Abstract：
BACKGROUND: Incidence of cutaneous melanoma is steadily growing, and its early recognition is of paramount importance. Small, pigmented lesions often represent a challenge for the clinician, as predictors of melanoma have not yet been uniquely identified in this setting.
OBJECTIVE: To identify dermoscopic features that aid in distinguishing small diameter melanomas (≤5 mm) from equivocal melanocytic nevi measuring ≤5 mm.
METHODS: A retrospective multicenter study was conducted to collect demographics, clinical and dermoscopic pictures of (i) histology-proven flat melanomas, measuring ≤5 mm, (ii) histology-proven but clinically/dermoscopically equivocal melanocytic nevi measuring ≤5 mm, and (iii) histology-proven flat melanomas, measuring >5 mm. An independent dermoscopic evaluation was performed. Differences in predefined dermoscopic features were assessed across the three groups.
RESULTS: A total of 103 melanomas measuring ≤5 mm were collected; 166 control lesions, comprising 85 large (>5 mm) melanomas and 81 dubious, clinically equivocal melanocytic nevi measuring ≤5 mm were included. Of the 103 mini-melanomas, only 44 were melanoma in situ. Five dermoscopic predictors of melanoma were identified for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm, namely: atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color. The latter were combined into a predictive model capable of identifying melanoma with 65% sensitivity and 86.4% specificity, at a cut-off score of 3. Among melanomas measuring ≤5 mm, presence of a blue-white veil (P = 0.0027) or negative pigment network (P = 0.0063) was associated with invasiveness.
CONCLUSIONS: A set of five dermoscopic predictors of melanoma, atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color is proposed for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm.
OBJECTIVE: To identify dermoscopic features that aid in distinguishing small diameter melanomas (≤5 mm) from equivocal melanocytic nevi measuring ≤5 mm.
METHODS: A retrospective multicenter study was conducted to collect demographics, clinical and dermoscopic pictures of (i) histology-proven flat melanomas, measuring ≤5 mm, (ii) histology-proven but clinically/dermoscopically equivocal melanocytic nevi measuring ≤5 mm, and (iii) histology-proven flat melanomas, measuring >5 mm. An independent dermoscopic evaluation was performed. Differences in predefined dermoscopic features were assessed across the three groups.
RESULTS: A total of 103 melanomas measuring ≤5 mm were collected; 166 control lesions, comprising 85 large (>5 mm) melanomas and 81 dubious, clinically equivocal melanocytic nevi measuring ≤5 mm were included. Of the 103 mini-melanomas, only 44 were melanoma in situ. Five dermoscopic predictors of melanoma were identified for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm, namely: atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color. The latter were combined into a predictive model capable of identifying melanoma with 65% sensitivity and 86.4% specificity, at a cut-off score of 3. Among melanomas measuring ≤5 mm, presence of a blue-white veil (P = 0.0027) or negative pigment network (P = 0.0063) was associated with invasiveness.
CONCLUSIONS: A set of five dermoscopic predictors of melanoma, atypical pigment network, blue-white veil, pseudopods, peripheral radial streaks, and presence of more than one color is proposed for the assessment of flat, non-facial melanocytic lesions measuring ≤5 mm.
摘要：
背景：皮肤黑色素瘤的发病率正在稳步增长，尽早认识到这一点至关重要。小,色素性病变通常对临床医生来说是一个挑战，在这种情况下，尚未唯一确定黑色素瘤的预测因子。
目的：确定有助于区分小直径黑色素瘤（≤5mm）和测量≤5mm的可疑黑素细胞痣的皮肤镜特征。
方法：进行了一项回顾性多中心研究，以收集人口统计学，（i）组织学证实的扁平黑色素瘤的临床和皮肤镜图片，测量≤5mm,（ii）组织学证实，但临床/皮肤镜检查上模棱两可的黑素细胞痣测量≤5毫米，和（iii）组织学证实的扁平黑色素瘤，测量>5毫米。进行独立的皮肤镜评估。在三组中评估预定义的皮肤镜特征的差异。
结果：共收集103个测量≤5毫米的黑素瘤；166个对照病变，包括85个大的（>5毫米）黑色素瘤和81个可疑的，包括临床上可疑的黑素细胞痣，测量≤5mm。在103例微小黑色素瘤中,只有44人是原位黑色素瘤。确定了五种黑色素瘤的皮肤镜预测因子，用于评估扁平，非面部黑素细胞病变测量≤5mm，即:非典型色素网络,蓝白色的面纱，伪足,周边径向条纹，存在不止一种颜色。后者被组合到一个预测模型中，能够以65%的灵敏度和86.4%的特异性识别黑色素瘤。截止得分为3分。在测量≤5mm的黑色素瘤中，蓝白色面纱（P=0.0027）或阴性色素网络（P=0.0063）的存在与侵袭性相关。
结论：一组黑色素瘤的五种皮肤镜预测因子，非典型颜料网络，蓝白色的面纱，伪足,周边径向条纹，并建议存在一种以上的颜色来评估平面，非面部黑素细胞病变测量≤5毫米。
目的：确定有助于区分小直径黑色素瘤（≤5mm）和测量≤5mm的可疑黑素细胞痣的皮肤镜特征。
方法：进行了一项回顾性多中心研究，以收集人口统计学，（i）组织学证实的扁平黑色素瘤的临床和皮肤镜图片，测量≤5mm,（ii）组织学证实，但临床/皮肤镜检查上模棱两可的黑素细胞痣测量≤5毫米，和（iii）组织学证实的扁平黑色素瘤，测量>5毫米。进行独立的皮肤镜评估。在三组中评估预定义的皮肤镜特征的差异。
结果：共收集103个测量≤5毫米的黑素瘤；166个对照病变，包括85个大的（>5毫米）黑色素瘤和81个可疑的，包括临床上可疑的黑素细胞痣，测量≤5mm。在103例微小黑色素瘤中,只有44人是原位黑色素瘤。确定了五种黑色素瘤的皮肤镜预测因子，用于评估扁平，非面部黑素细胞病变测量≤5mm，即:非典型色素网络,蓝白色的面纱，伪足,周边径向条纹，存在不止一种颜色。后者被组合到一个预测模型中，能够以65%的灵敏度和86.4%的特异性识别黑色素瘤。截止得分为3分。在测量≤5mm的黑色素瘤中，蓝白色面纱（P=0.0027）或阴性色素网络（P=0.0063）的存在与侵袭性相关。
结论：一组黑色素瘤的五种皮肤镜预测因子，非典型颜料网络，蓝白色的面纱，伪足,周边径向条纹，并建议存在一种以上的颜色来评估平面，非面部黑素细胞病变测量≤5毫米。
