Distinctive Dermatoscopic Features of Acral Lentiginous Melanoma in Situ from Plantar Melanocytic Nevi and Their Histopathologic Correlation

1998 ◽  
Vol 2 (4) ◽  
pp. 199-204 ◽  
Author(s):  
Yasuhiro Kawabata ◽  
Kunihiko Tamaki
Keyword(s):  
Skin Lesions ◽  
Melanocytic Nevus ◽  
Entire Surface ◽  
Acral Lentiginous Melanoma ◽  
Melanocytic Nevi ◽  
Melanoma In Situ ◽  
Technical Advances ◽  
Surface Profiles ◽  
Histopathologic Findings

Background: An acral lentiginous melanoma in situ on the sole is often difficult to differentiate with the naked eye from an acquired plantar melanocytic nevus. Recent technical advances in epiluminescence microscopy have contributed to the differentiation of these two pigmented skin lesions. Objective: In this study, the correlation between dermatoscopic and histopathologic findings of acral lentiginous melanoma in situ on the sole are compared to those of acquired plantar melanocytic nevi. Methods: Three acral lentiginous melanomas in situ on the sole, and two cases of acral lentiginous melanoma were compared with 50 acquired plantar melanocytic nevi by means of dermatoscopy and histopathology. Results: The dermatoscopic surface profiles of acquired melanocytic nevi were composed of linear pigmentation accentuated mainly on the sulcus superficialis. Histologically, some areas of the sulcus superficialis corresponded to rete ridges of the epidermis, and nests of nevus cells were also often located there. In contrast, the acral lentiginous melanomas in situ showed diffuse, irregularly shaped pigmentation distributed in a disorderly fashion over the entire surface. Histologically, isolated areas of proliferation and small nest formations of atypical melanocytes were irregularly distributed in the epidermis. Conclusion: A distinctive dermatoscopic feature of acral lentiginous melanoma in situ is diffuse and irregular pigmentation over the entire surface of the lesion. This feature is helpful for differentiating acral lentiginous melanoma in situ from acquired plantar melanocytic nevi.

scholarly journals Intracorneal Hematoma Showing Clinical and Dermoscopic Features of Acral Lentiginous Melanoma

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Ugur Uslu ◽  
Franz Heppt ◽  
Michael Erdmann
Keyword(s):  
Correct Diagnosis ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Melanocytic Nevus ◽  
Careful Examination ◽  
Acral Lentiginous Melanoma ◽  
Melanoma In Situ ◽  
Malignant Skin ◽  
Rule Out

Intra- and subcorneal hematoma, a skin alteration seen palmar and plantar after trauma or physical exercise, can be challenging to distinguish from in situ or invasive acral lentiginous melanoma. Thus, careful examination including dermoscopic and histologic assessment may be necessary to make the correct diagnosis. We here present a case of a 67-year-old healthy female patient who presented with a pigmented plantar skin alteration. Differential diagnoses included benign skin lesions, for example, hematoma or melanocytic nevus, and also acral lentiginous melanoma or melanoma in situ. Since clinical and dermoscopic examinations did not rule out a malignant skin lesion, surgical excision was performed and confirmed an intracorneal hematoma. In summary, without adequate physical trigger, it may be clinically and dermoscopically challenging to make the correct diagnosis in pigmented palmar and plantar skin alterations. Thus, biopsy or surgical excision of the skin alteration may be necessary to rule out melanoma.

Acral Junctional Nevus Versus Acral Lentiginous Melanoma In Situ: A Differential Diagnosis That Should Be Based on Clinicopathologic Correlation

2011 ◽  
Vol 135 (7) ◽  
pp. 847-852
Author(s):  
Francisco Bravo Puccio ◽  
Cesar Chian
Keyword(s):  
Clinical Picture ◽  
Correct Diagnosis ◽  
Complete Excision ◽  
Acral Lentiginous Melanoma ◽  
Clear Cut ◽  
Melanoma In Situ ◽  
Histopathologic Findings ◽  
Cell Proliferations ◽  
Early Phases

Abstract Context.—Acral lentiginous melanoma is the most prevalent clinical presentation of melanoma in ethnic groups other than whites and also occurs in significant numbers in North America and Europe. Despite a clear-cut clinical picture, histologic findings seen in partial biopsies may be too subtle and deceive pathologists dealing with such cases. Objectives.—To make pathologists aware of the histologic findings during early phases of acral lentiginous melanoma (including the in situ phase), to compare those findings with what is seen in acral junctional nevus, and to highlight their similarities and differences. This review will also emphasize the important clinical and dermatoscopic findings to be considered when diagnosing acral lentiginous melanoma. Data Sources.—Review of published articles on the epidemiology; the clinical, dermatoscopic, and histopathologic findings; and the molecular biology of acral lentiginous melanoma as well as the personal experience of the authors when dealing with such cases. Conclusions.—Acral lentiginous melanoma is a clinicopathologic entity with a clear-cut clinical picture: a diameter larger than 0.7 mm; ill-defined, darkly pigmented, flat lesion with irregular borders on acral locations; and the presence of mostly single-cell proliferations of melanocytes along the dermo-epidermal junction. Along with a few additional criteria, these findings should be sufficient to allow the pathologist to make the diagnosis and to recommend complete excision. Fluent communication between clinician and pathologist will facilitate a correct diagnosis.

