Melanoma and naevi with a globular pattern: confocal microscopy as an aid for diagnostic differentiation.
Title | Melanoma and naevi with a globular pattern: confocal microscopy as an aid for diagnostic differentiation. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Benati, E., Argenziano G., Kyrgidis A., Moscarella E., Ciardo S., Bassoli S., Farnetani F., Piana S., Cesinaro A. M., Lallas A., Borsari S., Pellacani G., & Longo C. |
Journal | Br J Dermatol |
Volume | 173 |
Issue | 5 |
Pagination | 1232-8 |
Date Published | 2015 Nov |
ISSN | 1365-2133 |
Keywords | Adult, Diagnosis, Differential, Early Detection of Cancer, Female, Humans, Male, Melanoma, Microscopy, Confocal, Nevus, Pigmented, Retrospective Studies, Risk Factors, Skin Neoplasms |
Abstract | BACKGROUND: Dermoscopically, one of the most common findings in melanocytic lesions is a globular pattern. A regular globular pattern is a common finding in naevi. Melanoma can also show a globular pattern, with globules typically irregular in size, colour and distribution.OBJECTIVES: To investigate the likelihood of diagnosing melanoma according to distinct dermoscopic and confocal aspects.METHODS: Dermoscopic and confocal aspects of 83 excised melanocytic lesions dermoscopically showing globules were analysed.RESULTS: Our study population included 39 acquired melanocytic naevi, 16 Spitz naevi and 28 melanomas. Univariate analysis showed that regular distribution of globules on dermoscopy is associated with a ninefold lower risk for melanoma, whereas an irregular distribution is associated with an almost 10-fold increased risk for melanoma. Concerning confocal features, dense nests are associated with a fivefold lower risk for melanoma, whereas loosely arranged nests are associated with an almost sixfold risk for melanoma; moreover, the presence of round cells is associated with a 17-fold lower risk for melanoma, whereas pleomorphic cells are associated with an almost 16-fold risk for melanoma.CONCLUSIONS: So that melanoma is not missed, clinicians should carefully analyse globular lesions in adults, focusing, in particular, on the distribution of globules and on the presence of confocal cytological atypia. |
DOI | 10.1111/bjd.14049 |
Alternate Journal | Br J Dermatol |
PubMed ID | 26212145 |