Association between the dermoscopic morphology of peripheral globules and melanocytic lesion diagnosis.


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:
Apr 2021
Historique:
received: 23 08 2020
accepted: 27 10 2020
pubmed: 19 11 2020
medline: 15 5 2021
entrez: 18 11 2020
Statut: ppublish

Résumé

The presence of peripheral globules is associated with enlarging melanocytic lesions; however, there are numerous patterns of peripheral globules distribution and it remains unknown whether specific patterns can help differentiate enlarging naevi from melanoma. To investigate whether morphological differences exist between the peripheral globules seen in different subsets of naevi and in melanoma. A cross-sectional study of clinical notes that mentioned peripheral globules, in addition to all melanoma images with peripheral globules on the International Skin Imaging Collaboration archive. Dermoscopic images were reviewed and annotated. Associations between diagnosis and categorical features were measured with odds ratios. Non-parametric tests were used for continuous factors. 184 lesions with peripheral globules from our clinic were included in the analysis; only 6 of these proved to be melanoma. 109 melanomas with peripheral globules from the International Skin Imaging Collaboration archive were added to the analysis. Melanomas were more common on the extremities and among older individuals. Melanomas were more likely to display atypical, tiered and/or focal peripheral globules. Only 5% of melanomas lacked dermoscopic melanoma-specific structures compared to 48% of naevi. Melanocytic lesions with atypical or asymmetrically distributed peripheral globules, especially when located on the extremities, should raise suspicion for malignancy. Melanocytic lesions with typical and symmetrically distributed peripheral globules, and with no other concerning dermoscopic features, are unlikely to be malignant.

Sections du résumé

BACKGROUND BACKGROUND
The presence of peripheral globules is associated with enlarging melanocytic lesions; however, there are numerous patterns of peripheral globules distribution and it remains unknown whether specific patterns can help differentiate enlarging naevi from melanoma.
OBJECTIVE OBJECTIVE
To investigate whether morphological differences exist between the peripheral globules seen in different subsets of naevi and in melanoma.
METHODS METHODS
A cross-sectional study of clinical notes that mentioned peripheral globules, in addition to all melanoma images with peripheral globules on the International Skin Imaging Collaboration archive. Dermoscopic images were reviewed and annotated. Associations between diagnosis and categorical features were measured with odds ratios. Non-parametric tests were used for continuous factors.
RESULTS RESULTS
184 lesions with peripheral globules from our clinic were included in the analysis; only 6 of these proved to be melanoma. 109 melanomas with peripheral globules from the International Skin Imaging Collaboration archive were added to the analysis. Melanomas were more common on the extremities and among older individuals. Melanomas were more likely to display atypical, tiered and/or focal peripheral globules. Only 5% of melanomas lacked dermoscopic melanoma-specific structures compared to 48% of naevi.
CONCLUSIONS CONCLUSIONS
Melanocytic lesions with atypical or asymmetrically distributed peripheral globules, especially when located on the extremities, should raise suspicion for malignancy. Melanocytic lesions with typical and symmetrically distributed peripheral globules, and with no other concerning dermoscopic features, are unlikely to be malignant.

Identifiants

pubmed: 33205467
doi: 10.1111/jdv.17035
pmc: PMC8414036
mid: NIHMS1735428
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

892-899

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : P30-CA008748
Pays : United States

Informations de copyright

© 2020 European Academy of Dermatology and Venereology.

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Auteurs

O Reiter (O)

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Dermatology, Rabin Medical Center, Petah Tikvah and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

E Chousakos (E)

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

N Kurtansky (N)

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

J K Nanda (JK)

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

S W Dusza (SW)

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

M A Marchetti (MA)

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

N Jaimes (N)

Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.

A Moraes (A)

Department of Dermatology, AC Camargo Cancer Center, São Paulo, Brazil.

A A Marghoob (AA)

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

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