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2.
Actas dermo-sifiliogr. (Ed. impr.) ; 107(10): 830-835, dic. 2016. tab, ilus
Article in Spanish | IBECS | ID: ibc-158285

ABSTRACT

El lentigo maligno es el melanoma más frecuente en la cara. El diagnóstico del lentigo maligno es complicado porque los signos clínicos y dermatoscópicos asociados a lentigo maligno pueden verse en otras lesiones cutáneas faciales. La microscopia confocal de reflectancia es una técnica de imagen que permite detectar hallazgos característicos del lentigo maligno. En la epidermis encontramos la pérdida del patrón en panal de abejas y células pagetoides con tendencia al foliculotropismo. Estas células pagetoides suelen ser de morfología dendrítica, aunque también pueden presentarse como células redondas mayores de 20μm con núcleos atípicos. En la unión dermoepidérmica las papilas dérmicas pueden estar mal delimitadas y haber células atípicas. Estas células pueden formar puentes que parecen estructuras mitocondriales. Además, podemos ver engrosamientos junturales con células atípicas localizados alrededor de los folículos simulando una cabeza de medusa. La microscopia confocal de reflectancia es muy útil en el diagnóstico del lentigo maligno


Lentigo maligna is the most common type of facial melanoma. Diagnosis is complicated, however, as it shares clinical and dermoscopic characteristics with other cutaneous lesions of the face. Reflectance confocal microscopy is an imaging technique that permits the visualization of characteristic features of lentigo maligna. These include a disrupted honeycomb pattern and pagetoid cells with a tendency to show folliculotropism. These cells typically have a dendritic morphology, although they may also appear as round cells measuring over 20μm with atypical nuclei. Poorly defined dermal papillae and atypical cells may be seen at the dermal-epidermal junction and can form bridges resembling mitochondrial structures. Other characteristic findings include junctional swelling with atypical cells located around the follicles, resembling caput medusae. Reflectance confocal microscopy is a very useful tool for diagnosing lentigo maligna


Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Microscopy, Confocal/instrumentation , Microscopy, Confocal/methods , Lentigo/complications , Lentigo , Sensitivity and Specificity , Lymphoma, Follicular/complications , Lymphoma, Follicular , Recurrence , Diagnosis, Differential , Retrospective Studies
4.
Actas Dermosifiliogr ; 107(10): 830-835, 2016 Dec.
Article in English, Spanish | MEDLINE | ID: mdl-27614735

ABSTRACT

Lentigo maligna is the most common type of facial melanoma. Diagnosis is complicated, however, as it shares clinical and dermoscopic characteristics with other cutaneous lesions of the face. Reflectance confocal microscopy is an imaging technique that permits the visualization of characteristic features of lentigo maligna. These include a disrupted honeycomb pattern and pagetoid cells with a tendency to show folliculotropism. These cells typically have a dendritic morphology, although they may also appear as round cells measuring over 20µm with atypical nuclei. Poorly defined dermal papillae and atypical cells may be seen at the dermal-epidermal junction and can form bridges resembling mitochondrial structures. Other characteristic findings include junctional swelling with atypical cells located around the follicles, resembling caput medusae. Reflectance confocal microscopy is a very useful tool for diagnosing lentigo maligna.


Subject(s)
Hutchinson's Melanotic Freckle/pathology , Microscopy, Confocal , Humans
6.
Actas dermo-sifiliogr. (Ed. impr.) ; 106(8): e41-e44, oct. 2015. ilus
Article in Spanish | IBECS | ID: ibc-142672

