Dermoscopic and histopathological correlation in macular hyperpigmented facial lesions

Authors

Keywords:

Actinic keratosis, Dermoscopy, Seborrheic keratosis, Solar lentigo

Abstract

Background/Aim: Solar lentigo, seborrheic keratosis, actinic keratosis, lentigo maligna are confusable hyperpigmented lesions. Dermoscopy is an important tool to distinguish the pigmented lesions on the face. This study aimed to determine the reliability of dermoscopy by comparatively analyzing dermoscopic findings with the histopathologic examination of facial hyperpigmented flat lesions. Methods: Patients with hyperpigmented flat lesions on the face such as solar lentigo, seborrheic keratosis, and actinic keratosis were included in this retrospective cohort study. Those with other causes of facial hyperpigmentation were excluded from the study, based on history, clinical evaluation, Wood's lamp examination, and dermoscopic findings. The dermoscopic criteria form, prepared for solar lentigo, seborrheic keratosis, actinic keratosis, and lentigo maligna were filled out. Biopsy was taken for histopathologic evaluation. Results: Fifty-one patients, 26 males, and 25 females, with 53 skin lesions were evaluated. We did not statistically evaluate 3 lesions that had a histopathologic diagnosis of actinic keratosis + solar lentigo. The other 50 lesions’ histopathologic diagnoses were actinic keratosis in 32 lesions, seborrheic keratosis in 9, and solar lentigo in 9. Kappa test was used for statistical analysis, which revealed a value of 0.645 (P<0.001). This shows that the dermoscopic and histopathological diagnoses of the hyperpigmented flat lesions on the face were moderately compatible. Conclusion: Since the dermoscopic diagnosis of facial pigmented lesions cannot be based on the presence of one criterion, we deduce that histopathology is still the gold standard for accurate diagnosis.

Downloads

Download data is not yet available.

References

Aksungur VL, Alpsoy E, Baykal C, Uzun S. Dermatolojide algoritmik tanı. İstanbul: Yelken Printing Office; 2007.

Anwar J, Wrone DA, Kimyai-Asadi A, Alam M. The development of actinic keratosis into invasive squamous cell carcinoma: evidence and evolving classification schemes. Clin Dermatol. 2004;22(3):189-96. doi: 10.1016/j.clindermatol.2003.12.006.

Arlette JP, Trotter MJ, Trotter T, Temple CLF. Management of lentigo maligna and lentigo maligna melanoma: seminars in surgical oncology. J Surg Oncol. 2004;86(4):179-86. doi: 10.1002/jso.20081.

Braun RP, Rabinovitz H, Oliviero M, Kopf AW, Saurat JH, Thomas L. Dermatoscopy of pigmented lesions. Ann Dermatol Venereol. 2002;129(2):187-202.

Menzies SW, Crotty KA, Ingvar C, McCarthy WH. An Atlas of Surface Microscopy of Pigmented Skin Lesions. Sydney: McGraw-Hill; 1996.

Çelebi M, Atılganoğlu U, Kural YB. Temel Dermoskopi. İstanbul: Nobel Medicine Bookstores; 2006.

Carli P, De Giorgi V, Soyer HP, Stante M, Mannone F, Giannotti B. Dermatoscopy in the diagnosis of pigmented skin lesions: a new semiology for the dermatologist. J Eur Acad Dermatol Venereol. 2000;14(5):353-69. doi: 10.1046/j.1468-3083.2000.00122.x.

Braun RP, Rabinovitz HS, Oliviero M, Kopf AW, Saurat JH. Dermoscopy of pigmented skin lesions. J Am Acad Dermatol. 2005;52(1):109-21. doi: 10.1016/j.jaad.2001.11.001.

Sahin MT, Öztürkcan S, Ermertcan AT, Güneş AT. A comparison of dermoscopic features among lentigo senilis/initial seborrheic keratosis, seborrheic keratosis, lentigo maligna and lentigo maligna melanoma on the face. J Dermatol. 2004;31(11):884-9. doi: 10.1111/j.1346-8138.2004.tb00621.x.

