Diagnostic accuracy of pigmented labial macules by in vivo reflectance confocal microscopy and correlation among techniques.
J Am Acad Dermatol
; 85(5): 1151-1160, 2021 11.
Article
en En
| MEDLINE
| ID: mdl-32147389
ABSTRACT
BACKGROUND:
Pigmented labial macules (PLMs) are clinical, dermoscopic, and histopathologic challenges.OBJECTIVE:
To describe and evaluate the utility of reflectance confocal microscopy (RCM) in PLMs and to establish a correlation between dermoscopy, RCM, histopathology, and immunohistochemistry.METHODS:
Prospective study of PLMs from 4 tertiary referral dermatology centers. The study included 51 biopsy specimen-proven PLMs. Dermoscopic, RCM images, and histopathologic preparations were evaluated for malignant criteria. Diagnostic accuracy of RCM for melanoma diagnosis, RCM Lip Score previously reported, and κ values between techniques were calculated.RESULTS:
Included were 5 melanomas and 46 benign PLMs. Dermoscopically, melanomas exhibited more frequently ≥3 colors and ≥3 structures. With RCM, pagetoid spreading, epithelial disarray, continuous proliferation of atypical cells around papillae, nonhomogeneously distributed papillae, marked cellular atypia, and a higher number of dendritic cells per papillae were more frequent in melanomas. The RCM Lip Score was significantly higher in malignant lesions. Good κ values were observed in most of the evaluated features. A perfect sensitivity and specificity was obtained combining dermoscopy and RCM.LIMITATIONS:
A low number of melanomas were obtained.CONCLUSIONS:
RCM improves lip melanoma diagnosis, and the RCM Lip Score represents a useful tool for the evaluation of a PLM.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
/
Melanoma
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Humans
Idioma:
En
Revista:
J Am Acad Dermatol
Año:
2021
Tipo del documento:
Article