肢端无色素性黑素瘤

报告1例肢端无色素性黑素瘤。患者女,51岁。因右足第2趾背水疱、糜烂1年余就诊。皮肤科检查见右足第2趾背有一浸润性斑块。皮损组织病理学检查示:真皮内可见一浸润性肿瘤团块,免疫组化染色示S-100蛋白( ),gp100及melanoma(pan)均(±)。诊断为无色素性黑素瘤。     

Dermatoscopy of a minute melanoma

We present a case report of a naevoid lentigo maligna (World Health Organisation level 1 melanoma) on the nose of a 46-year-old man. He was under surveillance because of a past history of two melanomas and developed a new lesion. The visible lesion was 1.6 mm in maximum diameter as measured by the scale on the dermatoscope footplate. The dermatoscopic structures present were limited to dots arranged asymmetrically. We believe that the fact that some of these dots were grey provided a useful clue to the diagnosis of melanoma.     

Rhinophymatous amelanotic melanoma

Amelanotic melanomas are well-known to mimic other dermatologic lesions and often result in delayed diagnosis and treatment. We report a case of an unusual presentation of amelanotic melanoma with an appearance similar to rhinophyma.     

Dermatoscopy for melanoma and pigmented lesions

This article presents an overview of the history and development of dermatoscopy over the last 2 decades. The common dermatoscopic diagnostic algorithms are discussed, including classic pattern analysis, the ABCD rule (asymmetry, border, color, and dermatoscopic structures), 7-point checklist, and Menzies method, as well as a new method by the authors (ASAP: a simple and practical approach). In addition, evidence on the clinical impact and challenges of dermatoscopy for the diagnosis and management of pigmented lesions and the importance of training are reviewed.     

Subungual amelanotic melanoma

We describe a 76-year-old white male with subungual amelanotic melanoma. The lack of pigmentation of the lesion may cause misdiagnosis and aggravate its poor prognosis.     

无色素性恶性黑素瘤的诊断

无色素性恶性黑素瘤是一种非常少见的恶性黑素瘤，其组成细胞来源于成黑素细胞，却缺少黑素颗粒。其临床表现可模仿很多黑素来源及非黑素来源其他疾病的特点，皮肤组织病理学检查也缺少特异性，易误诊为其他疾病，而延误治疗，免疫组化、电镜、皮肤镜、共焦扫描激光显微镜等检查有助于明确诊断。     

Subungual amelanotic malignant melanoma

A 52-year-old man with subungual amelanotic malignant melanoma was reported. He had a dome-shaped tumor on his right thumb nail bed without any involvement. Clinically, we considered various diseases including amelanotic malignant melanoma, squamous cell carcinoma, granuloma pyogenicum, and other granulomas. Histological features of the skin biopsy taken during the first visit suggested squamous cell carcinoma. We still considered the possibility of amelanotic malignant melanoma, however, and the specimens taken during the radical operation were examined histologically and histochemically and a diagnosis of subungual amelanotic malignant melanoma was determined.     

Key points in the dermoscopic diagnosis of hypomelanotic melanoma and nodular melanoma

Nodular melanoma (NM) and amelanotic/hypomelanotic melanoma (AHM) often present a challenge to the diagnosing clinician. A significant proportion of AHM are nodular in nature. Such tumors may lack features of asymmetry and altered peripheral pigmentation routinely observed in other melanoma subtypes. This lack of distinguishing clinical features can potentially result in delayed diagnosis or inappropriate treatment. This review highlights the key points in evaluating the range of lesions where AHM or NM are considered in the differential diagnosis and summarizes current evidence in relation to pigmented and vascular dermoscopic diagnostic criteria for both.     

Amelanotic/hypomelanotic melanoma: clinical and dermoscopic features

BACKGROUND: Amelanotic malignant melanoma is a subtype of cutaneous melanoma with little or no pigment on visual inspection. It may mimic benign and malignant variants of both melanocytic and nonmelanocytic lesions. OBJECTIVES: To evaluate whether dermoscopy is also a useful technique for the diagnosis of amelanotic/hypomelanotic melanoma (AHM). METHODS: We conducted a retrospective clinical study of 151 amelanotic/hypomelanotic skin lesions from 151 patients with a mean age of 47 years (+/- 17.5 SD). Digitized images of amelanotic/hypomelanotic skin lesions were converted to JPEG format and sent by e-mail from the five participating centres. Lesions included 55 amelanotic/hypomelanotic nonmelanocytic lesions (AHNML), 52 amelanotic/hypomelanotic benign melanocytic lesions (AHBML), and 44 AHM, 10 (23%) of which were nonpigmented, truly amelanotic melanomas (AM). The 44 AHM lesions were divided into thin melanomas (TnM) 1 mm (15 cases), according to the Breslow index. Five clinical features (elevation, ulceration, shape, borders and colour) as well as 10 dermoscopic criteria (pigment network, pigmentation, streaks, dots/globules, blue-whitish veil, regression structures, hypopigmentation, leaf-like areas, multiple grey-bluish globules, central white patch) and eight vascular patterns (comma, arborizing, hairpin, dotted, linear irregular, dotted and linear irregular vessels, and milky-red areas) were evaluated in order to achieve clinical and dermoscopic diagnoses. Statistical analyses were performed with the chi2-test and Fisher's exact test, when appropriate. RESULTS: The most frequent and significant clinical features for TnM and TkM were asymmetry and ulceration (the latter only for TkM) compared with AHBML. Irregular dots/globules (62% vs. 35%; P 相似文献   

Macular amelanotic melanoma in situ

This report aims at directing the attention to the rare entity of amelanotic melanoma in situ, as exemplified in a patient who had an amelanotic lentigo maligna 10 years ago and a recurrent lesion of identical clinical and histological (except for pagetoid tumor cells in the epidermis) appearance 4 years ago. Amelanotic melanomas in situ appear as inconspicuous reddish macules, which can hardly be diagnosed or even suspected on clinical grounds.     

Post traumatic amelanotic subungual melanoma

Subungual melanomas are rare; a delay in the diagnosis is common and is associated with advanced stage. Part of the reason for a delay in presentation to the physician is that patients often attribute the lesion to trauma. Trauma may play a role in the pathogenesis or just draw attention to a skin tumor that may be more susceptible to injury. We report a case of subungual melanoma that was observed in an 86 year old man. The preceding trauma history and misleading clinical appearance delayed the diagnosis slightly. Biopsy of every nodular acral tumor is very important. A direct role of the trauma in the pathogenesis of melanoma remains unclear.