Malignant melanoma in 2019: clinical and dermatoscopic features today


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. Clinical presentation of malignant melanoma (MM) are characterized by pronounced polymorphism and depend heavily on the stage of development and histological variety of the tumor. Objective. Evaluation of the clinical and dermatoscopic features of cases of MM identified in 2019. Methods. A retrospective evaluation of the clinical and dermatoscopic manifestations of 113 MM cases was performed; individual tumor signs were compared depending on the type of detection (active - by the physician, by complaints - by the patient), the maximum size of the lesion and the morphological phase of growth. Results. MM was detected in 84 (74.3%) women and 29 (25.7%) men. The mean age of patients was 50.4±14.7 years. Physicians revealed 23% of tumors. Only 26.5% of melanomas fully met the criteria for the ABCD clinical rule, 62.8% of patients noted a change in pigmented lesion. The sensitivity of the dermatoscopic ABCD rule and the 7-point Argenziano algorithm were 76.1 and 75.2%, respectively. Tumors detected by physicians more often imitated dermatoscopic patterns of melanocytic nevi (p<0.05). Small melanomas with a diameter of up to 6 mm were diagnosed at a younger age (p<0.001), did not meet ABCD clinical rule, and showed less color polymorphism and variegation during dermatoscopic examination (p<0.05). A blue-white veil and linear vessels were significantly more frequently detected in tumors identified by patients and were associated with a melanoma size of >6 mm and vertical growth phase. Conclusion. The study showed that a number of clinical characteristics of MM today differ significantly from the usual idea of this malignant tumor. Given the low efficiency of the ABCD clinical rule, proposed for self-assessment of skin tumors, informing the population about the problem of skin cancer should be directed to the need for routine check-ups and an early visit to a specialist if any changes in the «moles» are detected.

Full Text

Restricted Access

About the authors

Yu. Yu Sergeev

Society of Dermatoscopy and Optical Skin Diagnosis; Central State Medical Academy of Department for Presidential Affairs of the Russian Federation

Email: tosergeev@gmail.com
Dermatovenerologist, Chairman of the Board of the Society of Dermatoscopy and Optical Skin Diagnostics, Associate Professor at the Department of Dermatovenerology and Cosmetology

V. Yu Sergeev

Society of Dermatoscopy and Optical Skin Diagnosis; Central State Medical Academy of Department for Presidential Affairs of the Russian Federation

V. V Mordovtseva

Society of Dermatoscopy and Optical Skin Diagnosis; Moscow State University of Food Production

I. L Shlivko

Society of Dermatoscopy and Optical Skin Diagnosis; Privolzhsky Research Medical University; Scientific and Practical Center for Diagnosis and Treatment of Skin Tumors of the University Clinic «PRMU»

I. E Sinelnikov

Society of Dermatoscopy and Optical Skin Diagnosis; OOO Melanoma Unit

V. E Dobrovolsky

Society of Dermatoscopy and Optical Skin Diagnosis; Outpatient Clinic of the Sverdlovsk Regional Dermatovenerologic Dispensary, Branch №2, Nizhny Tagil

A. D Getman

Society of Dermatoscopy and Optical Skin Diagnosis; OOO NEO-Clinic; Private Institution for Further Professional Education for Medical Practitioners «New Level»

D. G Luchinina

Society of Dermatoscopy and Optical Skin Diagnosis; Republican Dermatovenerologic Dispensary, Yoshkar-Ola

O. E Garanina

Society of Dermatoscopy and Optical Skin Diagnosis; Privolzhsky Research Medical University; University Clinic of the Institute of Traumatology and Orthopedics

R. V Grishko

Society of Dermatoscopy and Optical Skin Diagnosis; Clinic of Innovative Medical Technologies "Vector" and "Gradient"

D. S Beinusov

Society of Dermatoscopy and Optical Skin Diagnosis; Center for Continuous Medical Education

S. S Yakushenko

Society of Dermatoscopy and Optical Skin Diagnosis; Regional Dermatovenerologic Dispensary, Lipetsk

M. Yu Evdokimov

Society of Dermatoscopy and Optical Skin Diagnosis; Sverdlovsk Regional Oncology Center

K. A Uskova

Society of Dermatoscopy and Optical Skin Diagnosis; Privolzhsky Research Medical University

