Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Rammel, K.
Classification of melanocytic nevi
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp.
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Hofmann-Wellenhof Rainer
- Zalaudek Iris
- Altmetrics:
- Abstract:
- Background information: In the past, the classification of melanocytic nevi relayed mainly on clinical and histological criteria. Several models have been proposed which may explain nevus development. Categorising nevi aims at an early differentiation and diagnosis of melanoma. Dermoscopy provides a valuable in vivo diagnostic tool that allows the visualisation of submacroscopic structures, which are otherwise invisible for the naked eye. This allows for a dermoscopic classification of melanocytic nevi. Objective: To review recent studies and reviews of dermoscopic imaging of melanocytic lesions that provide insights into the development of nevi and their distinct patterns, which contribute to their diagnosis and further management. Methods: Literature search was performed via PubMed (MEDLINE) and Journals@Ovid from January 2009 to June 2016, using the following relevant terms: dermoscopy, dermatoscopy, epiluminescence microscopy, surface microscopy, digital dermoscopy, digital dermatoscopy, digital epiluminescence microscopy, digital surface microscopy, nevus, nevi, naevus, naevi, melanocytic skin lesion, pigmented skin lesion, color, colour, pattern, pigment distribution, face, facial, acral, nail, mucosa, mucosal, trunk, scalp, age, elderly, old, skin type, melanoma history, melanoma related, UV, UVR, UV irradiation, UV radiation, UV rays, ultraviolet, pregnancy, genes, genetic, BRAF and recurrent. Only German and English articles were included. Overall 123 results have been identified, including further studies during research until May 2017. Results: From the 123 manuscripts, one randomised controlled trial of high evidence (A) and one meta-analysis and one systematic review of limited evidence (B) have been reviewed. The sample further included 75 prospective and retrospective studies from single or multiple institutions, which are graded as level of evidence B. The results provide the following dermoscopic criteria for the diagnosis of melanocytic nevi: colour (black, brown, grey, blue and pink), pattern (globular, reticular, structureless, starburst and mixed), pigment distribution (uniform, multifocal, central and eccentric hypo-/hyperpigmentation) and vascular structures (comma-shaped and dotted vessels). In addition, the following patient related factors influence nevus morphology and illustrate distinct dermoscopic features: age, body-site, skin-type, molecular and genetical alterations, history of melanoma, pregnancy, UV-irradiation and trauma. Conclusion: These dermoscopic criteria may help clinicians in the diagnosis of melanocytic lesions by providing the knowledge of a basic classification of nevus morphology as well as factors influencing their dermoscopic features.