Differentiating regressed melanoma from regressed lichenoid keratosis

被引:6
作者
Chan, Aegean H. [1 ]
Shulman, Kenneth J. [2 ]
Lee, Bonnie A. [1 ,3 ]
机构
[1] Albert Einstein Coll Med, Div Dermatol, 3411 Wayne Ave, Bronx, NY 10467 USA
[2] Dermpath Diagnost, Port Chester, NY USA
[3] Ackerman Acad Dermatopathol, Dermpath Diagnost, New York, NY USA
关键词
benign lichenoid keratosis; lichenoid keratosis; melanoma; regression; PLANUS-LIKE KERATOSIS; RECOGNITION;
D O I
10.1111/cup.12879
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
BackgroundDistinguishing regressed lichen planus-like keratosis (LPLK) from regressed melanoma can be difficult on histopathologic examination, potentially resulting in mismanagement of patients. ObjectiveWe aimed to identify histopathologic features by which regressed melanoma can be differentiated from regressed LPLK. MethodsTwenty actively inflamed LPLK, 12 LPLK with regression and 15 melanomas with regression were compared and evaluated by hematoxylin and eosin staining as well as Melan-A, microphthalmia transcription factor (MiTF) and cytokeratin (AE1/AE3) immunostaining. Results(1) A total of 40% of regressed melanomas showed complete or near complete loss of melanocytes within the epidermis with Melan-A and MiTF immunostaining, while 8% of regressed LPLK exhibited this finding. (2) Necrotic keratinocytes were seen in the epidermis in 33% regressed melanomas as opposed to all of the regressed LPLK. (3) A dense infiltrate of melanophages in the papillary dermis was seen in 40% of regressed melanomas, a feature not seen in regressed LPLK. ConclusionsIn summary, our findings suggest that a complete or near complete loss of melanocytes within the epidermis strongly favors a regressed melanoma over a regressed LPLK. In addition, necrotic epidermal keratinocytes and the presence of a dense band-like distribution of dermal melanophages can be helpful in differentiating these lesions.
引用
收藏
页码:338 / 341
页数:4
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