Evaluation of large clinically atypical vulvar pigmentation with RCM: atypical melanosis or early melanoma?


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 10 01 2018
accepted: 22 05 2018
pubmed: 20 6 2018
medline: 11 5 2019
entrez: 20 6 2018
Statut: ppublish

Résumé

Vulvar melanosis can occasionally be clinically challenging by mimicking an early melanoma. To report our experience of initial evaluation and follow-up in this peculiar subset of vulvar melanosis using reflectance confocal microscopy (RCM). We retrospectively evaluated 18 consecutive cases referred for atypical vulvar pigmentation or for which melanoma was considered and that underwent both RCM examination and histopathological assessment. In 13 cases with available dermoscopic pictures, RCM classification was compared to dermoscopic diagnosis, and in all cases, the density of melanocytes was evaluated on biopsies using MelanA immunostaining. Among the 18 atypical pigmented lesions, 17 vulvar melanosis and one melanoma were histologically determined. RCM concluded a benign vulvar melanosis in 10 of 17 cases, whereas dermoscopy did so in three of 12 cases. RCM identified the only early malignant lentiginous melanoma. In several cases of vulvar melanosis, RCM could identify foci of melanocytic hyperplasia in an otherwise benign pattern. In this clinically and dermoscopically challenging subset of vulvar pigmentations, RCM appears relevant for initial extensive evaluation, especially to target initial biopsy sampling, and to perform non-invasive monitoring of foci of melanocytic hyperplasia.

Sections du résumé

BACKGROUND BACKGROUND
Vulvar melanosis can occasionally be clinically challenging by mimicking an early melanoma.
OBJECTIVE OBJECTIVE
To report our experience of initial evaluation and follow-up in this peculiar subset of vulvar melanosis using reflectance confocal microscopy (RCM).
METHODS METHODS
We retrospectively evaluated 18 consecutive cases referred for atypical vulvar pigmentation or for which melanoma was considered and that underwent both RCM examination and histopathological assessment. In 13 cases with available dermoscopic pictures, RCM classification was compared to dermoscopic diagnosis, and in all cases, the density of melanocytes was evaluated on biopsies using MelanA immunostaining.
RESULTS RESULTS
Among the 18 atypical pigmented lesions, 17 vulvar melanosis and one melanoma were histologically determined. RCM concluded a benign vulvar melanosis in 10 of 17 cases, whereas dermoscopy did so in three of 12 cases. RCM identified the only early malignant lentiginous melanoma. In several cases of vulvar melanosis, RCM could identify foci of melanocytic hyperplasia in an otherwise benign pattern.
CONCLUSIONS CONCLUSIONS
In this clinically and dermoscopically challenging subset of vulvar pigmentations, RCM appears relevant for initial extensive evaluation, especially to target initial biopsy sampling, and to perform non-invasive monitoring of foci of melanocytic hyperplasia.

Identifiants

pubmed: 29920797
doi: 10.1111/jdv.15141
doi:

Substances chimiques

MART-1 Antigen 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

84-92

Subventions

Organisme : Lyon 1 University
Organisme : Hospices Civils de Lyon
Organisme : The Cancer Research Center of Lyon

Informations de copyright

© 2018 European Academy of Dermatology and Venereology.

Auteurs

C Theillac (C)

Dermatology Department, Centre Hospitalier de Lyon Sud, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Pierre Bénite, France.

E Cinotti (E)

Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France.
Pour le Groupe Imagerie Cutanée Non Invasive de la Société Française de Dermatologie, Paris, France.

J Malvehy (J)

Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain.

S Ronger Savle (S)

Dermatology Department, Centre Hospitalier de Lyon Sud, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Pierre Bénite, France.

B Balme (B)

Pathology Department, Centre Hospitalier de Lyon Sud, Lyon, France.

P Robinson (P)

DRCI, Hospices Civils de Lyon, Lyon, France.

J L Perrot (JL)

Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France.
Pour le Groupe Imagerie Cutanée Non Invasive de la Société Française de Dermatologie, Paris, France.

C Douchet (C)

Pathology Department, University Hospital of Saint-Etienne, Saint-Etienne, France.

A C Biron Schneider (AC)

Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France.

L Alos (L)

Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain.

A Garcia (A)

Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain.

A Barreiro (A)

Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain.

B Labeille (B)

Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France.
Pour le Groupe Imagerie Cutanée Non Invasive de la Société Française de Dermatologie, Paris, France.

G Duru (G)

Department of Biostatistics, Université Claude Bernard Lyon 1, Villeurbanne, France.

S Dalle (S)

Dermatology Department, Centre Hospitalier de Lyon Sud, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Pierre Bénite, France.

L Thomas (L)

Dermatology Department, Centre Hospitalier de Lyon Sud, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Pierre Bénite, France.

S Debarbieux (S)

Dermatology Department, Centre Hospitalier de Lyon Sud, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Pierre Bénite, France.
Pour le Groupe Imagerie Cutanée Non Invasive de la Société Française de Dermatologie, Paris, France.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH