Digital dermoscopy analysis in the diagnosis of acral and nail melanocytic tumors / Digitalna dermoskopija u dijagnozi melanocitnih tumora noktiju i akralnih delova tela

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Abstract

Digital dermoscopy (epiluminiscence microscopy) is a technology for in vivo imaging of the skin used for the differentiation of pigmented skin lesions. Melanocytic tumors and pigmentations of the nails and acral skin regions represent differential diagnostic problems that can hardly be evaluated with the naked eye, especially at an early stage. Two patients with a total of three very suspicious lesions underwent dermoscopy. Clinical diagnoses were as follows: subungual hemorrhage, plantar wart (previously treated as a plantar wart several times) and acral melanoma. Dermoscopy increased the suspicion to: subungual melanoma, acral amelanotic melanoma and acral nevus, respectively. Histologic examination has verified the following diagnoses: subungual melanoma, acral lentiginous melanoma and acral junctional nevus. Dermoscopic examination of pigmented structures on the above-mentioned sites is a very useful adjunct in establishing accurate diagnosis that can help in differentiating benign from malignant lesions.

Sažetak

Uvod: Digitalna dermoskopija (epiluminiscentna mikroskopija) je in vivo mikroskopija kože koja omogućava diferencijaciju pigmentnih lezija kože. Melanocitni tumori i pigmentacije noktiju i akralnih delova tela predstavljaju diferencijalno-dijagnostički problem koji se teško prepoznaje golim okom, posebno u ranom stadijumu.

Prikaz 2 slučaja. Ovo je prikaz dve bolesnice koje su podvrgnute dermoskopiji zbog ukupno 3 veoma sumnjive lezije. Njihove kliničke dijagnoze bile su sledeće: subungualni hematom, plantarna bradavica (prethodno lečena kao takva u nekoliko navrata) i akralni melanom. Dermoskopijom se došlo do sledećih rezultata: subungualni melanom, akralni amelanocitni melanom i akralni nevus. Histološkom analizom postavljene su sledeće dijagnoze: subungualni melanom, akralni lentiginozni melanom i akralni lentiginozni junkcioni nevus.

Zaključak: Dermoskopski pregled pigmentnih struktura na gore navedenim lokalizacijama veoma je korisna dodatna metoda u postavljanju tačne dijagnoze koja može da se koristi u diferencijaciji benignih i malignih lezija.

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Serbian Journal of Dermatology and Venereology

The Journal of Serbian Association of Dermatovenereologists (SAD)

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