Journal of the American Academy of Dermatology ( IF 13.8 ) Pub Date : 2020-02-14 , DOI: 10.1016/j.jaad.2020.02.019 Chryssoula Papageorgiou 1 , Ioannis Spyridis 1 , Sofia Magdalini Manoli 1 , Iuliana Busila 2 , Irina Elena Nasturica 2 , Konstantinos Lallas 1 , Angeliki Panagopoulou 1 , Ilias Papadimitriou 1 , Nikolaos Sideris 1 , Theodosia Gentsidi 1 , Ruben Gonzalez-Cuevas 3 , Andjelka Ilieva 4 , Dimitrios Ioannides 1 , Zoe Apalla 5 , Aimilios Lallas 1
Background
Even with the addition of dermoscopy, a significant morphologic overlap exists between irritated seborrheic keratosis (ISK) and squamous cell carcinoma (SCC).
Objective
The aim of this study was to investigate the dermoscopic criteria that could serve as potent predictors for the differential diagnosis between ISK and SCC.
Methods
Dermoscopic images of histopathologically diagnosed ISKs and SCCs were evaluated by 3 independent investigators for the presence of predefined criteria.
Results
A total of 104 SCCs and 61 ISKs were included. The main dermoscopic predictors of SCC were dotted vessels (odds ratio [OR], 10.4), branched linear vessels (OR, 5.30), white structureless areas (OR, 6.78), white circles surrounding follicles (OR, 23.45), a diffuse irregular (OR, 2.55) or peripheral (OR, 2.8) vessel arrangement, and a central scale arrangement (OR, 3.35). Dermoscopic predictors of ISK were hairpin vessels (OR, 0.38), a diffuse regular vessel arrangement (OR, 0.39 and OR, 0.36), and white halos surrounding vessels covering more than 10% of the lesion (OR, 0.29 and OR, 0.12).
Limitations
First, the retrospective design of the study; second, the differential diagnosis included in the study was restricted to ISK and SCC.
Conclusions
We confirmed the significant morphologic overlap between ISK and SCC, but we also identified potent predictors for the differential diagnosis between these 2 entities.
中文翻译:
皮肤镜下刺激性脂溢性角化病与鳞状细胞癌鉴别诊断的准确性
背景
即使增加皮肤镜检查,刺激性脂溢性角化病 (ISK) 和鳞状细胞癌 (SCC) 之间仍存在显着的形态学重叠。
客观的
本研究的目的是研究可作为 ISK 和 SCC 鉴别诊断的有效预测指标的皮肤镜标准。
方法
由 3 名独立研究人员评估组织病理学诊断的 ISK 和 SCC 的皮肤镜图像是否存在预定义的标准。
结果
共纳入 104 个 SCC 和 61 个 ISK。SCC 的主要皮肤镜预测指标是点状血管(优势比 [OR],10.4)、分支线性血管(OR,5.30)、白色无结构区域(OR,6.78)、毛囊周围的白色圆圈(OR,23.45)、弥漫性不规则(OR, 2.55) 或外围 (OR, 2.8) 血管排列,以及中央刻度排列 (OR, 3.35)。ISK 的皮肤镜预测指标是发夹血管 (OR, 0.38)、弥漫性规则血管排列 (OR, 0.39 和 OR, 0.36),以及覆盖超过 10% 病变部位的血管周围的白色光晕 (OR, 0.29 和 OR, 0.12) .
限制
一、研究的回顾性设计;其次,研究中包括的鉴别诊断仅限于 ISK 和 SCC。
结论
我们确认了 ISK 和 SCC 之间的显着形态学重叠,但我们还确定了这两种实体之间鉴别诊断的有效预测因子。