期刊
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
卷 31, 期 12, 页码 2016-2024出版社
WILEY
DOI: 10.1111/jdv.14381
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资金
- University of Sydney
- Spanish Fondo de Investigaciones Sanitarias [PI15/00716, PI15/00956]
- Biomedical Network Research on Rare Diseases (CIBERER) of the Instituto de Salud Carlos III, Spain
- Catalan Government, Spain [AGAUR 2014 SGR 603]
- European Commission under the 6th Framework Programme [LSHC-CT-2006-018702]
- European Commission under the 7th Framework Programme, Diagnoptics
- National Cancer Institute (NCI) of the US National Institute of Health (NIH) [CA83115]
- Fundacio La Marato de TV3, Catalonia, Spain [201331-30]
BackgroundDesmoplastic melanoma (DM) is frequently misdiagnosed clinically and often associated with melanoma in situ (MIS). ObjectiveTo improve the detection of DM using dermoscopy and reflectance confocal microscopy (RCM). MethodsA descriptive analysis of DM dermoscopy features and a case-control study within a melanoma population for RCM feature evaluation was performed blindly, using data obtained between 2005 and 2015. After retrospectively identifying all DM cases with RCM data over the study period (n = 16), a control group of non-DM melanoma patients with RCM data, in a ratio of at least 3 : 1, was selected. The control group was matched by age and primary tumour site location, divided into non-DM invasive melanomas (n = 27) and MIS (n = 27). Invasive melanomas were selected according to the melanoma subtypes associated with the DM cases. The main outcomes were the frequency of melanoma-specific features on dermoscopy for DM; and the odds ratios of RCM features to distinguish DM from MIS and/or other invasive melanomas; or MIS from the combined invasive melanoma group. ResultsAt least one of the 14 melanoma-specific features evaluated on dermoscopy was found in 100% of DMs (n = 15 DM with dermoscopy). Known RCM melanoma predictors were commonly found in the DMs, such as pagetoid cells (100%) and cell atypia (100%). The RCM feature of spindle cells in the superficial dermis was more common in DM compared with the entire melanoma control group (OR 3.82, 95% CI 1.01-14.90), and particularly compared to MIS (OR 5.48, 95% CI 1.11-32.36). Nucleated cells in the dermis and the RCM correlate of dermal inflammation were also significant RCM features favouring DM over MIS, as well as invasive melanoma over MIS. ConclusionDermoscopy and RCM may be useful tools for the identification of DM. Certain RCM features may help distinguish DM from MIS and other invasive melanomas. Larger studies are warranted.
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