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Romanian Journal of Internal Medicine

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Dermatoscopy of Verrucous Pigmented Lesions is Essential for Choosing the Appropriate Treatment

Virginia Chiţu
  • Corresponding author
  • First Department of Dermatology, “Colentina” Clinical Hospital, Bucharest, Romania
  • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • Email:
/ Sabina Zurac
  • Department of Pathology, “Colentina” Clinical Hospital, Bucharest, Romania
  • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
/ Alina E. Cipi
  • “Regina Maria” Private Healthcare Network, Bucharest, Romania
Published Online: 2015-12-10 | DOI: https://doi.org/10.1515/rjim-2015-0047

Abstract

Dermatoscopy, as a noninvasive rapid method, which allows the viewing of melanin in the epidermis and papillary dermis, has an important role in diagnosis of the pigmented lesions localized on skin, mucous membrane, scalp and nails. The term of verrucous pigmented lesions includes a series of non-melanocytic and melanocytic, benign and malignant lesions. Among these, the most frequent is the seborrheic keratosis, a common epidermal tumor, affecting the sun exposed areas of adult. At the other end of the spectrum regarding the frequency is the seborrheic keratosis-like melanoma, whose underdiagnosis has a serious impact on the patient’s life. In this work we present the clinical and dermoscopical aspects of three cases of verrucous pigmented lesions (two seborrheic keratoses and one seborrheic keratosis-like melanoma) that determined the diagnostic algorithm as well as the therapeutic approach. The above-presented cases underline the importance of dermatoscopy to determine the malignant potential of the pigmented lesions, the final appropriate treatment being possible after the histopathologic confirmation.

Dermatoscopia este o tehnică extrem de utilă în diagnosticarea leziunilor pigmentate cutaneo-mucoase, permiţând identificarea leziunilor posibil maligne. Leziunile pigmentate verucoase necesită o evaluare atentă, deoarece alături de leziuni benigne precum keratozele seboreice, nevii melanocitari, includ şi melanomul verucos. În acest articol sunt prezentate aspectele clinice şi dermatoscopice care au stat la baza diagnosticării a trei leziuni pigmentate verucoase cutanate. Influenţa datelor clinice asupra interpretării parametrilor dermatoscopici este un fapt incontestabil, fapt observat şi în cele două cazuri de keratoză seboreică prezentate, ambele încadrate eronat ca leziuni melanocitare (nev verucos, respectiv melanom). În primul caz prezentat, vârsta pacientei şi aprecierea inexactă a duratei de evoluţie au condus spre diagnosticul de nev verucos, deşi parametrii dermatoscopici erau specifici keratozei seboreice. În al doilea caz de keratoză seboreică confirmată histopatologic, amplitudinea aspectelor clinice de melanom au făcut ca examinatorul să identifice parametrii dermatoscopici compatibili cu diagnosticul de melanom, ignorându-i pe cei specifici keratozei seboreice. Cazul de melanom prezentat în acest articol clinic a mimat o keratoză seboreică, iar imaginea dermatoscopică a prezentat doar trăsături subtile specifice melanomului. În toate cele trei cazuri prezentate dermatoscopia a identificat leziunile ca posibil maligne şi a impus biopsia excizională pentru precizarea diagnosticului şi alegerea conduitei terapeutice adecvate.

Keywords: dermatoscopy; dermoscopy; nevus; melanoma; seborrheic keratosis; pigmented

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About the article

Received: 2015-06-23

Published Online: 2015-12-10

Published in Print: 2015-12-01



Citation Information: Romanian Journal Of Internal Medicine, ISSN (Online) 1220-4749, DOI: https://doi.org/10.1515/rjim-2015-0047. Export Citation

© 2015 Virginia Chiţu et al., published by De Gruyter Open. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. (CC BY-NC-ND 3.0)

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