Dermoscopy of DFs. A prospective morphologic study of 412 cases

Department of Dermatology, Hospital Sant Pau i Santa Tecla, Rambla Vella, 14, 43003, Tarragona, Spain.
Archives of dermatology (Impact Factor: 4.79). 02/2008; 144(1):75-83. DOI: 10.1001/archdermatol.2007.8
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To describe the dermoscopic features, including vascular structures and patterns associated with dermatofibromas in a large series of cases.
Digital dermoscopic images of the prospectively collected dermatofibromas were evaluated for the presence of multiple structures and patterns.
Dermatofibromas were collected in the Departments of Dermatology of the Hospital de Sant Pau i Santa Tecla, Tarragona, Spain, and Hospital de Sant Llatzer, Palma de Mallorca, Spain.
A total of 412 dermatofibromas (from 292 patients) with complete documentation were collected.
Frequency and intraobserver and interobserver agreement of the dermoscopic structures and patterns in dermatofibromas.
A total of 19 morphological dermoscopic structures were evaluated. Pigment network was observed in 71.8% (3% atypical pigment network), white scarlike patch in 57.0%, and a white network in 17.7%. Different vascular structures were observed in 49.5% (dotted vessels in 30.6%). Ten dermoscopic patterns were observed. The most common pattern seen in our series (34.7% of cases) was central white patch and peripheral pigment network, but in 65.3% of the cases, dermatofibromas presented different patterns including simulators of melanoma.
The most common pattern associated with dermatofibroma is the classic dermoscopic pattern (pigment network and central white patch), but this tumor has a wide range of presentations.

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    • "During observations carried out by Zaballos et al. [16] concerning 412 dermatofibromas, a pigment network were observed in 71% of lesions and white scar-like areas were noted in a total of 57% of lesions [16]. What is more, the presence of white scar-like areas should always suggest the necessity of ruling out melanoma through a dermoscopic examination – especially its desmoplastic type [17] or the fully regressive melanoma [18]. "
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    ABSTRACT: Introduction The accessory nipple (AN) is characterised by its network-like structures, which may suggest the diagnosis of a melanocytic lesion. The knowledge about additional dermoscopic features of AN may greatly minimise the risk of unnecessary surgical excisions. Aim To analyse and present different clinical and dermoscopic forms, in which the AN may appear. Material and methods Ninety AN with dermoscopic features were evaluated in the study, detected in 14 patients between the years 2008 and 2014. Results The most common dermoscopic features of the AN were central, scar-like areas (15/19) and peripheral network-like structures (12/19). A number of cleft-like appearances (8/19) and central network-like structures (7/19) had also been observed. Moreover, among the dermoscopic features, white cobblestone-like structures (7/19), a central round dimpling with a plug (6/19) and fisheye-like structures resembling comedo-like openings (9/19) have all also been noted. There is a statistical significance in the occurrence of white cobblestone-like structures with central network-like structures (Fisher's exact test p = 0.0449). The presence of peripheral network-like structures with the occurrence of central scar-like areas was statistically highly significant (p = 0.0091). The central round dimpling was never observed alongside any central network-like structures in any of the lesions (p = 0.0436). Conclusions Accessory nipples are most commonly characterised by the occurrence of a peripheral network-like structure accompanied by the presence of a scar-like area.
    Postepy Dermatologii I Alergologii 06/2014; 31(3):127-33. DOI:10.5114/pdia.2014.43189 · 0.85 Impact Factor
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    • "The lesion reported here presented as a pale nodule with asymmetric peripheral pigmentation in contrast to the more common presentation of BCM as non-pigmented [3]. There were similarities to the clinical appearance of dermatofibroma (DF) which commonly presents as a nodule with a white center and reticular pigmentation peripherally [5]. The clinical appearance could also be interpreted as that of a dermal nevus, Spitz nevus or basal cell carcinoma (BCC), although Spitz nevus is rare at mature age. "
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    ABSTRACT: Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis. We report a case of balloon cell melanoma on the forearm of a 61-year-old man with both polarized and non-polarized dermatoscopy and dermatopathology. It presented as a firm pale nodule with focal eccentric pigmentation. The clinical images evoke a differential diagnosis of dermatofibroma, dermal nevus, Spitz nevus and basal cell carcinoma as well as melanoma. This melanoma was partially pigmented due to a small, pigmented superficial spreading component on the edge of the non-pigmented balloon cell nodule, prompting further evaluation. In retrospect there was the clue to malignancy of polarizing-specific white lines (chrysalis structures) and polymorphous vessels, including a pattern of dot vessels. The reticular lines exclude basal cell carcinoma, polarizing-specific white lines are inconsistent with the diagnosis of dermal nevus and their eccentric location is inconsistent with both Spitz nevus and dermatofibroma. Excision biopsy was performed, revealing a superficial spreading melanoma with two distinct invasive components, one of atypical non-mature epithelioid cells and the other an amelanotic nodular component, comprising more than 50% of the lesion, characterized by markedly distended epithelioid melanocytes showing pseudo-xanthomatous cytoplasmic balloon cell morphology. A diagnosis of balloon cell melanoma, Breslow thickness 1.9 mm, mitotic rate 3 per square millimeter was rendered. Wide local excision was performed, as was sentinel lymph node biopsy, which was negative.
    01/2014; 4(1):69-73. DOI:10.5826/dpc.0401a11
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    ABSTRACT: Urokinase plasminogen activator (uPA), a serine proteinase, is important in the development and epidermal wound healing, and seems to play a regulatory role in the proliferation of mouse epidermal keratinocytes (KC). In the present study, we found detectable uPA expression in outer root sheath (ORS) KC in the early anagen phase in mouse vibrissa follicles, but not in the late anagen or in the telogen and categen phases. uPA was also detected in ORS KC cultured from neonatal mice vibrissa. Specific exogenous inhibitors of uPA, amiloride and uPA antibody, significantly reduced the proliferation of ORS KC. Thus uPA is consistently elevated in the hyperproliferative hair follicle KC, and inhibition of the enzyme decreases hair follicle KC proliferation. We deduce that uPA is a very important mediator of the hair follicle cycle because its activity correlates with ORS KC proliferation.
    Cell Biology International 02/2004; 28(8-9):571-5. DOI:10.1016/j.cellbi.2004.04.012 · 1.93 Impact Factor
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