Does Shave Biopsy Accurately Predict the Final Breslow Depth of Primary Cutaneous Melanoma?

2009 ◽  
Vol 75 (5) ◽  
pp. 369-373 ◽  
Author(s):  
Phillip Moore ◽  
Jon Hundley ◽  
Jennifer Hundley ◽  
Edward A. Levine ◽  
Phillip Williford ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Residual Disease ◽  
Tumor Stage ◽  
Skin Lesions ◽  
Tumor Depth ◽  
Primary Cutaneous Melanoma ◽  
Tumor Registry ◽  
Melanoma In Situ ◽  
Additional Surgery

Shave biopsy (SB) is used for the diagnosis of suspicious skin lesions, including melanoma. Its accuracy for melanoma has not been confirmed. We examined our experience with SB to determine its ability to predict true Breslow depth (BD). We performed a retrospective review of the tumor registry for all patients diagnosed with melanoma by SB from 1995 to 2004. Site and depth of lesion, tumor stage, correlation of BD between SB and wide local excision (WLE), and changes in surgical management due to discordance were examined. Melanoma-in-situ was defined as a depth of 0 for this analysis. One hundred thirty-nine patients were diagnosed with melanoma by SB. Pathology after WLE were as follows: 54 (39%) patients had no residual disease, 67 (48%) had a BD equal to or less than the SB, and 18 (13%) had a thicker BD compared with the SB. For these 18 patients, the median BD by SB and WLE was 1.1 mm (range 0-6.5) and 3.5 mm (range 0.5-20.5), respectively ( P = 0.0017). Upstaging of final BD from SB to WLE was significantly associated with increasing tumor depth and higher stage of melanoma ( P < 0.0001). Only seven of the 139 patients (5%) required further surgery because of the increased depth of the WLE. SB underestimated the final BD of melanoma in 13 per cent of patients, but changed the management of few patients. SB is a valuable tool for practitioners in the diagnosis of melanoma. Nevertheless, patients diagnosed with melanoma by SB should be counseled about the rare need for additional surgery.

Histologic Spectrum of Melanocytic Nevi Removed from Patients > 60 Years of Age

2007 ◽  
Vol 11 (5) ◽  
pp. 168-173 ◽  
Author(s):  
Magda Martinka ◽  
Andrea K. Bruecks ◽  
Martin J. Trotter
Keyword(s):  
Growth Pattern ◽  
Older Patients ◽  
Older Individuals ◽  
Younger Adults ◽  
Melanocytic Nevi ◽  
Dysplastic Nevus ◽  
Melanoma In Situ ◽  
Intradermal Nevus ◽  
Consensus Diagnosis

Background: The histology of melanocytic nevi removed from older patients often differs from that of nevi from younger adults. According to the literature, the most common nevus in older individuals is the intradermal nevus, and purely junctional nevi are rare and should alert the pathologist to a possible melanoma precursor. Objective: To evaluate the histologic features of melanocytic nevi removed from patients > 60 year of age. Methods: Biopsies of nevi ( N = 215) from 172 patients > 60 years (mean age 69 ± 7 years) were examined retrospectively by three dermatopathologists, a consensus diagnosis was rendered, and the spectrum of histologic features was documented. Results: Junctional melanocytic nevi were frequently diagnosed in older patients (21% of cases) and a lentiginous, often heavily pigmented growth pattern was common (12% of nevi). Severely atypical (dysplastic) changes were found in 6% of nevi removed from older patients. Conclusions: We conclude that benign junctional nevi are relatively common in older patients and that a lentiginous, heavily pigmented growth pattern, traditionally associated with younger individuals, is often seen in both junctional and compound nevi in this older age group. This pattern must be differentiated from dysplastic nevus and melanoma in situ, which they may clinically resemble.

scholarly journals Melanomas and Dysplastic Nevi Differ in Epidermal CD1c+ Dendritic Cell Count

