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Clinical, Dermoscopic and Histopathologic Correlation in Melanocytic Nevi

Yıl 2019, Cilt: 41 Sayı: 3, 262 - 270, 01.07.2019
https://doi.org/10.20515/otd.457625

Öz

Dermoscopy
is a noninvasive technique that facilitates the diagnosis of melanocytic nevus
(MN). Different algorithms are used in the differential diagnosis of
melanocytic lesions. In this study, we aimed to correlate the sensitivity and
specificity of the ABCD rule, 7 point control list and pattern analysis in MN. A
total of 60 MNs of 38 patients who applied to dermatology outpatient clinic
have been evaluated. Hand dermatoscopy (Dermatoscope Delta 10) and digital
dermatoscope (MoleMax II) were used for dermoscopic examination, and  each of the dermoscopic images were assessed
with the pattern analysis, the 7 point checklist and the ABCD rule. After
dermoscopic examination, lesions were examined histopathologically following
excisional or punch biopsy. The concordance between dermoscopic and
histopathologic diagnosis were evaluated.
In
our study, the sensitivities of ABCD rule, 7 point control list and pattern
analysis were 94.6%, 92.9% and 97.5% respectively. The specificities were 78.3%,
 85% and 95% respectively. According to
our study, pattern analysis method had
the highest specificity and sensitivity.  

Kaynakça

  • 1. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ. Fitzpatrick’s dermatology in general medicine. 7th ed. New York: McGraw-Hill; 2007.
  • 2. Anadolu R, Akay BN. Melanomun dermoskopik bulguları. İç: Tüzün Y, editör, Dermatolojide Gelişmeler-6. İstanbul:Acamedia; 2007.s.76-85.
  • 3. Pehamberger H, Steiner A, Wolff K. In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions. J Am Acad Dermatol 1987;17:571-83.
  • 4. Nachbar F, Stolz W, Merkle T, et al. The ABCD rule of dermatoscopy. High prospective value in the diagnosis of doubtful melanocytic skin lesions. J Am Acad Dermatol 1994;30:551-9.
  • 5. Stolz W, Riemann A, Cognetta AB, Braun-Falco O. ABCD rule of dermatoscopy: a new practical method for early recognition of malignant melanoma. Eur J Dermatol. 1994;4:521-7.
  • 6. Argenziano G, Fabbrocini G, Carli P, et al. Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions: comparison of the ABCD rule of dermatoscopy and a new 7-point checklist based on pattern analysis. Arch Dermatol. 1998;134:1563-70.
  • 7. Rabinovitz HS, Barnhill RL. Benign Melanocytic Neoplasms. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd edn. St. Louis: Mosby Elsevier; 2012, p. 1861-1863.
  • 8. Rabinovitz HS, Barnhill RL. Benign Melanocytic Neoplasms. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd edn. St. Louis: Mosby Elsevier; 2012, p. 1868-1871.
  • 9. Carli P, de Giorgi V, Chiarugi A, et al. Addition of dermoscopy to conventional naked-eye examination in melanoma screening: a randomized study. J Am Acad Dermatol 2004;50:683-9.
  • 10. Steiner A, Pehamberger H, Wolff K. In vivo epiluminescence microscopy of pigmented skin lesions. II. Diagnosis of small pigmented skin lesions and early detection of malignant melanoma. J Am Acad Dermatol 1987;17:584-91.
  • 11. Steiner A, Pehamberger H, Wolff K. Improvement of the diagnostic accuracy in pigmented skin lesions by epiluminescent light microscopy. Anticancer Res 1987;7:433-4.
  • 12. Blum A, Rassner G, Garbe C. Modified ABC-point list of dermoscopy: A simplified and highly accurate dermoscopic algorithm for the diagnosis of cutaneous melanocytic lesions. J Am Acad Dermatol 2003;48:672-8.
  • 13. Annessi G, Bono R, Sampogna F, Faraggiana T, Abeni D. Sensitivity, specificity, and diagnostic accuracy of three dermoscopic algorithmic methods in the diagnosis of doubtful melanocytic lesions: the importance of light brown structureless areas in differentiating atypical melanocytic nevi from thin melanomas. J Am Acad Dermatol 2007;56:759-67.
  • 14. Şahin MT, Ermertcan AT, İnanır Işıl, Demir MA, Öztürkcan S. Nevus Nevosellularislerde Dermoskopik ve Histopatolojik Tanıların Karşılaştırılması. ADÜ Tıp Fakültesi Dergisi 2004;5:19-22.
  • 15. Hofmann-Wellenhof R, Blum A, Wolf IH, et al. Dermoscopic classification of Clark's nevi (atypical melanocytic nevi). Clin Dermatol 2002;20:255-8.
  • 16. Özdemir F, Ünal İ, Ceylan C, Ertam İ. Bölgemizde görülen Clark nevusların dermoskopik klasifikasyonu. Türkderm 2001;35:300-6.
  • 17. Morales-Callaghan AM, Castrodeza-Sanz J, Martínez-García G, Peral-Martínez I, Miranda-Romeroa A. Correlation between clinical, dermatoscopic and histopathologic variables in atypical melanocytic nevi. Actas Dermosifiliogr 2008;99:380-9.
  • 18. Carli P, De Giorgi V, Massi D, Giannotti B. The role of pattern analysis and the ABCD rule of dermoscopy in the detection of histological atypia in melanocytic naevi. Br J Dermatol 2000;143:290-7.
  • 19. Steiner A, Binder M, Schemper M, Wolff K, Pehamberger H. Statistical evaluation of epiluminescence microscopy criteria for melanocytic pigmented skin lesions. J Am Acad Dermatol 1993;29:581-8.
  • 20. Friedman RJ, Farber MJ, Warycha MA, Papathasis N, Miller MK, Heilman ER. The "dysplastic" nevus. Clinics in Dermatol 2009;27:103-15.
  • 21. Roesch A, Burgdorf W, Stolz W, et al. Dermatoscopy of "dysplastic nevi": a beacon in diagnostic darkness. Eur J Dermatol 2006;16:479-93.

