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Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma

INTRODUCTION: Non-invasive imaging techniques offer the possibility to optimize the first approach to melanoma. Reflectance Confocal Microscopy (RCM) has a promising role in predicting the main prognostic events in the dermo-epidermal and papillary dermis. OBJECTIVES: To identify pre-surgical criter...

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Autores principales: Barragán-Estudillo, Zamira Faride, Brito, Johanna, Chavez-Bourgeois, Marion, Alejo, Beatriz, Alos, Llucia, García, Adriana Patricia, Puig, Susana, Malvehy, Josep, Carrera, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mattioli 1885 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9681198/
https://www.ncbi.nlm.nih.gov/pubmed/36534562
http://dx.doi.org/10.5826/dpc.1204a174
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author Barragán-Estudillo, Zamira Faride
Brito, Johanna
Chavez-Bourgeois, Marion
Alejo, Beatriz
Alos, Llucia
García, Adriana Patricia
Puig, Susana
Malvehy, Josep
Carrera, Cristina
author_facet Barragán-Estudillo, Zamira Faride
Brito, Johanna
Chavez-Bourgeois, Marion
Alejo, Beatriz
Alos, Llucia
García, Adriana Patricia
Puig, Susana
Malvehy, Josep
Carrera, Cristina
author_sort Barragán-Estudillo, Zamira Faride
collection PubMed
description INTRODUCTION: Non-invasive imaging techniques offer the possibility to optimize the first approach to melanoma. Reflectance Confocal Microscopy (RCM) has a promising role in predicting the main prognostic events in the dermo-epidermal and papillary dermis. OBJECTIVES: To identify pre-surgical criteria that can predict the main prognostic features of melanoma. METHODS: A retrospective cohort-study evaluated dermoscopic, confocal and histopathological characteristics of consecutively diagnosed sporadic melanomas. RCM-melanoma patterns classified into 1) dendritic-cell, 2) round-cell, 3) dermal nest and 4) combined type. Acral, facial and mucosal locations were excluded. RESULTS: Ninety-two primary melanomas were included: 44 males and 48 females (mean age 60.4 years, standard deviation [SD] 16.2) with a mean Breslow of 1.43 mm (SD 1.6). The most frequent dermoscopic presentation was the multicomponent pattern, the predominant confocal pattern was dendritic-cell type (44.6%). The presence of pigmented network on dermoscopy was related to lower Breslow and mitotic rates (both P = 0.002); in contrast to the presence of visible vessels, which was related to higher Breslow and mitotic indexes (both P = 0.001). Confocal observation of dermal nests or atypical cells in the papillary dermis was related to a higher mitotic rate (P = 0.006 and P = 0.03, respectively). Similarly, diffuse inflammatory infiltrates visible in the superficial dermis was associated with higher Breslow (P = 0.04) and mitotic index (P = 0.04). CONCLUSIONS: Dermoscopic and RCM in vivo findings on primary melanoma correlate with histopathologic Breslow index, mitotic rate and tumor infiltrating lymphocytes. The architecture and cytology of primary melanoma can be estimated by combining dermoscopy and RCM prior to excision.
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spelling pubmed-96811982022-12-02 Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma Barragán-Estudillo, Zamira Faride Brito, Johanna Chavez-Bourgeois, Marion Alejo, Beatriz Alos, Llucia García, Adriana Patricia Puig, Susana Malvehy, Josep Carrera, Cristina Dermatol Pract Concept Original Article INTRODUCTION: Non-invasive imaging techniques offer the possibility to optimize the first approach to melanoma. Reflectance Confocal Microscopy (RCM) has a promising role in predicting the main prognostic events in the dermo-epidermal and papillary dermis. OBJECTIVES: To identify pre-surgical criteria that can predict the main prognostic features of melanoma. METHODS: A retrospective cohort-study evaluated dermoscopic, confocal and histopathological characteristics of consecutively diagnosed sporadic melanomas. RCM-melanoma patterns classified into 1) dendritic-cell, 2) round-cell, 3) dermal nest and 4) combined type. Acral, facial and mucosal locations were excluded. RESULTS: Ninety-two primary melanomas were included: 44 males and 48 females (mean age 60.4 years, standard deviation [SD] 16.2) with a mean Breslow of 1.43 mm (SD 1.6). The most frequent dermoscopic presentation was the multicomponent pattern, the predominant confocal pattern was dendritic-cell type (44.6%). The presence of pigmented network on dermoscopy was related to lower Breslow and mitotic rates (both P = 0.002); in contrast to the presence of visible vessels, which was related to higher Breslow and mitotic indexes (both P = 0.001). Confocal observation of dermal nests or atypical cells in the papillary dermis was related to a higher mitotic rate (P = 0.006 and P = 0.03, respectively). Similarly, diffuse inflammatory infiltrates visible in the superficial dermis was associated with higher Breslow (P = 0.04) and mitotic index (P = 0.04). CONCLUSIONS: Dermoscopic and RCM in vivo findings on primary melanoma correlate with histopathologic Breslow index, mitotic rate and tumor infiltrating lymphocytes. The architecture and cytology of primary melanoma can be estimated by combining dermoscopy and RCM prior to excision. Mattioli 1885 2022-10-01 /pmc/articles/PMC9681198/ /pubmed/36534562 http://dx.doi.org/10.5826/dpc.1204a174 Text en ©2022 Barragán-Estudillo et al. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
spellingShingle Original Article
Barragán-Estudillo, Zamira Faride
Brito, Johanna
Chavez-Bourgeois, Marion
Alejo, Beatriz
Alos, Llucia
García, Adriana Patricia
Puig, Susana
Malvehy, Josep
Carrera, Cristina
Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma
title Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma
title_full Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma
title_fullStr Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma
title_full_unstemmed Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma
title_short Dermoscopy and Reflectance Confocal Microscopy to Estimate Breslow Index and Mitotic Rate in Primary Melanoma
title_sort dermoscopy and reflectance confocal microscopy to estimate breslow index and mitotic rate in primary melanoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9681198/
https://www.ncbi.nlm.nih.gov/pubmed/36534562
http://dx.doi.org/10.5826/dpc.1204a174
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