Stolz W, Braun-Falco O, Bilek P, Landthaler M, Burgdorf WHC, Cognetta AB. Color Atlas of Dermatoscopy. Berlin: Blackwell Publishing; 2002.

Soyer HP, Argenziano G, Hofmann-Wellenhof R, Johr R. Color Atlas of Melanocytic Lesions of the Skin. Berlin: Springer; 2007.

Stolz W, Schiffner R, Burgdorf WH. Dermatoscopy for facial pigmented skin lesions. Clin Dermatol. 2002;20(3):276-8. doi: 10.1016/s0738-081x(02)00221-3.

Pock L, Drlik L, Hercogova J. Dermatoscopy of pigmented actinic keratosis--a striking similarity to lentigo maligna. Int J Dermatol. 2007;46(4):414-6. doi: 10.1111/j.1365-4632.2006.03052.x.

Peris K, Micantonio T, Piccolo D, Fargnoli MC. Dermoscopic features of actinic keratosis. J Dtsch Dermatol Ges. 2007;5(11):970-6. doi: 10.1111/j.1610-0387.2007.06318.x.

Stante M, De Giorgi V, Stanganelli I, Alfaioli B, Carli P. Dermoscopy for early detection of facial lentigo maligna. Br J Dermatol. 2005;152(2):361-4. doi: 10.1111/j.1365-2133.2004.06328.x.

Zalaudek I, Giacomel J, Argenziano G, Hofmann-Wellenhof R, Micantonio T, Di Stefani A, et al. Dermoscopy of facial nonpigmented actinic keratosis. Br J Dermatol. 2006;155(5):951-6. doi: 10.1111/j.1365-2133.2006.07426.x.

Braun RP, Rabinovitz HS, Krischer J, Kreusch J, Oliviero M, Naldi L, et al. Dermoscopy of pigmented seborrheic keratosis: a morphological study. Arch Dermatol. 2002;138(12):1556-60. doi: 10.1001/archderm.138.12.1556.

Schiffner R, Perusquia AM, Stolz W. One-year follow-up of a lentigo maligna: first dermoscopic signs of growth. Br J Dermatol. 2004;151(5):1087-9. doi: 10.1111/j.1365-2133.2004.06225.x.

Robinson JK. Use of digital epiluminescence microscopy to help define the edge of lentigo maligna. Arch Dermatol. 2004;140(9):1095-100. doi: 10.1001/archderm.140.9.1095.

Cognetta AB, Stolz W, Katz B, Tullos J, Gossain S. Dermatoscopy of lentigo maligna. Dermatol Clin. 2001;19(2):307-18. doi: 10.1016/s0733-8635(05)70268-0.

Elgart GW. Seborrheic keratoses, solar lentigines, and lichenoid keratoses. Dermatoscopic features and correlation to histology and clinical signs. Dermatol Clin. 2001;19(2):347-57. doi: 10.1016/s0733-8635(05)70272-2.

Fleiss JL, Levin B, Cho Paik M. Statistical Method for Rates and Proportions. New Jersey: Wiley; 2003.

Stefanis AJ, Apalla Z, Papageorgiou C, Ioannides D, Nikolaidou C, Lallas A. A tiny facial pigmented macule: overcoming the diagnostic challenge. Dermatol Pract Concept. 2018;8(4):322-3. doi: 10.5826/dpc.0804a15.

Haas N, Hermes B, Henz BM. Detection of a novel pigment network feature in reticulated black solar lentigo by high-resolution epiluminescence microscopy. Am J Dermatopathol. 2002;24(3):213-7. doi: 10.1097/00000372-200206000-00005.

Zalaudek I, Ferrara G, Leinweber B, Mercogliano A, D’Ambrosio A, Argenziano G. Pitfalls in the clinical and dermoscopic diagnosis of pigmented actinic keratosis. J Am Acad Dermatol. 2005;53(6):1071-4. doi: 10.1016/j.jaad.2005.08.052.

