Acral Melanocytic Lesions Under Conventional, Sub-Ultraviolet Reflectance, and Ultraviolet-Induced Fluorescence...

Area of Science:

• Dermatology
• Oncology
• Medical Imaging

Background:

• Differentiating benign from malignant acral melanocytic lesions (AMLs) is diagnostically challenging.
• Conventional dermoscopy (CD) is standard, but advanced techniques like sub-ultraviolet reflectance dermoscopy (sUVRD) and ultraviolet-induced fluorescence dermoscopy (UVFD) may improve visualization.
• This study aimed to compare the visibility of key AML features across CD, sUVRD, and UVFD.

Purpose of the Study:

• To compare the diagnostic performance of conventional dermoscopy (CD), sub-ultraviolet reflectance dermoscopy (sUVRD), and ultraviolet-induced fluorescence dermoscopy (UVFD) in visualizing features of acral melanocytic lesions (AMLs).
• To assess the utility of advanced dermoscopic modalities in distinguishing benign nevi from melanoma in situ (MIS) and invasive melanoma.

Main Methods:

• Retrospective analysis of 42 AMLs from 37 patients, including nevi, MIS, and invasive melanomas.
• Three dermatologists assessed 11 specific lesion features using CD, sUVRD, and UVFD on a 5-point scale.
• Features evaluated included patterns (PFP, PRP, fibrillar), structures (dots/clods, radial lines, blue-white areas, blotch), and surface characteristics (scale, ulceration, margins, eccrine duct openings).

Main Results:

• CD generally provided higher visibility scores than UVFD for most features and outperformed sUVRD for specific patterns.
• sUVRD demonstrated superior visualization of eccrine duct openings compared to CD and UVFD.
• While scale, ulceration, and lesion margins were consistently visible across all modalities, CD showed significant advantages in visualizing specific features for nevi, MIS, and invasive melanomas when compared to UVFD.

Conclusions:

• Conventional dermoscopy (CD) remains the primary tool for visualizing key features of acral melanocytic lesions (AMLs).
• Sub-ultraviolet reflectance dermoscopy (sUVRD) and ultraviolet-induced fluorescence dermoscopy (UVFD) offer complementary visualization capabilities.
• These advanced dermoscopic techniques may enhance the overall assessment and diagnosis of AMLs when used adjunctively with CD.