic signs in the diagnosis and progression of extrafacial lentigo maligna: Evaluation of a series of 41 cases

Folliculotropism in pigmented facial macules: Differential diagnosis with reflectance confocal microscopy

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