Melanositik Nevuslarda Klinik, Dermoskopik ve Histopatolojik Korelasyon

Yıl 2019, Cilt: 41 Sayı: 3, 262 - 270, 01.07.2019
https://doi.org/10.20515/otd.457625

Öz

Dermoskopi,
melanositik nevuslara (MN) tanı konmasını kolaylaştıran noninvazif bir
tekniktir. Melanositik lezyonların ayırıcı tanısında farklı algoritmalar
kullanılmaktadır. Bu çalışmada MN’larda ABCD kuralı,
7 nokta kontrol listesi ve
patern analizinin duyarlılık, özgüllük ve tanısal doğruluklarının korelasyonu
amaçlanmıştır. Çalışmamızda dermatoloji polikliniğine başvuran 38 hastaya ait
toplam 60  MN klinik, dermoskopik ve
histopatolojik olarak değerlendirilmiştir. Dermoskopik muayenede el dermoskopu
(Dermatoskop Delta 10) ve digital dermoskop (MoleMax II) kullanılmış; her bir
lezyon ABCD kuralı,
7 nokta kontrol listesi ve patern
analizine göre skorlanmıştır. Dermoskopik muayene sonrası lezyonlar eksizyon
veya punch biyopsi ile alınarak histopatolojik olarak incelenmiş; dermoskopik
ve histopatolojik tanıların uyumluluğu değerlendirilmiştir. Çalışmamızda ABCD
kuralının, 7 nokta kontrol listesinin ve patern analizinin duyarlılıkları  sırasıyla %94.6, %92.9 ve %97.5 olarak
saptanırken;  özgüllükleri ise sırasıyla
%78.3
,  %85  %95 olarak bulunmuştur. Çalışmamıza göre
melanositik lezyonların patern analizi yöntemi en yüksek özgüllük ve
duyarlılılığa sahiptir. 

