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In Vivo Observation of Magnified Features of Pigmented Lesions on Volar Skin Using Video Macroscope: Usefulness of Epiluminescence Techniques in Clinical Diagnosis

In Vivo Observation of Magnified Features of Pigmented Lesions on Volar Skin Using Video... Abstract Background and Design: In vivo epiluminescence microscopy is now used as a useful noninvasive method for determining clinical diagnosis of pigmented skin lesions. Until now, however, pigmented lesions on the volar skin have been hardly studied with this method. In the present epiluminescent study, various kinds of pigmented lesions on the volar skin were extensively investigated by means of video macroscope, a newly developed electronic device with a higher magnification power, and correlation between the magnified features and histopathologic findings was evaluated. Results: Magnified features of most lesions of acquired or congenital melanocytic nevus on the volar skin were classified into the following three typical patterns: (1) a parallel pattern formed by pigmented parallel lines corresponding to the furrows of the skin markings, (2) a latticelike pattern composed of pigmented lines along and across the furrows of the skin markings, and (3) a fibrillar pattern formed by densely packed, fibrillar pigmented lines arranged in the direction crossing the furrows. In contrast, macular or plaque portions of acral lentiginous melanoma exhibited disorderly arranged, irregular pigment patterns, mainly affecting the ridges of the skin markings. In addition, brown globules of various shades and many black dots of variable sizes were often observed and, on the margin of the lesions, pseudopods and/or the ''serrated'' pattern were detected. Cutaneous hemorrhagic macule and so-called black heel showed highly specific features and thus could be easily diagnosed with video macroscopy. Conclusion: Video macroscope proved to be a very useful instrument for the diagnosis of pigmented lesions on the volar skin.(Arch Dermatol. 1995;131:298-304) References 1. Bahmer FA, Rohrer C. Ein Beitrag zur Abgrenzung früher Melanome mittels einer einfachen Methode der hochauflösenden Hautoberflächen-Fotografie . Akt Dermatol. 1985;11:149-153. 2. 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;17:571-583.Crossref 3. 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;17:589-591.Crossref 4. Soyer HP, Smolle J, Hödl S, Pachernegg H, Kerl H. Surface microscopy: a new approach to the diagnosis of cutaneous pigmented tumors . Am J Dermatopathol. 1989;11:1-10.Crossref 5. Kreusch J, Rassner G. Strukturanalyse melanozytischer Pigmentmale durch Auflichtmikroskopie . Hautarzt. 1990;41:27-33. 6. Braun-Falco 0, Stolz W, Bilek P, Merkle T, Landthaler M. Das Dermatoskop: eine Vereinfachung der Autflichtmikroskopie von pigmentierten Hautveraederungen . Hautarzt. 1990;41:131-136. 7. Kenet RO, Kang S, Kenet BJ, Fitzpatrick TB, Sober AJ, Barnhill RL. Clinical diagnosis of pigmented lesions using digital epiluminescence microscopy: grading protocol and atlas . Arch Dermatol. 1993:129:157-174.Crossref 8. Pehamberger H, Binder M, Steiner A, Wolff K. In vivo epiluminescence: microscopy improvement of early diagnosis of melanoma . J Invest Dermatol. 1993;100:356S-362S.Crossref 9. Lever WF, Schaumburg-Lever G. Histopathology of the Skin . 7th ed. Philadelphia, Pa: JB Lippincott; 1990. 10. Maize JC, Ackerman AB. Pigmented Lesions of the Skin . Philadelphia, Pa: Lea & Febiger; 1987. 11. Clark WH, Goldman LI, Mastrangelo MJ. Human Malignant Melanoma . New York, NY: Grune & Stratton; 1979. 12. Bahmer FA, Fritsch P, Kreusch J, et al. Terminology in surface microscopy . J Am Acad Dermatol. 1990;23:1159-1162.Crossref 13. Yadav S, Vossaert KA, Kopf AW, Silverman M, Grin-Jorgensen C. Histopathologic correlates of structures seen on dermoscopy (epiluminescence microscopy) . Am J Dermatopathol. 1993;15:297-305.Crossref 14. Ackerman AB, Magna-Garacia M. Naming acquired melanocytic nevi: Unna's, Miescher's, Spitz's, Clark's . Am J Dermatopathol. 1990;12:193-209.Crossref 15. Saida T, Yoshida N. Guidelines for histopathologic diagnosis of plantar malignant melanoma: two-dimensional coordination of maximum diameter of lesions and degrees of intraepidermal proliferation of melanocytes . Dermatologica . 1990;181:112-116.Crossref 16. Ackerman AB. What naevus is dysplastic, a syndrome and the commonest precursor of malignant melanoma? a riddle and an answer . Histopathology . 1988;13:241-256.Crossref 17. Fritsch P, Pechlaner R. Differentiation of benign from malignant melanocytic lesions using incident light microscopy . In: Ackerman AB, ed. Pathology of Malignant Melanoma . New York, NY: Masson Publishing USA Inc; 1981:301-312. 18. Kreusch J, Rassner G, Trahn C, Pietsch-Breitfeld B, Henke D, Selbmann HK. Epiluminescent microscopy: a score of morphological features to identify malignant melanoma . Pigment Cell Res. 1992( (suppl 2) ):295-298. 19. Schindewolf T, Stolz W, Alber R, Abmayer W, Harms H. Composition of classification rates for conventional and dermatoscopic images of malignant and benign melanocytic lesions using computerized colour image analysis . Eur J Dermatol. 1993;3:299-303. 20. Puppin D, Salomon D, Saurat J-H. Amplified surface microscopy: preliminary evaluation of a 400-fold magnification in the surface microscopy of cutaneous melanocytic lesions . J Am Acad Dermatol. 1993;28:923-927.Crossref 21. Pinkus H, Rogin J, Goldman P. Eccrine poroma: tumor exhibiting features of the epidermal sweat duct unit . Arch Dermatol. 1956;74:511-521.Crossref 22. Saida T. Malignant melanoma in situ on the sole of the foot: its clinical and histopathologic characteristics . Am J Dermatopathol. 1989;11:124-130.Crossref 23. Ishihara Y, Kawachi S, Saida T. Video macroscopic findings of the pigmented lesions on the volar skin [in Japanese] . Jpn J Dermatol. 1993;103:1323-1331. 24. Okada N, Nakatani S, Ozawa K, Sato K, Yoshikawa K. Video macroscopic study of psoriasis . J Am Acad Dermatol. 1991;25:1077-1078.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

