ABSTRACT
INTRODUCTION: Acral melanocytic nevi dermoscopic patterns have been well described in several populations. There have been no prospective studies assessing the prevalence, clinical characteristics and dermoscopic patterns of acral nevi in the Polish population. AIM: To characterize the prevalence of acral nevi, frequency of dermoscopic patterns, relationships between acral nevi and patients' characteristics. MATERIAL AND METHODS: This was a prospective study conducted in the Dermatological Outpatient Clinic of the University Hospital in Krakow. Study inclusion criteria: presence of nevi on foot soles and/or palms, Caucasian race, Polish origin, and age ≥ 18 years. RESULTS: Six hundred and twenty-four acral melanocytic lesions were observed in 287 patients, 174 (60.6%) women and 113 (39.4%) men, mean age 43.5 and 42.8 years, respectively. Four hundred and thirty-four (69.6%) lesions were present on soles, 190 (30.4%) on palms. No acral melanomas were detected. The following dermoscopic patterns were observed: parallel furrow 262 (42%), lattice-like 106 (17%), fibrillar 66 (11%) and other 190 (30%). Patients with acral nevi on the soles or both on the palms and soles had a higher number of atypical nevi on the body (p = 0.011) and a much higher total body nevi count (p = 0.043), when compared to those with acral nevi only on the palms. CONCLUSIONS: The study revealed a higher prevalence of acral nevi in the analysed population. A higher number of acral nevi was associated with a higher number of atypical nevi and higher total body nevi count, the risk factors for melanoma. Because of that it is possible to note that a higher number of acral nevi should increase diagnostic alertness.
ABSTRACT
INTRODUCTION: Melanoma malignum is a relatively rare neoplasm, among all skin neoplasms, but its related mortality is high. Diagnosis and removal of the lesion at an early stage are crucial for significant increase in chances of survival andis highly determined by patients' awareness in terms of melanoma risk factors. AIM: The aim of the study was to determine the level of patients' knowledge and awareness in terms of skin melanoma, its risk factors, health promoting behaviors, as well as learning about the sources of this knowledge. MATERIAL AND METHODS: Study group included 142 patients from the Department of Dermatology at the University Hospital in Kraków. Patients were divided into two groups: 88 people from the Videodermatoscopy Office (VDO), 53 people from other offices (OO). A questionnaire including 40 questions was used as a research tool for the studied group. It applied to data obtained from demographic data, determination of skin phototype according to Fitzpatrick scale, history of possible suspicious or removed skin lesions, awareness in terms of skin neoplasm prevention, patients' knowledge about skin melanoma, and its source. Collected data were then subjected to statistical analysis. RESULTS: VDO patients provided more accurate answers to questions regarding melanoma, prognosis, risk factors, possible melanoma sites, and treatment. Melanoma was correctly described as a malignant neoplasm by 92% people from the VDO group, and 65% of the OO group, surgical melanoma removal as the correct method was indicated by 84% vs. 68% and excessive exposure to sunlight 88.2% vs. 74%, sunbathing without use of skin sunscreen lotions 92.1% vs. 84%, melanoma in the family 75% vs. 66%, use of tanning salons 80.3% vs. 66%, exposure to excessive sun effect during childhood 67.1% vs. 34%, previously removed melanoma 44.7% vs. 24%, use of tanning beds 80.3% vs. 66%, high number of nevi 68.4% vs. 38% as melanoma risk factors, features of alarming nevi (multiple colors 77.3% vs. 56.6%, growth over time 75% vs. 50.9%, irregular borders 72.7% vs. 45.3%, diameter >5 mm 72.7% vs. 45.3%, asymmetrical shape 61.4% vs. 67.9%). 51.3% of patients of the VDO vs. 8% of the OO group indicated physician as the source of knowledge and 79,1% vs. 61% of them perform regular self-examination. CONCLUSION: Crucial links in the process of melanoma diagnostics include: health awareness of patients, involvement of physicians, both dermatologists, and primary healthcare physicians, as well as appropriately prepared and comprehensive information and education provided by media. According to the foregoing information, physicians have to be ready not only to diagnose the problem reported by a patient, but also to take the initiative and educate patients in terms of disease character, risk factors and motivating to perform self-examination of the skin, as this provides the most measurable results.
ABSTRACT
BACKGROUND: Dermoscopy is a non-invasive diagnostic technique that allows visualization melanocytic lesions in even up to 100x magnification. Pattern, structure, distribution and density of melanin pigmentation allows to perform differential diagnosis between benign melanocytic nevi and malignant melanoma. Unique anatomical structure of acral volar skin determine the dermoscopic patterns of acral melanocytic lesions OBJECTIVE: The aim of the study was to analyse retrospectively dermoscopic patterns observed on the soles of the feet of the patients who were diagnosed at the Department of Dermatology Jagiellonian University, Krakow. MATERIALS AND METHODS: Using retrospective data 360 dermoscopic images of acral melanocytic lesions present on the soles of 257 Caucasian patients were analysed, 179 (69.6%) women and 78 (30.4%) men. The types of patterns, the frequency of their occurrence and distribution of patterns on the skin soles of the feet have been analysed. Statistical analysis was performed using IBM SPSS Statistics. RESULTS: The most common pattern was the lattice-like pattern, which was seen in 120 (33.3%) images of melanocytic nevi. The fibrillar pattern was detected in 109 (30%) images and the parallel furrow pattern was identified in 80 (22.2%) images. 131 (36.4%) melanocytic lesions were located in arch area of the soles, while 126 (35%) in areas directly pressed by body weight and 103 (28.6%) in other areas. The fibrillar pattern was mostly observed in melanocytic lesions located in areas directly pressed by body weight 94 (86.2%), while the lattice-like pattern in arch area 81 (67.5%) and the parallel furrow pattern in other areas of the soles of the feet 51 (63.7%). Two of the melanocytic lesions showed nonspecific pattern and one parallel ridge pattern. One acral malignant lesion localized in arch area of the sole was detected. CONCLUSION: Dermoscopic patterns seen in melanocytic nevi in European population are similar to those seen in Japanese population. In analysed population the most common patten was lattice like pattern, followed by fibrillar and parallel furrow pattern, which differs from results of other studies Analysis showed differences in distribution of melanocytic nevi between anatomical sites of the soles. The lattice-like pattern was mosly observed in arch area, the fibrillar pat tern in areas directly pressed by body weight, the parallel furrow pattern in other areas. Vast majority of dermoscopic images showed patterns describing benign melanocytic lesions. Three of 360 melanocytic lesions had dermoscopic signs of malignancy.
