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Gouda G, Pyne J, Dicker T. Pigmented Macules on the Head and Neck: A Systematic Review of Dermoscopy Features. Dermatol Pract Concept 2022; 12:e2022194. [PMID: 36534577 PMCID: PMC9681183 DOI: 10.5826/dpc.1204a194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Differentiating early melanoma from other flat pigmented lesions on the head and neck is challenging both clinically and dermoscopically, partly due to the wide differential diagnosis and the lack of specific diagnostic algorithms. OBJECTIVES To review publications covering the dermoscopic features of pigmented macules on the head and neck. METHODS Embase and PubMed (Medline) database from January 2015 to January 2021 were searched using a four-step search. Keywords used were dermoscopy/dermatoscopy or epiluminescence microscopy, lentigo maligna, lentigo maligna melanoma, lichen-planus-like-keratosis, solar lentigo, seborrheic keratosis, pigmented actinic keratosis (PAK), pigmented Bowen disease (pBD), pigmented intraepidermal carcinoma (pIEC) and head and neck. RESULTS The commonest reported dermoscopic features of facial melanoma were irregular dots, atypical dots/globules, asymmetric pigmented follicular openings, rhomboid gray/black structures, increased vascular network, brown globules/dots and a pattern of circles. Pseudopods, radial streaming, blue white veil, irregular blotches, scar-like depigmentation and atypical pigment network were recorded in low frequencies. For PAK, pBD and pIEC perifollicular erythema, white/yellow surface scale, linear wavy vessels around hair follicles, hair follicular openings surrounded by a white halo, evident follicles or follicular or keratotic plugs, rosette sign and sharply demarcated borders were the salient features. CONCLUSIONS Further studies are needed to determine the dermoscopic criteria for pigmented melanocytic and non-melanocytic lesions on the head and neck. Furthermore, there is a gap in the knowledge of site-specific dermoscopic features on specific sites, namely ears, nose, cheeks, scalp and neck which will also benefit from further studies.
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Affiliation(s)
- Gracy Gouda
- Faculty of Health Sciences, University of New South Wales, Sydney, Australia
- Faculty of Medicine, University of Queensland, Australia
| | - John Pyne
- Faculty of Health Sciences, University of New South Wales, Sydney, Australia
| | - Tony Dicker
- Faculty of Medicine, University of Queensland, Australia
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Garbarino F, Pampena R, Lai M, Pereira AR, Piana S, Cesinaro AM, Cinotti E, Fiorani D, Ciardo S, Farnetani F, Chester J, Pellacani G, Guitera P, Longo C. Flat scalp melanoma dermoscopic and reflectance confocal microscopy features correspond to histopathologic type and lesion location. J Eur Acad Dermatol Venereol 2021; 35:1670-1677. [PMID: 33960517 PMCID: PMC8361774 DOI: 10.1111/jdv.17313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/13/2021] [Indexed: 11/29/2022]
Abstract
Background Dermoscopy and Reflectance Confocal Microscopy (RCM) features of scalp melanoma according to lesion location and histopathology have not been fully investigated. Objectives To reveal dermoscopic and RCM features of scalp melanoma according to lesion location and histopathology. Methods We retrospectively retrieved images of suspicious, atypical excised, flat melanocytic lesions of the scalp, assessed on dermoscopy and RCM at five centres, from June 2007 to April 2020. Lesions were classified according to histopathological diagnoses of nevi, lentigo maligna melanoma (LM/LMM) or superficial spreading melanoma (SSM). Clinical, dermoscopic and RCM images were evaluated; LM/LMM and SSM subtypes were compared through multivariate analysis. Results Two hundred forty‐seven lesions were included. In situ melanomas were mostly LM (81.3%), while invasive melanomas were mostly SSM (75.8%). Male sex, baldness and chronic sun‐damaged skin were associated with all types of melanomas and in particular with LM/LMM. LMs were mostly located in the vertex area and SSM in the frontal (OR: 8.8; P < 0.05, CI 95%) and temporal (OR: 16.7; P < 0.005, CI 95%) areas. The dermoscopy presence of pseudo‐network, pigmented rhomboidal structures, obliterated hair follicles and annular–granular pattern were associated with LM diagnoses, whereas bluish‐white veil was more typical of SSM. Observations on RCM of atypical roundish and dendritic cells in the epidermis were associated with SSM (42.4%) and dendritic cells with LM (62.5%) diagnoses. Folliculotropism on RCM was confirmed as a typical sign of LM. Conclusions Flat scalp melanomas reveal specific dermoscopic and RCM features according to histopathologic type and scalp location.
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Affiliation(s)
- F Garbarino
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - R Pampena
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - M Lai
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - A R Pereira
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
| | - S Piana
- Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A M Cesinaro
- Department of Pathology, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - E Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Siena, Italy
| | - D Fiorani
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Siena, Italy
| | - S Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - F Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - J Chester
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - G Pellacani
- Department of Dermatology, University of La Sapienza, Roma, Italy
| | - P Guitera
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia.,Melanoma Institute Australia, Sydney, NSW, Australia
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
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Tognetti L, Cartocci A, Cinotti E, Moscarella E, Farnetani F, Carrera C, Lallas A, Tiodorovic D, Longo C, Puig S, Perrot JL, Argenziano G, Pellacani G, Cataldo G, Balistreri A, Cevenini G, Rubegni P. Dermoscopy of early melanomas: variation according to the anatomic site. Arch Dermatol Res 2021; 314:183-190. [PMID: 33772339 PMCID: PMC8850209 DOI: 10.1007/s00403-021-02226-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 01/01/2023]
Abstract
To date, is yet to be elucidated whether the body location of cutaneous melanoma can significantly affect an early dermoscopic diagnosis and, consequently, if it can be regarded as a prognostic factor. To investigate the dermoscopic appearance of early melanomas (EMs) at different body sites; to test the ability of dermoscopists in recognizing specific dermoscopic features in EMs. A pool of 106 experienced dermoscopists evaluated the presence of 10 dermoscopic features assumed as suggestive of malignancy among 268 images of EMs with ambiguous appearance located at 16 body sites. According to 720 evaluations, EMs of the "upper extremities" showed a prevalence of early atypical lentiginous features. EMs of the "anterior trunk" exhibited the lower rate of recognition for all features. EMs of the "rear trunk" can be regarded as an intermediate area, showing high recognition rates of regression-related and chronic-traumatism-related features.
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Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Alessandra Cartocci
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy. .,Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Carrera
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - Aimilios Lallas
- First Department of Dermatology, Aristotele University, Thessaloniki, Greece
| | | | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Susana Puig
- Melanoma Unit, Department of Dermatology, University of Barcelona, Barcelona, Spain
| | - Jean Luc Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | | | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Gennaro Cataldo
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Alberto Balistreri
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Gabriele Cevenini
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
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