References

  1. Friedman R.J., Rigei D.S., Kopf A.W. Early detection of malignant melanoma: the role of physician examination and self-examination of the skin. CA Cancer J. Clin. 1985;35(3):130-51. doi: 10.3322/canjclin.35.3.130.
  2. Marghoob A.A., Malvehy J., Braun R.R. Atlas of dermoscopy, 2nd ed. London, In forma Healthcare, 2012. 384 p.
  3. Kittler H., Marghoob A.A., Argenziano G., et al. Standardization of terminology in dermoscopy/dermatoscopy: results of the third consensus conference of the International Society of Dermoscopy. J. Am Acad Dermatol. 2016;74(6):1093-106. doi: 10.1016/j. jaad.2015.12.038.
  4. Nachbar F., Stolz W., Merkle T., et al. The ABCD rule of dermatoscopy. High prospective value in the diagnosis of doubtful melanocytic skin lesions. J. Am Acad Dermatol. 1994;30(4):551-59. doi: 10.1016/s0190-9622(94)70061-3.
  5. Argenziano G., Fabbrocini G., Carli R., et al. Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions. Comparison of the ABCD rule of dermatoscopy and a new 7-point checklist based on pattern analysis. Arch Dermatol. 1998;134(12):1563-70. doi: 10.1001/ archderm.134.12.1563.
  6. Gershenwald J.E., Scolyer R.A., Hess K.R., et al. Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J. Clin. 2017;67(6):472-92. doi: 10.3322/caac.21409.
  7. Галил-Оглы ГА., Молочков В.А., Сергеев Ю.В. Дерматоонкология. М., 2005. 872 с.
  8. Ламоткин И.А. Меланоцитарные и меланиновые поражения кожи. М., 2015. 248 с.
  9. Sacchetto L., Zanetti R., Comber H., et al. Trends in incidence of thick, thin and in situ melanoma in Europe. Eur J. Cancer. 2018;92:108-18. doi: 10.1016/j.ejca.2017.12.024.
  10. Katalinic A., Kunze U., Schäfer T. Epidemiology of cutaneous melanoma and non-melanoma skin cancer in Schleswig-Holstein, Germany: incidence, clinical subtypes, tumour stages and localization (epidemiology of skin cancer). Br J. Dermatol. 2003;149(6):1200-206. doi: 10.1111/j.1365-2133.2003.05554.x.
  11. Соколов Д.В. Дерматоскопия в ранней диагностике и скрининге меланомы кожи. Дисс. докт. мед. наук. М., 2009.
  12. Сергеев Ю.Ю., Мордовцева В.В., Сергеев В.Ю. Меланома кожи в практике дерматолога. Фарматека. 2017; 17:67-72.
  13. Garbe C., Leiter U. Melanoma epidemiology and trends. Clin Dermatol. 2009;27(1):3-9. doi: 10.1016/j.clindermatol.2008.09.001.
  14. Shaikh W.R., Dusza S.W., Weinstock M.A., et al. Melanoma thickness and survival trends in the United States, 1989 to 2009. J. Natl Cancer Inst. 2015;108(1):djv294. doi: 10.1093/jnci/djv294.
  15. Каприн А.Д., Старинский В.В., Петрова Г В. Злокачественные новообразования в России в 2018 году (заболеваемость и смертность). М., 2019. 250 с.
  16. Сергеев Ю.Ю., Сергеев В.Ю., Мордовцева В.В. Динамическое наблюдение за меланоцитарными образованиями при помощи дерматоскопии (обзор литературы). Медицинский алфавит. Серия «Дерматология». 2020;1,6(420):66-71.
  17. Argenziano G., Kittler H., Ferrara G., et al. Slow-growing melanoma: a dermoscopy follow-up study. Br J. Dermatol. 2010;162(2):267-73. doi: 10.1111/j.1365-2133.2009.09416.x.
  18. Сергеев Ю.Ю., Мордовцева В.В. Опыт диагностики меланомы кожи диаметром менее 6 мм. Клиническая дерматология и венерология. 2018;17(4):97-105
  19. Сергеев Ю.Ю., Мордовцева В.В. Скрининг рака кожи в амбулаторных условиях. Кремлевская медицина. Клинический вестник. 2018;1:84-8
  20. Bergenmar M., Hansson J., Brandberg Y Detection of nodular and superficial spreading melanoma with tumour thickness10.1097/00008469-200202000-0000.
  21. Liu W, Dowling J.P, Murray W.K., et al. Rate of growth in melanomas: characteristics and associations of rapidly growing melanomas. Arch Dermatol. 2006;142(12):1551-58. doi: 10.1001/archderm.142.12.1551

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies