The Zig-Zag Pattern of Lentigo Maligna

Slutsky, Jordan B.; Marghoob, Ashfaq A.

doi:10.1001/archdermatol.2010.307

Cited by 28 publications

(20 citation statements)

References 1 publication

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“…For example the term “zig-zag pattern” 36 (similar to “polygons” 98 or “angulated lines” 99 ) that has been introduced to describe a specific clue to lentigo maligna is relatively new but relatively high up on the familiarity level when compared with other terms published in the same year. Familiarity and usage in the community are important measures of the practical utility and we used them as objective criteria for inclusion in the standardized dictionary.…”

Section: Discussionmentioning

confidence: 99%

“…They rather constitute a family of terms with similar meanings. An example would be the family “rhomboids,” “polygons,” “angulated lines,” and “zig-zag pattern.” “Rhomboids” was introduced years ago 107 to describe the angulated pigmented lines around follicular openings in lentigo maligna (the new term “zig-zag” pattern 36 can be regarded as a variant of rhomboids on facial skin). “Angulated lines” 99 and “polygons” 98 and have been introduced recently to characterize pigmented lines that form angles in flat melanomas on nonfacial, sun-damaged skin (Fig 3, B ).…”

Section: Discussionmentioning

confidence: 99%

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Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy

Kittler

Marghoob

Argenziano

et al. 2016

Journal of the American Academy of Dermatology

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246

208

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Background Evolving dermoscopic terminology motivated us to initiate a new consensus. Objective We sought to establish a dictionary of standardized terms. Methods We reviewed the medical literature, conducted a survey, and convened a discussion among experts. Results Two competitive terminologies exist, a more metaphoric terminology that includes numerous terms and a descriptive terminology based on 5 basic terms. In a survey among members of the International Society of Dermoscopy (IDS) 23.5% (n = 201) participants preferentially use descriptive terminology, 20.1% (n = 172) use metaphoric terminology, and 484 (56.5%) use both. More participants who had been initially trained by metaphoric terminology prefer using descriptive terminology than vice versa (9.7% vs 2.6%, P < .001). Most new terms that were published since the last consensus conference in 2003 were unknown to the majority of the participants. There was uniform consensus that both terminologies are suitable, that metaphoric terms need definitions, that synonyms should be avoided, and that the creation of new metaphoric terms should be discouraged. The expert panel proposed a dictionary of standardized terms taking account of metaphoric and descriptive terms. Limitations A consensus seeks a workable compromise but does not guarantee its implementation. Conclusion The new consensus provides a revised framework of standardized terms to enhance the consistent use of dermoscopic terminology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy

Kittler

Marghoob

Argenziano

et al. 2016

Journal of the American Academy of Dermatology

Self Cite

246

208

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“…The presence of geometric structures in melanoma has been previously described: rhomboidal structures in facial lentigo maligna [3,6], the geometric cutaneous sign [17], and a “zig-zag” pattern in facial lentigo maligna [18]. The presence of the large polygons defined by straight lines and often centred around follicles remains to be explained and verified, but may be due to regression phenomena.…”

Section: Discussionmentioning

confidence: 99%

Dermatoscopic features of cutaneous non-facial and non-acral lentiginous growth pattern melanomas

Keir

2014

Dermatol Pract Concept

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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.

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“…The investigators were asked to assess the presence of predefined clinical and dermoscopic criteria. The selection of dermoscopic criteria was based on the available literature . Furthermore, we added into the dermoscopic evaluation a new criterion, which we named ‘evident follicles’.…”

Section: Methodsmentioning

confidence: 99%

“…This is because early facial melanoma (lentigo maligna type, LM), pigmented actinic keratosis (PAK) and solar lentigo/early seborrhoeic keratosis (SL/SK) may show overlapping morphological features . Even though significant progress has been made in differentiating LM from SL/SK by means of dermoscopy, its differentiation from PAK still remains troublesome …”

mentioning

confidence: 99%

Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis

et al. 2016

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The Zig-Zag Pattern of Lentigo Maligna

Cited by 28 publications

References 1 publication

Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy

Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy

Dermatoscopic features of cutaneous non-facial and non-acral lentiginous growth pattern melanomas

Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis

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