Background: Seborrheic keratoses (SebK) with atypical dermoscopy presentation are increasingly reported. These lesions do not exhibit typical dermoscopy features of SebK and sometimes mimic melanoma, thus complicating the differential diagnosis. Reflectance confocal microscopy (RCM) is a non-invasive tool, which allows an in vivo imaging of the skin. Objective: To evaluate the agreement between RCM classification and histological diagnoses, and the reliability of well-known RCM criteria for SebK in the identification of SebK with atypical dermoscopy presentation. Methodology: We retrospectively analysed at RCM excised lesions presenting in dermoscopy ≥1 score at revisited 7-point checklist. The study population consisted of cases showing no melanocytic RCM findings. Lesions were investigated for distinct non-melanocytic RCM features, blinded from histopathology diagnoses. Histopathology matching was then performed before statistical analysis. Results: The study consisted of 117 cases, classified at RCM as SebK (71 cases), dermatofibroma (DF; 18 cases), basal cell carcinoma (BCC; 13 cases), squamous cell carcinoma (SCC; 2 cases), and “non specific” (13 cases). Overall K strength of agreement at histopathology matching proved 0.76. Of the 71 cases classified at RCM with SebK, agreement was achieved in 97%. Conclusions: RCM classification proved high agreement with histopathology for SebK with atypical dermoscopy presentations, allowing an early differential diagnosis. RCM features in this group of lesions were similar to those described for typical cases of SebK, and may assist clinician therapy decision making, whilst avoiding unnecessary excisions.

Seborrheic keratoses mimicking melanoma unveiled by in vivo reflectance confocal microscopy / Pezzini, Claudia; Mandel, Victor Desmond; Persechino, Flavia; Ciardo, Silvana; Kaleci, Shaniko; Chester, Johanna; DE CARVALHO, Nathalie; Persechino, Severino; Pellacani, Giovanni; Farnetani, Francesca. - (2018). ((Intervento presentato al convegno 5th World Congress of Dermoscopy tenutosi a Salonicco nel 14-16 Giugno 2018.

Seborrheic keratoses mimicking melanoma unveiled by in vivo reflectance confocal microscopy

PEZZINI, Claudia
;
MANDEL, Victor Desmond;PERSECHINO, Flavia;KALECI, Shaniko;CHESTER, Johanna;DE CARVALHO, Nathalie;PELLACANI, Giovanni;FARNETANI, Francesca
2018

Abstract

Background: Seborrheic keratoses (SebK) with atypical dermoscopy presentation are increasingly reported. These lesions do not exhibit typical dermoscopy features of SebK and sometimes mimic melanoma, thus complicating the differential diagnosis. Reflectance confocal microscopy (RCM) is a non-invasive tool, which allows an in vivo imaging of the skin. Objective: To evaluate the agreement between RCM classification and histological diagnoses, and the reliability of well-known RCM criteria for SebK in the identification of SebK with atypical dermoscopy presentation. Methodology: We retrospectively analysed at RCM excised lesions presenting in dermoscopy ≥1 score at revisited 7-point checklist. The study population consisted of cases showing no melanocytic RCM findings. Lesions were investigated for distinct non-melanocytic RCM features, blinded from histopathology diagnoses. Histopathology matching was then performed before statistical analysis. Results: The study consisted of 117 cases, classified at RCM as SebK (71 cases), dermatofibroma (DF; 18 cases), basal cell carcinoma (BCC; 13 cases), squamous cell carcinoma (SCC; 2 cases), and “non specific” (13 cases). Overall K strength of agreement at histopathology matching proved 0.76. Of the 71 cases classified at RCM with SebK, agreement was achieved in 97%. Conclusions: RCM classification proved high agreement with histopathology for SebK with atypical dermoscopy presentations, allowing an early differential diagnosis. RCM features in this group of lesions were similar to those described for typical cases of SebK, and may assist clinician therapy decision making, whilst avoiding unnecessary excisions.
5th World Congress of Dermoscopy
Salonicco
14-16 Giugno 2018
Pezzini, Claudia; Mandel, Victor Desmond; Persechino, Flavia; Ciardo, Silvana; Kaleci, Shaniko; Chester, Johanna; DE CARVALHO, Nathalie; Persechino, Severino; Pellacani, Giovanni; Farnetani, Francesca
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/1205217
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