Reflectance confocal microscopy of facial neoplasms: Follicular involvement as a clue to diagnosis.

Autor: Shahriari N; Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Grant-Kels JM; Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA.; Department of Dermatology, University of Florida, Gainesville, Florida, USA., Rabinovitz H; Skin and Cancer Associates, Plantation, Florida, USA.; Dermatology Department, Medical College of Georgia at Augusta University, Augusta, Georgia, USA., Oliviero M; Skin and Cancer Associates, Plantation, Florida, USA., Scope A; The Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Dermatology Service, Memorial Sloan Kettering Center, New York, New York, USA.
Jazyk: angličtina
Zdroj: Journal of cutaneous pathology [J Cutan Pathol] 2023 Feb; Vol. 50 (2), pp. 178-184. Date of Electronic Publication: 2022 Nov 22.
DOI: 10.1111/cup.14353
Abstrakt: Background: Facial skin is characterized by high density of follicles. Facial neoplasms may present overlapping clinical and dermoscopic findings. Our goal was to evaluate and compare, via reflectance confocal microscopy (RCM), follicular involvement in facial neoplasms.
Methods: We retrospectively searched our image database, between January 2008 and December 2020, for all facial lesions with (1) a standardized set of clinical, dermoscopic, and RCM images, and (2) a biopsy-proven diagnosis of lentigo maligna/lentigo maligna melanoma (LM/LMM, n = 39), basal cell carcinoma (BCC, n = 51), squamous cell carcinoma in situ (SCCIS, n = 5), actinic keratosis (AK, n = 11), and lichen-planus-like keratosis (LPLK, n = 18). Two readers jointly evaluated the RCM images for a set of predefined features of follicular involvement.
Results: Diffuse obliteration of follicles was frequent in BCC (88%), while follicular infiltration by refractile dendritic cells and/or by bright round nucleated cells was common in melanoma (90% and 44%, respectively). Extension of atypical keratinocytes down follicles was more prominent among SCCIS than AK (80% vs. 45%, p = 0.01). In most LPLK (89%), there was follicular sparing.
Conclusions: Evaluation of RCM criteria centering on the follicles can be useful in the differential diagnosis between common facial neoplasms.
(© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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