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Comparison of dermatoscopic images of acral lentiginous melanoma and acral melanocytic nevus occurring on body weight-bearing areas.

Watanabe S, Sawada M, Ishizaki S, Kobayashi K, Tanaka M - Dermatol Pract Concept (2014)

Bottom Line: All the cases with nevi showed regular FP showing regular distribution of fibrils, whereas all the melanomas showed irregular distribution of fibrils and colors.White fibrils corresponding to the eccrine ducts in the horny layer were more often present on the ridges in ALM, which showed negative FP.Differentiating between the regular and irregular FP, including negative FP, might be helpful for the discrimination of melanoma from nevus.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Tokyo Woman's Medical University Medical Center East, Tokyo, Japan.

ABSTRACT

Background: Because body weight-bearing produces a shift in the horny layer, acral melanocytic nevus on the body weight-bearing area of the sole showed a regular fibrillar pattern (FP) due to slanting of the melanin columns in the horny layer. On the other hand, acral lentiginous melanoma (ALM) on the body weight-bearing area of the sole tended to show irregular fibrillar pattern showing rather structureless pigmentation instead of a parallel ridge pattern, which is due to the shift of the horny layer.

Objective: To elucidate the subtle difference between the regular FP of nevus and irregular FP in ALM.

Methods: In this study, the dermatoscopic features of five cases of ALM and five cases of acral melanocytic nevus on the weight-bearing area of the sole were compared.

Results: All the cases with nevi showed regular FP showing regular distribution of fibrils, whereas all the melanomas showed irregular distribution of fibrils and colors. Fibrils in nevi tended to be clear at the furrows and dim at the ridges. White fibrils corresponding to the eccrine ducts in the horny layer were more often present on the ridges in ALM, which showed negative FP.

Conclusion: Differentiating between the regular and irregular FP, including negative FP, might be helpful for the discrimination of melanoma from nevus.

No MeSH data available.


Related in: MedlinePlus

Dermatoscopy of acral lentiginous melanoma on the loaded area, case 1. On the gray-blue to dark brown structureless background, a negative fibrillar pattern was conspicuous at the 12 to 6 o’clock position (black arrowhead). (Copyright: ©2014 Watanabe et al.)
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f2-dp0404a08: Dermatoscopy of acral lentiginous melanoma on the loaded area, case 1. On the gray-blue to dark brown structureless background, a negative fibrillar pattern was conspicuous at the 12 to 6 o’clock position (black arrowhead). (Copyright: ©2014 Watanabe et al.)

Mentions: Negative FP was more commonly observed in ALM (Figures 2 and 3), however, only one case of acral melanocytic nevus showed these findings. Negative FP could be observed when the background was dark. ALM often shows PRP, which is characterized by rather diffuse pigmentation divided by whitish lines at the furrows. When body weight-bearing produces a shift in the horny layer, the pigmentation of the PRP might become more diffuse, thus darkening the background. The eccrine ducts are usually whitish and therefore not conspicuous on a lighter background, but when the background became dark, the eccrine dust could be seen more clearly as whitish fibrils, thus indicating a negative FP. Acral melanocytic nevus also shows hypopigmented spaces between the fibrils, simulating negative FP, however, these hypopigmented spaces were not as thin and white as the eccrine ducts. Furthermore, these hypopigmented spaces did not terminate at the center of the ridges and were distributed more irregularly (Figures 4 and 5). Acral melanocytic nevus also showed negative FP, when it produced more melanin than usual and demonstrated long and dense fibrils (Figure 6).


Comparison of dermatoscopic images of acral lentiginous melanoma and acral melanocytic nevus occurring on body weight-bearing areas.

Watanabe S, Sawada M, Ishizaki S, Kobayashi K, Tanaka M - Dermatol Pract Concept (2014)

Dermatoscopy of acral lentiginous melanoma on the loaded area, case 1. On the gray-blue to dark brown structureless background, a negative fibrillar pattern was conspicuous at the 12 to 6 o’clock position (black arrowhead). (Copyright: ©2014 Watanabe et al.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4230258&req=5

f2-dp0404a08: Dermatoscopy of acral lentiginous melanoma on the loaded area, case 1. On the gray-blue to dark brown structureless background, a negative fibrillar pattern was conspicuous at the 12 to 6 o’clock position (black arrowhead). (Copyright: ©2014 Watanabe et al.)
Mentions: Negative FP was more commonly observed in ALM (Figures 2 and 3), however, only one case of acral melanocytic nevus showed these findings. Negative FP could be observed when the background was dark. ALM often shows PRP, which is characterized by rather diffuse pigmentation divided by whitish lines at the furrows. When body weight-bearing produces a shift in the horny layer, the pigmentation of the PRP might become more diffuse, thus darkening the background. The eccrine ducts are usually whitish and therefore not conspicuous on a lighter background, but when the background became dark, the eccrine dust could be seen more clearly as whitish fibrils, thus indicating a negative FP. Acral melanocytic nevus also shows hypopigmented spaces between the fibrils, simulating negative FP, however, these hypopigmented spaces were not as thin and white as the eccrine ducts. Furthermore, these hypopigmented spaces did not terminate at the center of the ridges and were distributed more irregularly (Figures 4 and 5). Acral melanocytic nevus also showed negative FP, when it produced more melanin than usual and demonstrated long and dense fibrils (Figure 6).

Bottom Line: All the cases with nevi showed regular FP showing regular distribution of fibrils, whereas all the melanomas showed irregular distribution of fibrils and colors.White fibrils corresponding to the eccrine ducts in the horny layer were more often present on the ridges in ALM, which showed negative FP.Differentiating between the regular and irregular FP, including negative FP, might be helpful for the discrimination of melanoma from nevus.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Tokyo Woman's Medical University Medical Center East, Tokyo, Japan.

ABSTRACT

Background: Because body weight-bearing produces a shift in the horny layer, acral melanocytic nevus on the body weight-bearing area of the sole showed a regular fibrillar pattern (FP) due to slanting of the melanin columns in the horny layer. On the other hand, acral lentiginous melanoma (ALM) on the body weight-bearing area of the sole tended to show irregular fibrillar pattern showing rather structureless pigmentation instead of a parallel ridge pattern, which is due to the shift of the horny layer.

Objective: To elucidate the subtle difference between the regular FP of nevus and irregular FP in ALM.

Methods: In this study, the dermatoscopic features of five cases of ALM and five cases of acral melanocytic nevus on the weight-bearing area of the sole were compared.

Results: All the cases with nevi showed regular FP showing regular distribution of fibrils, whereas all the melanomas showed irregular distribution of fibrils and colors. Fibrils in nevi tended to be clear at the furrows and dim at the ridges. White fibrils corresponding to the eccrine ducts in the horny layer were more often present on the ridges in ALM, which showed negative FP.

Conclusion: Differentiating between the regular and irregular FP, including negative FP, might be helpful for the discrimination of melanoma from nevus.

No MeSH data available.


Related in: MedlinePlus