In Vivo Observation of Magnified Features of Pigmented Lesions on Volar Skin Using Video Macroscope: Usefulness of Epiluminescence Techniques in Clinical Diagnosis

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1995.01690150062013
Publisher site
See Article on Publisher Site

Abstract

Abstract Background and Design: In vivo epiluminescence microscopy is now used as a useful noninvasive method for determining clinical diagnosis of pigmented skin lesions. Until now, however, pigmented lesions on the volar skin have been hardly studied with this method. In the present epiluminescent study, various kinds of pigmented lesions on the volar skin were extensively investigated by means of video macroscope, a newly developed electronic device with a higher magnification power, and correlation between the magnified features and histopathologic findings was evaluated. Results: Magnified features of most lesions of acquired or congenital melanocytic nevus on the volar skin were classified into the following three typical patterns: (1) a parallel pattern formed by pigmented parallel lines corresponding to the furrows of the skin markings, (2) a latticelike pattern composed of pigmented lines along and across the furrows of the skin markings, and (3) a fibrillar pattern formed by densely packed, fibrillar pigmented lines arranged in the direction crossing the furrows. In contrast, macular or plaque portions of acral lentiginous melanoma exhibited disorderly arranged, irregular pigment patterns, mainly affecting the ridges of the skin markings. In addition, brown globules of various shades and many black dots of variable sizes were often observed and, on the margin of the lesions, pseudopods and/or the ''serrated'' pattern were detected. Cutaneous hemorrhagic macule and so-called black heel showed highly specific features and thus could be easily diagnosed with video macroscopy. Conclusion: Video macroscope proved to be a very useful instrument for the diagnosis of pigmented lesions on the volar skin.(Arch Dermatol. 1995;131:298-304) References 1. Bahmer FA, Rohrer C. Ein Beitrag zur Abgrenzung früher Melanome mittels einer einfachen Methode der hochauflösenden Hautoberflächen-Fotografie . Akt Dermatol. 1985;11:149-153. 2. 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;17:571-583.Crossref 3. 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;17:589-591.Crossref 4. Soyer HP, Smolle J, Hödl S, Pachernegg H, Kerl H. Surface microscopy: a new approach to the diagnosis of cutaneous pigmented tumors . Am J Dermatopathol. 1989;11:1-10.Crossref 5. Kreusch J, Rassner G. Strukturanalyse melanozytischer Pigmentmale durch Auflichtmikroskopie . Hautarzt. 1990;41:27-33. 6. Braun-Falco 0, Stolz W, Bilek P, Merkle T, Landthaler M. Das Dermatoskop: eine Vereinfachung der Autflichtmikroskopie von pigmentierten Hautveraederungen . Hautarzt. 1990;41:131-136. 7. Kenet RO, Kang S, Kenet BJ, Fitzpatrick TB, Sober AJ, Barnhill RL. Clinical diagnosis of pigmented lesions using digital epiluminescence microscopy: grading protocol and atlas . Arch Dermatol. 