Jungyoon Ohn1,2,3, Gwanghyun Jo1,2, Youngjoo Cho4, Sarah Lee Sheu5, Kwang Hyun Cho1,2, Je-Ho Mun1,2. 1. Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Republic of Korea. 3. Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. 4. Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee. 5. Department of Dermatology, Stanford University, Stanford, California.
Abstract
Importance: Subungual melanoma in situ (SMIS) is a malignant neoplasm that requires early diagnosis and complete surgical excision; however, little is known about the usefulness of the detailed dermoscopic features of longitudinal melanonychia (LM) to predict the diagnosis of SMIS. Objectives: To investigate the characteristic dermoscopic findings of SMIS and to establish a predictive scoring model for the diagnosis of SMIS in patients with adult-onset LM affecting a single digit. Design, Setting, and Participants: A cohort study of 19 patients with biopsy-proven SMIS and 26 patients with benign LM diagnosed in a tertiary referral hospital in Seoul, South Korea, from September 1, 2013, to July 31, 2017. Main Outcomes and Measures: Patient demographics, frequency of specific dermoscopic findings, and a predictive scoring model. Results: Of the total 45 patients with pigmented nails, the 19 patients with SMIS included 14 women and had a mean (SD) age of 52.0 (14.4) years, and the 26 patients with benign LM included 18 women and had a mean (SD) age of 48.1 (13.2) years. Asymmetry (odds ratio [OR], 34.00; 95% CI, 3.88-297.70), border fading (OR, 9.33; 95% CI, 2.37-36.70), multicolor (OR, 11.59; 95% CI, 2.21-60.89), width of the pigmentation of at least 3 mm (OR, 5.31; 95% CI, 1.01-28.07), and presence of the Hutchinson sign (OR, 18.18; 95% CI, 2.02-163.52) were features of LM that were significantly associated with SMIS. A predictive scoring model incorporating these dermoscopic features of SMIS was assessed. The model, ranging from 0 to 8 points, showed a reliable diagnostic value (the receiver operating characteristic curve had an area under the curve [C statistic] of 0.91) in differentiating SMIS from benign LM at a cutoff value of 3, with a sensitivity of 89% and a specificity of 62%. Conclusions and Relevance: This study suggests characteristic dermoscopic features for SMIS. A predictive scoring model based on these morphologic features may help differentiate SMIS from benign LM.
Importance: Subungual melanoma in situ (SMIS) is a malignant neoplasm that requires early diagnosis and complete surgical excision; however, little is known about the usefulness of the detailed dermoscopic features of longitudinal melanonychia (LM) to predict the diagnosis of SMIS. Objectives: To investigate the characteristic dermoscopic findings of SMIS and to establish a predictive scoring model for the diagnosis of SMIS in patients with adult-onset LM affecting a single digit. Design, Setting, and Participants: A cohort study of 19 patients with biopsy-proven SMIS and 26 patients with benign LM diagnosed in a tertiary referral hospital in Seoul, South Korea, from September 1, 2013, to July 31, 2017. Main Outcomes and Measures: Patient demographics, frequency of specific dermoscopic findings, and a predictive scoring model. Results: Of the total 45 patients with pigmented nails, the 19 patients with SMIS included 14 women and had a mean (SD) age of 52.0 (14.4) years, and the 26 patients with benign LM included 18 women and had a mean (SD) age of 48.1 (13.2) years. Asymmetry (odds ratio [OR], 34.00; 95% CI, 3.88-297.70), border fading (OR, 9.33; 95% CI, 2.37-36.70), multicolor (OR, 11.59; 95% CI, 2.21-60.89), width of the pigmentation of at least 3 mm (OR, 5.31; 95% CI, 1.01-28.07), and presence of the Hutchinson sign (OR, 18.18; 95% CI, 2.02-163.52) were features of LM that were significantly associated with SMIS. A predictive scoring model incorporating these dermoscopic features of SMIS was assessed. The model, ranging from 0 to 8 points, showed a reliable diagnostic value (the receiver operating characteristic curve had an area under the curve [C statistic] of 0.91) in differentiating SMIS from benign LM at a cutoff value of 3, with a sensitivity of 89% and a specificity of 62%. Conclusions and Relevance: This study suggests characteristic dermoscopic features for SMIS. A predictive scoring model based on these morphologic features may help differentiate SMIS from benign LM.
Authors: Sergio H Hirata; Sergio Yamada; Fernando A Almeida; Jane Tomomori-Yamashita; Mauro Y Enokihara; Francisco M Paschoal; Milvia M Enokihara; Cinthia M Outi; Nilceo S Michalany Journal: J Am Acad Dermatol Date: 2005-11 Impact factor: 11.527
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Authors: E Benati; S Ribero; C Longo; S Piana; S Puig; C Carrera; F Cicero; H Kittler; T Deinlein; I Zalaudek; W Stolz; A Scope; G Pellacani; E Moscarella; B M Piraccini; M Starace; G Argenziano Journal: J Eur Acad Dermatol Venereol Date: 2016-11-15 Impact factor: 6.166
Authors: Soo Ick Cho; Jaewon Lee; Gwanghyun Jo; Sang Wha Kim; Kyung Won Minn; Ki Yong Hong; Seong Jin Jo; Kwang Hyun Cho; Byung Jun Kim; Je-Ho Mun Journal: PLoS One Date: 2019-03-07 Impact factor: 3.240