Dendritic cells in reflectance confocal microscopy are a clue for early melanoma diagnosis in extrafacial flat pigmented melanocytic lesions

被引：6

作者：

Guiducci, Laura ^{[1
]}

Kaleci, Shaniko ^{[1
]}

Chester, Johanna ^{[1
]}

Longo, Caterina ^{[1
,2
]}

Ciardo, Silvana ^{[1
]}

Farnetani, Francesca ^{[1
]}

Pellacani, Giovanni ^{[1
,3
]}

机构：

[1] Univ Modena & Reggio Emilia, Dept Dermatol, Via Pozzo 71, I-41124 Modena, Italy

[2] Azienda Unita Sanitaria Locale IRCCS Reggio Emili, Ctr Oncol Alta Tecnol Diagnost Dermatol, Reggio Emilia, Italy

[3] Sapienza Univ Rome, Dept Clin Internal Anesthesiol & Cardiovasc Sci, Dermatol Clin, Rome, Italy

来源：

EXPERIMENTAL DERMATOLOGY | 2022年 / 31卷 / 07期

关键词：

dendritic cells; extrafacial pigmented lesions; melanoma; nevi; reflectance confocal microscopy; LENTIGO MALIGNA; SKIN-LESIONS; MORPHOLOGIC FEATURES; ACCURACY; PATTERNS; MACULES; IMPACT; NEVI;

D O I：

10.1111/exd.14553

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Differential diagnosis of extrafacial flat pigmented lesions with dermoscopic reticular and/or homogeneous pattern is challenging. Dendritic cells upon reflectance confocal microscopy (RCM) still represent a pitfall. This study aims to determine the role of dendritic cells upon RCM in the epidermis and dermo-epidermal junction (DEJ), together with common RCM features for melanoma and nevi, in dermoscopically equivocal extrafacial flat pigmented lesions. A retrospective evaluation of RCM images of melanocytic extrafacial flat pigmented lesions with reticular and/or homogeneous dermoscopic pattern and with histopathological diagnosis, was performed. A multivariate model of RCM features was used to obtain a score of independent risk factors. A total of 698 lesions were included. Increasing patient age, epidermal dendritic cells, many dendritic cells in the DEJ (>30%) and many (>5/mm(2)) round atypical cells were independent risk factors for melanoma. Edged papillae and melanophages were indicative of nevus. A score based on these features was developed to assist in melanoma differential diagnosis. The RCM observation of abundant (>30%) dendritic cells in the DEJ is highly suggestive of malignity. This independent risk factor should also be considered for improved differential diagnosis of extrafacial melanoma.

引用

页码：1048 / 1055

页数：8

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