1993:129:157-174.Crossref 8. Pehamberger H, Binder M, Steiner A, Wolff K. In vivo epiluminescence: microscopy improvement of early diagnosis of melanoma . J Invest Dermatol. 1993;100:356S-362S.Crossref 9. Lever WF, Schaumburg-Lever G. Histopathology of the Skin . 7th ed. Philadelphia, Pa: JB Lippincott; 1990. 10. Maize JC, Ackerman AB. Pigmented Lesions of the Skin . Philadelphia, Pa: Lea & Febiger; 1987. 11. Clark WH, Goldman LI, Mastrangelo MJ. Human Malignant Melanoma . New York, NY: Grune & Stratton; 1979. 12. Bahmer FA, Fritsch P, Kreusch J, et al. Terminology in surface microscopy . J Am Acad Dermatol. 1990;23:1159-1162.Crossref 13. Yadav S, Vossaert KA, Kopf AW, Silverman M, Grin-Jorgensen C. Histopathologic correlates of structures seen on dermoscopy (epiluminescence microscopy) . Am J Dermatopathol. 1993;15:297-305.Crossref 14. Ackerman AB, Magna-Garacia M. Naming acquired melanocytic nevi: Unna's, Miescher's, Spitz's, Clark's . Am J Dermatopathol. 1990;12:193-209.Crossref 15. Saida T, Yoshida N. Guidelines for histopathologic diagnosis of plantar malignant melanoma: two-dimensional coordination of maximum diameter of lesions and degrees of intraepidermal proliferation of melanocytes . Dermatologica . 1990;181:112-116.Crossref 16. Ackerman AB. What naevus is dysplastic, a syndrome and the commonest precursor of malignant melanoma? a riddle and an answer . Histopathology . 1988;13:241-256.Crossref 17. Fritsch P, Pechlaner R. Differentiation of benign from malignant melanocytic lesions using incident light microscopy . In: Ackerman AB, ed. Pathology of Malignant Melanoma . New York, NY: Masson Publishing USA Inc; 1981:301-312. 18. Kreusch J, Rassner G, Trahn C, Pietsch-Breitfeld B, Henke D, Selbmann HK. Epiluminescent microscopy: a score of morphological features to identify malignant melanoma . Pigment Cell Res. 1992( (suppl 2) ):295-298. 19. Schindewolf T, Stolz W, Alber R, Abmayer W, Harms H. Composition of classification rates for conventional and dermatoscopic images of malignant and benign melanocytic lesions using computerized colour image analysis . Eur J Dermatol. 1993;3:299-303. 20. Puppin D, Salomon D, Saurat J-H. Amplified surface microscopy: preliminary evaluation of a 400-fold magnification in the surface microscopy of cutaneous melanocytic lesions . J Am Acad Dermatol. 1993;28:923-927.Crossref 21. Pinkus H, Rogin J, Goldman P. Eccrine poroma: tumor exhibiting features of the epidermal sweat duct unit . Arch Dermatol. 1956;74:511-521.Crossref 22. Saida T. Malignant melanoma in situ on the sole of the foot: its clinical and histopathologic characteristics . Am J Dermatopathol. 1989;11:124-130.Crossref 23. Ishihara Y, Kawachi S, Saida T. Video macroscopic findings of the pigmented lesions on the volar skin [in Japanese] . Jpn J Dermatol. 1993;103:1323-1331. 24. Okada N, Nakatani S, Ozawa K, Sato K, Yoshikawa K. Video macroscopic study of psoriasis . J Am Acad Dermatol. 1991;25:1077-1078.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Mar 1, 1995

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