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Grzegorz Dyduch ◽  
Katarzyna Ewa Tyrak ◽  
Anna Glajcar ◽  
Joanna Szpor ◽  
Magdalena Ulatowska-Białas ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Dendritic Cell ◽  
Cell Count ◽  
Immune Surveillance ◽  
Melanocytic Nevi ◽  
Dysplastic Nevi ◽  
Melanoma In Situ ◽  
Significant Difference ◽  
The Mean

Background. Dendritic cells could be involved in immune surveillance of highly immunogenic tumors such as melanoma. Their role in the progression melanocytic nevi to melanoma is however a matter of controversy. Methods. The number of dendritic cells within epidermis, in peritumoral zone, and within the lesion was counted on slides immunohistochemically stained for CD1a, CD1c, DC-LAMP, and DC-SIGN in 21 of dysplastic nevi, 27 in situ melanomas, and 21 invasive melanomas. Results. We found a significant difference in the density of intraepidermal CD1c+ cells between the examined lesions; the mean CD1c cell count was 7.00/mm2 for invasive melanomas, 2.94 for in situ melanomas, and 13.35 for dysplastic nevi. The differences between dysplastic nevi and melanoma in situ as well as between dysplastic nevi and invasive melanoma were significant. There was no correlation in number of positively stained cells between epidermis and dermis. We did not observe any intraepidermal DC-LAMP+ cells neither in melanoma in situ nor in invasive melanoma as well as any intraepidermal DC-SIGN+ cells in dysplastic nevi. Conclusion. It was shown that the number of dendritic cells differs between dysplastic nevi, in situ melanomas, and invasive melanomas. This could eventually suggest their participation in the development of melanoma.

Acral Lentiginous Melanoma in Situ

1982 ◽  
Vol 70 (5) ◽  
pp. 615 ◽  
Author(s):  
Lynn R. Dondero ◽  
Stephen H. Miller ◽  
Clifton White ◽  
Robert J. Demuth ◽  
Stephen H. Milier
Keyword(s):  
Acral Lentiginous Melanoma ◽  
Melanoma In Situ

scholarly journals A 9-Year Teledermoscopy Service: Retrospective Service Review

Iproceedings ◽  
10.2196/35401 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e35401
Author(s):  
Novell Shu Chyng Teoh ◽  
Amanda Oakley
Keyword(s):  
Waiting Time ◽  
Conflicts Of Interest ◽  
Significant Risk ◽  
Patient Characteristics ◽  
Skin Lesions ◽  
Number Needed To Treat ◽  
Melanoma In Situ ◽  
Male Sex

Background A teledermoscopy service was established in January 2010, where patients attended nurse-led clinics for imaging of lesions of concern and remote diagnosis by a dermatologist. Objective The study aimed to review the number of visits, patient characteristics, the efficiency of the service, and the diagnoses made. Methods We evaluated the waiting time and diagnosis of skin lesions for all patient visits from January 1, 2010, to May 31, 2019. The relationships between patient characteristics and the diagnosis of melanoma were specifically analyzed. Results The teledermoscopy clinic was attended by 6479 patients for 11,005 skin lesions on 8805 occasions. Statistically significant risk factors for the diagnosis of melanoma/melanoma in situ were male sex, European ethnicity, and Fitzpatrick skin type 2. Attendance was maximal during 2015 and 2016. The seasonal variation in visits 2011-2018 revealed a consistent peak at the end of summer and a dip at the end of winter. In the year 2010, 306 patients attended; 76% (233/306) of these were discharged to primary care and 24% (73/306) were referred to hospital for specialist assessment. For patients diagnosed by the dermatologist with suspected melanoma from January 1, 2010, to May 31, 2019, the median waiting time for an imaging appointment was 44.5 days (average 57.9 days, range 8-218 days). The most common lesions diagnosed were benign naevus (2933/11,005, 27%), benign keratosis (2576/11,005, 23%), and keratinocytic cancer (1707/11,005, 15%); melanoma was suspected in 5% (507/11,005) of referred lesions (Multimedia Appendix 1). The positive predictive value of melanoma/melanoma in situ was 61.1% (320 true positives and 203 false positives). The number needed to treat (ie, the ratio of the total number of excisions to the number with a histological diagnosis of melanoma/melanoma in situ) was 2.02. Conclusions Diagnoses were comparable to the experience of other teledermoscopy services. Teledermoscopy using a nurse-led imaging clinic can provide efficient and convenient access to dermatology by streamlining referrals to secondary care and prioritizing patients with skin cancer for treatment. Conflicts of Interest None declared.

Acral lentiginous melanoma in situ arising from compound nevus.

1989 ◽  
Vol 51 (6) ◽  
pp. 1134-1138 ◽  
Author(s):  
Masashi KANAMORI ◽  
Masayuki SHIMIZU
Keyword(s):  
Acral Lentiginous Melanoma ◽  
Melanoma In Situ
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