Differentiating Seborrheic Keratosis from Melanoma Among Lesions Exhibiting Blue-White Veil: A Retrospective Study.

IF 12.8 1区医学 Q1 DERMATOLOGY Journal of the American Academy of Dermatology Pub Date : 2024-11-09 DOI:10.1016/j.jaad.2024.10.070

Isabella N Dana, Nicholas R Kurtansky, Larissa M Pastore, James R Xu, Zaeem H Nazir, Stephen W Dusza, Emmanouil Chousakos, Ofer Reiter, Cristian Navarrete-Dechent, Ralph P Braun, Harold S Rabinovitz, Ashfaq A Marghoob

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Abstract

Background: Differentiating melanoma (MM) from seborrheic keratosis (SK) containing a blue-white veil (BWV) remains challenging.

Objective: Identify dermoscopic features that can improve upon the differentiation between MMs and SKs exhibiting BWV.

Methods: Images from 110 MMs and 121 SKs containing BWV were aggregated, and 91 MMs and 62 SKs from this dataset had complete agreement on the presence of BWV according to 3 expert dermoscopists. Independent readers recorded the presence or absence of dermoscopic structures using a web-based data collection instrument. Odds ratios were used to evaluate the association between features and diagnosis, and Fisher's exact test was used to determine significance of associations.

Results: The combination of milia-like cysts and/or comedo-like openings (MCCO) within the BWV and BWV encompassing the entire lesion occurred in 56% of SKs and 0% of MM. All MMs had at least one MM-specific structure other than BWV or lacked MCCO.

Limitations: Agreement on dermoscopic feature prevalence was variable. The subset of lesions with complete agreement on the presence of BWV may not be representative of lesions encountered in an individual clinician's practice.

Conclusion: Lesions exhibiting BWV with MCCO and no additional MM-specific features suggests a benign diagnosis, as was not seen in any cases of MM.

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在显示蓝白面纱的病变中区分脂溢性角化病和黑色素瘤：一项回顾性研究。

背景：将黑色素瘤（MM）与含有蓝白斑（BWV）的脂溢性角化病（SK）区分开来仍然具有挑战性：目的：确定皮肤镜特征，以便更好地区分显示蓝白斑的 MM 和 SK：方法：汇总了 110 个 MM 和 121 个 SK 的 BWV 图像，根据 3 位皮肤镜专家的意见，该数据集中的 91 个 MM 和 62 个 SK 在是否存在 BWV 方面意见完全一致。独立读者使用基于网络的数据收集工具记录是否存在皮肤镜结构。结果显示，粟粒样囊肿和粟粒样囊肿的组合与BWV的诊断之间存在显著的相关性，而粟粒样囊肿和粟粒样囊肿的组合与BWV的诊断之间存在显著的相关性：结果：在56%的SK和0%的MM中，BWV和BWV内的粟粒样囊肿和/或粉瘤样开口（MCCO）同时出现。除BWV外，所有MM至少有一种MM特异性结构，或缺乏MCCO：局限性：对皮肤镜特征发生率的共识不一。局限性：对皮肤镜特征发生率的一致意见不一，对 BWV 存在情况完全一致的皮损子集可能并不代表临床医生在实践中遇到的皮损：结论：表现出BWV和MCCO的皮损以及没有其他MM特异性特征的皮损提示良性诊断，这在任何MM病例中都未见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Academy of Dermatology 医学-皮肤病学

CiteScore

8.60

自引率

5.80%

发文量

2023

审稿时长

49 days

期刊介绍： The Journal of the American Academy of Dermatology (JAAD) is the official scientific publication of the American Academy of Dermatology (AAD). Its primary goal is to cater to the educational requirements of the dermatology community. Being the top journal in the field, JAAD publishes original articles that have undergone peer review. These articles primarily focus on clinical, investigative, and population-based studies related to dermatology. Another key area of emphasis is research on healthcare delivery and quality of care. JAAD also highlights high-quality, cost-effective, and innovative treatments within the field. In addition to this, the journal covers new diagnostic techniques and various other topics relevant to the prevention, diagnosis, and treatment of skin, hair, and nail disorders.