H. P. Soyer, G. Argenziano, R. Hofmann-Wellenhof, R. H. Johr (Eds.) Color Atlas of Melanocytic Lesions of the Skin

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H. P. Soyer, G. Argenziano, R. Hofmann-Wellenhof, R. H. Johr (Eds.) Color Atlas of Melanocytic Lesions of the Skin

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H. P. Soyer G. Argenziano R. Hofmann-Wellenhof R. H. Johr (Eds.)

With 366 Figures and 26 Tables

Color Atlas

of Melanocytic Lesions

of the Skin

123

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H. Peter Soyer, MD, FACD Professor of Dermatology School of Medicine University of Queensland Princess Alexandra Hospital Australia

Giuseppe Argenziano, MD Professor of Dermatology Department of Dermatology Second University of Naples Nuovo Policlinico – Edificio 13 Via Pansini 5

I-80131 Naples Italy

Rainer Hofmann-Wellenhof, MD Professor of Dermatology Department of Dermatology Medical University Graz Auenbruggerplatz 8 A-8036 Graz Austria

Robert H. Johr, MD

Clinical Professor of Dermatology and Pediatrics Director, Pigmented Lesion Clinic

University of Miami, School of Medicine Miami, FL 33136

USA

Library of Congress Control Number: 2007924719

ISBN 978-3-540-35105-4 Springer Berlin Heidelberg New York

This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law.

Springer is a part of Springer Science+Business Media springer.com

The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

Editor: Marion Philipp, Heidelberg, Germany Desk Editor: Ellen Blasig, Heidelberg, Germany

Production: LE-TEX Jelonek, Schmidt & Vöckler GbR, Leipzig, Germany Cover design: Frido Steinen-Broo, EStudio, Calamar, Spain

Reproduction and typesetting: am-productions GmbH, Wiesloch, Germany Printed on acid-free paper 24/3180/YL 5 4 3 2 1 0

The Queensland Institute of Dermatology

Brisbane, QLD 4102

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This book is dedicated to the memory of Paolo Carli

an outstanding scientist and a special human being.

H. Peter Soyer and Giuseppe Argenziano on behalf of all authors

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Foreword

Melanocytic tumors of the skin deserve special attention because of the following important facts

■ Melanoma is frequent and early detection is critical.

■ a correct interpretation is necessary because the implications may be very serious.

■ it is a dynamically developing field where major progress has been made over the past decade.

This atlas, written in a concise way, is a highly useful presentation that focuses on the full spec- trum of pigmented skin tumors. The prominent features include classical clinical as well as his- topathological criteria for diagnosis, illustrations of excellent quality, as well as new concepts and practical aspects of management. of special interest are modern diagnostic techniques with emphasis on dermatoscopy. Case studies and core messages indicating pathways of the diagnostic approach are at the end of each chapter.

all these features characterize the book as an impressive contribution to the literature in the area of melanocytic tumors.

My co-workers in Graz, Dr. H. Peter Soyer and Dr. rainer Hofmann-Wellenhof, as well as Dr. Giuseppe argenziano from Naples and Dr.

robert Johr from Miami, together with many international contributors who are all experts in their respective disciplines, have produced a splendid piece of work which presents highly relevant information on a complex and chal- lenging subject. This book will greatly assist physicians in providing optimal care for pa- tients with melanocytic skin lesions.

Helmut Kerl

Professor & Chairman Department of Dermatology Medical University of Graz austria

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Preface

at the beginning of many scientific endeavors there is an idea shared by a small group of en- thusiastic people. This was the case with our group, friends and colleagues from austria, italy, and the United States. our idea was to write a color atlas of melanocytic skin lesions, with particular emphasis on the morphological dimension, using a systematic and logical approach. as practicing dermatologists with back- grounds in dermoscopy and dermatopathology, we wanted to describe the many faces of benign and malignant pigmented skin lesions based on clinico-pathological and dermoscopic−pathological correlations. Together with a large group of distinguished dermatologists from around the world, we prepared this atlas.

in 1894 Paul Gerson Unna published the text- book Histopathology of Skin Diseases. His well- known saying on the relationship between dermatology and histopathology has been slightly modified by us and now reads as follows: “The dermatologist is fortunate in being able to study the clinical and dermoscopic picture with his/

her histologically trained eye and the micro- scopic picture with his/her clinically and der- moscopically trained eye.” in this spirit we hope that you enjoy reading this atlas and that it will help you in your daily practice.

