Clinical and dermoscopic characterization of pediatric and adolescent melanomas: Multicenter study of 52 cases

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:78

Article

Carrera, Cristina^1,2  Scope, Alon^2,3,4  Dusza, Stephen W.²  Argenziano, Giuseppe⁵  Nazzaro, Gianluca⁶  Phan, Alice⁷  Tromme, Isabelle⁸  Rubegni, Pietro⁹  Malvehy, Josep¹  Puig, Susana¹  Marghoob, Ashfaq A.² 

[1] Univ Barcelona, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Melanoma Unit,Dept Dermatol,Hosp Clin Barcelona, Barcelona, Spain

[2] Mem Sloan Kettering Canc Ctr, Dept Med, Dermatol Serv, 16 E 60th St, New York, NY 10022 USA

[3] Tel Aviv Univ, Sheba Med Ctr, Tel Aviv, Israel

[4] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel

[5] Univ Campania, Dermatol Unit, Naples, Italy

[6] Univ Milano UOC Dermatol, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dipartimento Fisiopatol & Trapianti, Milan, Italy

[7] Univ Claude Bernard Lyon 1, Ctr Hosp Lyon Sud, Dept Dermatol, Pierre Benite, France

[8] Catholic Univ Louvain, Clin Univ St Luc, King Albert Inst 2, Dept Dermatol, Brussels, Belgium

[9] Univ Siena, Dipartimento Sci Med Chirurg & Neurosci, Sez Dermatol, Siena, Italy

关键词: childhood;    dermoscopy;    detection;    melanoma;    pediatric melanoma;    Spitz;    spitzoid;   

DOI  :  10.1016/j.jaad.2017.09.065

来源: Elsevier

【 摘 要 】

Background: Knowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse, and this may in part contribute to delay in detection and thicker tumors. Objective: To analyze the clinicodermoscopic characteristics of PM. Methods: Retrospective study of 52 melanomas diagnosed in patients before the age of 20 years. Results: On the basis of its clinical, dermoscopic, and histopathologic characteristics, PM can be classified as spitzoid or nonspitzoid. The nonspitzoid melanomas (n = 37 [72.3%]) presented in patients with a mean age of 16.3 years (range, 8-20) and were associated with a high-risk phenotype and a pre-existing nevus (62.2%). The spitzoid melanomas (n = 15 [27.7%]) were diagnosed in patients at a mean age of 12.5 years (range, 2-19) and were mostly de novo lesions (73.3%) located on the limbs (73.3%). Whereas less than 25% of PMs fulfilled the modified clinical ABCD criteria (amelanotic, bleeding bump, color uniformity, de novo at any diameter), 40% of spitzoid melanomas did. Dermoscopic melanoma criteria were found in all cases. Nonspitzoid melanomas tended to be multicomponent (58.3%) or have nevus-like (25%) dermoscopic patterns. Spitzoid melanomas revealed atypical vascular patterns with shiny white lines (46.2%) or an atypical pigmented spitzoid pattern (30.8%). There was good correlation between spitzoid subtype histopathologically and dermoscopically (k = 0.66). Limitations: A retrospective study without re-review of pathologic findings. Conclusion: Dermoscopy in addition to conventional and modified clinical ABCD criteria helps in detecting PM. Dermoscopy assists in differentiating spitzoid from nonspitzoid melanomas.

【 授权许可】

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