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Vol. 99. Issue 1.
Pages 44-53 (January - February 2008)
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Vol. 99. Issue 1.
Pages 44-53 (January - February 2008)
Original article
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Dermoscopic Study of Cutaneous Malignant Melanoma: Descriptive Analysis of 45 Cases
Estudio Dermoscópico del Melanoma Maligno Cutáneo: Análisis Descriptivo de 45 Casos
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M de Troya-Martína,
Corresponding author
magdatm@hcs.es

Correspondencia: Alhaurín, 1, 29640 Fuengirola, Málaga, Spain.
, N Blázquez-Sáncheza, I Fernández-Canedoa, M Frieyro-Eliceguia, R Fúnez-Liébanab, F Rivas-Ruizc
a Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, Spain
b Servicio de Anatomía Patológica, Hospital Costa del Sol, Marbella, Málaga, Spain
c Unidad de Investigación, Hospital Costa del Sol, Marbella, Málaga, Spain
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Article information
Abstract
Introduction

Dermoscopy or epiluminescence microscopy is a novel in vivo technique that can be used for the diagnosis of pigmented cutaneous lesions. The aim of this study was to analyze the dermoscopic patterns observed in a consecutive series of primary cutaneous melanomas.

Material and methods

A cross-sectional study was carried out in which clinical, histological, and dermoscopic characteristics were analyzed in 45 primary melanomas.

Results

Two thirds of the series were thin melanomas and 50% were in situ melanomas. According to the ABCD rule, there was clinical suspicion of melanoma in 72% of the lesions. Specific dermoscopic patterns were observed in 93%. A multicomponent pattern was the most commonly observed (71%). A nonspecific pattern was observed in 7% of lesions. The most noteworthy local findings were irregular pigmented patches (80%), irregular dots and globules (68% and 62%), atypical pigmented network (57%), blue-gray veil (42%), and radial streaming and pseudopods (20%). In addition, hypopigmented areas (86%), regression structures (80%), and vascular abnormalities (73%) were also often seen. Acral lesions presented patterns characteristic of these sites.

Conclusion

Analysis of dermoscopic patterns aids early definitive diagnosis of melanoma and is particularly useful in the case of clinically indolent lesions. Dermoscopic findings provide information complementary to that obtained by conventional histology.

Key words:
dermoscopy
epiluminescence microscopy
malignant melanoma
Resumen
Introducción

La dermatoscopia o microscopía de epiluminiscencia es una novedosa técnica de microscopía in vivo útil para el diagnóstico de las lesiones pigmentadas cutáneas. El objetivo del presente trabajo es analizar los patrones dermoscópicos de una serie consecutiva de melanomas cutáneos primarios.

Material y métodos

Se trata de un estudio de corte transversal, en el que se analizan las características clínicas, histológicas y dermoscópicas de 45 melanomas primarios.

Resultados

Las dos terceras partes de la serie eran melanomas de espesor fino y el 50% melanomas in situ. Clínicamente, el 72% de las lesiones eran sospechosas de melanoma (regla ABCD). Dermoscópicamente, el 93% presentaron patrones dermoscópicos específicos. El patrón global más frecuente fue el multicomponente (71%). El 7% de las lesiones mostraron un patrón inespecífico. Los hallazgos locales más destacables fueron las manchas de pigmento irregulares (80%), el retículo pigmentado atípico (57%), los puntos y glóbulos irregulares (68 y 62%), las proyecciones radiales/pseudópodos (20%) y el velo azul-gris (42%). Además, destacó la presencia de áreas hipopigmentadas (86%), estructuras de regresión (80%) y vascularización atípica (73%). Las lesiones acras mostraron patrones característicos de estas localizaciones.

Conclusión

El análisis de patrones dermoscópicos facilita el diagnóstico de certeza del melanoma en estadios precoces, y es particularmente útil en lesiones poco expresivas clínicamente. La identificación de hallazgos dermoscópicos ofrece información complementaria al estudio histológico convencional.

Palabras clave:
dermatoscopia
microscopía de epiluminiscencia
melanoma maligno
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Copyright © 2008. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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