Kaynakça

  • 1. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ. Fitzpatrick’s dermatology in general medicine. 7th ed. New York: McGraw-Hill; 2007.
  • 2. Anadolu R, Akay BN. Melanomun dermoskopik bulguları. İç: Tüzün Y, editör, Dermatolojide Gelişmeler-6. İstanbul:Acamedia; 2007.s.76-85.
  • 3. Pehamberger H, Steiner A, Wolff K. In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions. J Am Acad Dermatol 1987;17:571-83.
  • 4. Nachbar F, Stolz W, Merkle T, et al. The ABCD rule of dermatoscopy. High prospective value in the diagnosis of doubtful melanocytic skin lesions. J Am Acad Dermatol 1994;30:551-9.
  • 5. Stolz W, Riemann A, Cognetta AB, Braun-Falco O. ABCD rule of dermatoscopy: a new practical method for early recognition of malignant melanoma. Eur J Dermatol. 1994;4:521-7.
  • 6. Argenziano G, Fabbrocini G, Carli P, et al. Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions: comparison of the ABCD rule of dermatoscopy and a new 7-point checklist based on pattern analysis. Arch Dermatol. 1998;134:1563-70.
  • 7. Rabinovitz HS, Barnhill RL. Benign Melanocytic Neoplasms. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd edn. St. Louis: Mosby Elsevier; 2012, p. 1861-1863.
  • 8. Rabinovitz HS, Barnhill RL. Benign Melanocytic Neoplasms. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd edn. St. Louis: Mosby Elsevier; 2012, p. 1868-1871.
  • 9. Carli P, de Giorgi V, Chiarugi A, et al. Addition of dermoscopy to conventional naked-eye examination in melanoma screening: a randomized study. J Am Acad Dermatol 2004;50:683-9.
  • 10. Steiner A, Pehamberger H, Wolff K. In vivo epiluminescence microscopy of pigmented skin lesions. II. Diagnosis of small pigmented skin lesions and early detection of malignant melanoma. J Am Acad Dermatol 1987;17:584-91.
  • 11. Steiner A, Pehamberger H, Wolff K. Improvement of the diagnostic accuracy in pigmented skin lesions by epiluminescent light microscopy. Anticancer Res 1987;7:433-4.
  • 12. Blum A, Rassner G, Garbe C. Modified ABC-point list of dermoscopy: A simplified and highly accurate dermoscopic algorithm for the diagnosis of cutaneous melanocytic lesions. J Am Acad Dermatol 2003;48:672-8.
  • 13. Annessi G, Bono R, Sampogna F, Faraggiana T, Abeni D. Sensitivity, specificity, and diagnostic accuracy of three dermoscopic algorithmic methods in the diagnosis of doubtful melanocytic lesions: the importance of light brown structureless areas in differentiating atypical melanocytic nevi from thin melanomas. J Am Acad Dermatol 2007;56:759-67.
  • 14. Şahin MT, Ermertcan AT, İnanır Işıl, Demir MA, Öztürkcan S. Nevus Nevosellularislerde Dermoskopik ve Histopatolojik Tanıların Karşılaştırılması. ADÜ Tıp Fakültesi Dergisi 2004;5:19-22.
  • 15. Hofmann-Wellenhof R, Blum A, Wolf IH, et al. Dermoscopic classification of Clark's nevi (atypical melanocytic nevi). Clin Dermatol 2002;20:255-8.
  • 16. Özdemir F, Ünal İ, Ceylan C, Ertam İ. Bölgemizde görülen Clark nevusların dermoskopik klasifikasyonu. Türkderm 2001;35:300-6.
  • 17. Morales-Callaghan AM, Castrodeza-Sanz J, Martínez-García G, Peral-Martínez I, Miranda-Romeroa A. Correlation between clinical, dermatoscopic and histopathologic variables in atypical melanocytic nevi. Actas Dermosifiliogr 2008;99:380-9.
  • 18. Carli P, De Giorgi V, Massi D, Giannotti B. The role of pattern analysis and the ABCD rule of dermoscopy in the detection of histological atypia in melanocytic naevi. Br J Dermatol 2000;143:290-7.
  • 19. Steiner A, Binder M, Schemper M, Wolff K, Pehamberger H. Statistical evaluation of epiluminescence microscopy criteria for melanocytic pigmented skin lesions. J Am Acad Dermatol 1993;29:581-8.
  • 20. Friedman RJ, Farber MJ, Warycha MA, Papathasis N, Miller MK, Heilman ER. The "dysplastic" nevus. Clinics in Dermatol 2009;27:103-15.
  • 21. Roesch A, Burgdorf W, Stolz W, et al. Dermatoscopy of "dysplastic nevi": a beacon in diagnostic darkness. Eur J Dermatol 2006;16:479-93.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Asude Kara Polat 0000-0002-5040-6901

İlham Sabuncu Bu kişi benim 0000-0002-8764-7709

Evrim Yılmaz Bu kişi benim 0000-0003-1937-8313

Zeynep Nurhan Saraçoğlu 0000-0002-9116-2288

Ayşe Esra Koku Aksu 0000-0002-3457-1958

Muzaffer Bilgin 0000-0002-6072-6466

Yayımlanma Tarihi 1 Temmuz 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 41 Sayı: 3

Kaynak Göster

Vancouver Kara Polat A, Sabuncu İ, Yılmaz E, Saraçoğlu ZN, Koku Aksu AE, Bilgin M. Melanositik Nevuslarda Klinik, Dermoskopik ve Histopatolojik Korelasyon. Osmangazi Tıp Dergisi. 2019;41(3):262-70.


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