ABSTRACT

El diagnóstico clínico diferencial entre el epitelioma basocelular y el nevus melanocítico intradérmico facial puede ser a veces complicado, sobre todo en pacientes jóvenes o con múltiples nevus. La dermatoscopia es una herramienta útil que permite observar signos dermatoscópicos asociados a epitelioma como las ruedas de carro, las hojas de arce, los nidos y puntos azul grisáceos y la ulceración, además permite distinguir los vasos telangiéctasicos arboriformes y los vasos cortos curvados bien enfocados característicos de los epiteliomas basocelulares de los vasos en coma presentes en los nevus melanocíticos intradérmicos. Sin embargo, el diagnóstico diferencial clínico y dermatoscópico entre estas 2 afecciones dermatológicas puede ser complejo. Presentamos 2 lesiones faciales en 2 pacientes de 38 años de difícil diagnóstico clínico y dermatoscópico en los que la microscopia confocal mostró nidos celulares con separación entre los nidos y el estroma, y polarización de los núcleos de las células tumorales, que son signos confocales asociados a epitelioma basocelular


The clinical distinction between basal cell carcinoma (BCC) and intradermal melanocytic nevus lesions on the face can be difficult, particularly in young patients or patients with multiple nevi. Dermoscopy is a useful tool for analyzing characteristic dermoscopic features of BCC, such as cartwheel structures, maple leaf–like areas, blue-gray nests and dots, and ulceration. It also reveals arborizing telangiectatic vessels and prominent curved vessels, which are typical of BCC, and comma vessels, which are typical of intradermal melanocytic nevi. It is, however, not always easy to distinguish between these 2 conditions, even when dermoscopy is used. We describe 2 facial lesions that posed a clinical and dermoscopic challenge in two 38-year-old patients; confocal microscopy showed separation between tumor nests and stroma and polarized nuclei, which are confocal microscopy features of basal cell carcinoma


Subject(s)
Female , Humans , Carcinoma, Basal Cell/classification , Carcinoma, Basal Cell/etiology , Nevus/classification , Nevus/diagnosis , Nevus/therapy , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell , Intradermal Tests/methods , Diagnosis, Differential , Microscopy, Confocal/instrumentation , Microscopy, Confocal/methods , Microscopy, Confocal , Nevus/pathology , Nevus , Basal Cell Nevus Syndrome/diagnosis , Basal Cell Nevus Syndrome/therapy , Basal Cell Nevus Syndrome
7.
Actas Dermosifiliogr ; 106(8): e41-4, 2015 Oct.
Article in English, Spanish | MEDLINE | ID: mdl-26093995

ABSTRACT

The clinical distinction between basal cell carcinoma (BCC) and intradermal melanocytic nevus lesions on the face can be difficult, particularly in young patients or patients with multiple nevi. Dermoscopy is a useful tool for analyzing characteristic dermoscopic features of BCC, such as cartwheel structures, maple leaf-like areas, blue-gray nests and dots, and ulceration. It also reveals arborizing telangiectatic vessels and prominent curved vessels, which are typical of BCC, and comma vessels, which are typical of intradermal melanocytic nevi. It is, however, not always easy to distinguish between these 2 conditions, even when dermoscopy is used. We describe 2 facial lesions that posed a clinical and dermoscopic challenge in two 38-year-old patients; confocal microscopy showed separation between tumor nests and stroma and polarized nuclei, which are confocal microscopy features of basal cell carcinoma.


Subject(s)
Carcinoma, Basal Cell/diagnostic imaging , Facial Neoplasms/diagnostic imaging , Microscopy, Confocal , Nevus, Pigmented/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Adult , Carcinoma, Basal Cell/blood supply , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/pathology , Dermatologic Agents/adverse effects , Dermatologic Agents/therapeutic use , Dermoscopy , Diagnosis, Differential , Facial Neoplasms/blood supply , Facial Neoplasms/diagnosis , Facial Neoplasms/pathology , Female , Humans , Nevus, Pigmented/blood supply , Nevus, Pigmented/diagnosis , Nevus, Pigmented/pathology , Psoriasis/complications , Psoriasis/drug therapy , Skin Neoplasms/blood supply , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Ustekinumab/adverse effects , Ustekinumab/therapeutic use
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