Nascimento MM, Shitara D, Enokihara MMSS, Yamada S, Pellacani G, Rezze GG. Inner gray halo, a novel dermoscopic feature for the diagnosis of pigmented actinic keratosis: clues for the differential diagnosis with lentigo maligna. J Am Acad Dermatol. 2014;71(4):708-15. doi: 10.1016/j.jaad.2014.05.025.

Akay BN, Kocyigit P, Heper AO, Erdem C. Dermatoscopy of flat pigmented facial lesions: diagnostic challenge between pigmented actinic keratosis and lentigo maligna. Br J Dermatol. 2010;163(6):1212-17. doi: 10.1111/j.1365-2133.2010.10025.x.

De Giorgi V, Massi D, Stante M, Carlı P. False "melanocytic" parameters shown by pigmented seborrheic keratoses: a finding which is not uncommon in dermoscopy. Dermatol Surg. 2002;28(8):776-9. doi: 10.1046/j.1524-4725.2002.02002.x.

Argenziano G, Soyer HP, Chimenti S, Talamini R, Corona R, Sera F, et al. Dermoscopy of pigmented skin lesions: Results of a consensus meeting via the Internet. J Am Acad Dermatol. 2003;48(5):679-93. doi: 10.1067/mjd.2003.281.

Schiffner R, Schiffner-Rohe J, Vogt T, Landthaler M, Wlotzke U, Cognetta AB, et al. Improvement of early recognition of lentigo maligna using dermatoscopy. J Am Acad Dermatol. 2000;42(1):25-32. doi: 10.1016/s0190-9622(00)90005-7.

Tiodorovic-Zivkovic D, Argenziano G, Lallas A, Thomas L, Ignjatovic A, Rabinovitz H, et al. Age, gender, and topography influence the clinical and dermoscopic appearance of lentigo maligna. J Am Acad Dermatol. 2015;72(5):801-8. doi: 10.1016/j.jaad.2015.01.030.

Lallas A, Tschandl P, Kyrgidis A, Stolz W, Rabinovitz H, Cameron A, et al. Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis. Br J Dermatol. 2016;174(5):1079-85. doi: 10.1111/bjd.14355.

Bafounta ML, Beauchet A, Aegerter P, Saiag P. Is dermoscopy (epiluminescence microscopy) useful for the diagnosis of melanoma? Results of a meta-analysis using techniques adapted to the evaluation of diagnostic tests. Arch Dermatol. 2001;137(10):1343-50. doi: 10.1001/archderm.137.10.1343.

Costa-Silva M, Calistru A, Barros AM, Lopes S, Esteves M, Azevedo F. Dermatoscopy of flat pigmented facial lesions—evolution of lentigo maligna diagnostic criteria. Dermatol Pract Concept. 2018;8(3):198-203. doi: 10.5826/dpc.0803a10.

Sahin MT, Ermertcan AT, Inanir I, Demir MA, Ozturkcan S. Nevus nevosellularıslerde dermoskopik ve histopatolojik tanıların karşılaştırılması. ADÜ Tıp Fakültesi Dergisi. 2004;5(2):19-22.

Blum A, Siggs G, Marghoob AA, Kreusch J, Cabo H, Campos-do-Carmo G, et al. Collision skin lesions—results of a multicenter study of the International Dermoscopy Society (IDS). Dermatol Pract Concept. 2017;7(4):51-62. doi: https://doi.org/10.5826/dpc.0704a12.

Downloads

Published

2022-02-01

Issue

Section

Research Article

How to Cite

1.
Mülayim K, Yücel A. Dermoscopic and histopathological correlation in macular hyperpigmented facial lesions. J Surg Med [Internet]. 2022 Feb. 1 [cited 2024 Jul. 15];6(2):125-30. Available from: https://jsurgmed.com/article/view/996688