H. Peter Soyer

Giuseppe Argenziano Rainer Hofmann-Wellenhof Robert Johr

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I.1 The Morphologic Dimension in the Diagnosis of Melanocytic Skin lesions . . . 1 H. Peter Soyer

and Elisabeth M.T. Wurm I.2 Clinical Examination

of Melanocytic Neoplasms

including aBCDE Criteria . . . 3 Alfred W. Kopf

I.3 Dermoscopic Examination . . . 7 Ralph P. Braun, Harold S. Rabinovitz,

Margaret Oliviero, Alfred W. Kopf, Jean-Hillaire Saurat, Luc Thomas I.4 Melanoma: the Morphological

Dimension . . . 23 Lorenzo Cerroni

II.1 laser-Scanning Confocal

Microscopy . . . 39 Salvador González and Allan Halpern II.2 automatic Diagnosis . . . 47 Josef Smolle

II.3 Multispectral image analysis . . . 52 Dina Gutkowicz-Krusin

and Harold Rabinovitz

II.4 Teledermatology . . . 57 Cesare Massone,

Elisabeth M.T. Wurm, Rainer Hofmann-Wellenhof, Gian Piero Lozzi, H. Peter Soyer III.1 The life of Melanocytic Nevi . . . 61 Harald Kittler

III.2 acral Nevus . . . 66 Masaru Tanaka, Masayuki Kimoto,

Toshiaki Saida

III.3 agminated Nevus . . . 75 Ulrike Weigert and Wilhelm Stolz III.4 Blue Nevus . . . 78 Gerardo Ferrara

and Giuseppe Argenziano

III.5 atypical (Dysplastic) Nevus . . . 87 Rainer Hofmann-Wellenhof

and H. Peter Soyer

III.6 Combined Nevus . . . 97 Horacio Cabo

III.7 Common Nevus . . . 102 Rainer Hofmann-Wellenhof

and H. Peter Soyer

III.8 Congenital Melanocytic Nevi . . . 106 Alon Scope, Cristiane Benvenuto-

Andrade, Ashfaq A. Marghoob III.9 Melanocytic Nevi on the Genitalia

and Melanocytic Nevi

on other Special locations . . . 119 Ingrid H. Wolf

III.10 Halo Nevus . . . 124 Alessandro Di Stefani

and Sergio Chimenti III.11 irritated Nevus

and Meyerson’s Nevus . . . 129 Regina Fink-Puches,

Iris Zalaudek,

Rainer Hofmann-Wellenhof III.12 Melanocytic lesions

in Darker racial Ethnic Groups . . . 135 Heather Woolery-Lloyd

III.13 Miescher Nevus . . . 139 Steven Q. Wang, Harold H.

Rabinovitz, Alfred W. Kopf

Contents

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XII Contents

III.14 Nevi with Particular Pigmentation:

Black, Pink, and White Nevus . . . . 142 Iris Zalaudek, Robert Johr,

Bernd Leinweber

III.15 recurrent Nevus . . . 147 Andreas Blum

III.16 Spitz Nevus and its Variants . . . 151 Gerardo Ferrara, Elvira Moscarella,

Caterina M. Giorgio, Giuseppe Argenziano III.17 Syndromes involving

Melanocytic lesions . . . 164 Cheryl G. Aber,

Elizabeth Alvarez Connelly, Lawrence A. Schachner

III.18 Nail apparatus Nevus (Subungual Nevus, Nail Matrix Nevus) . . . 173

Luc Thomas

III.19 Unna Nevus . . . 181 Susana Puig and Josep Malvehy IV.1 Epidemiology of Melanoma . . . 185 Scott Kitchener

IV.2 acral Melanoma . . . 196 Toshiaki Saida, Hiroshi Koga,

Yoriko Yamazaki, Masaru Tanaka IV.3 amelanotic Melanoma . . . 204 Jürgen Kreusch

IV.4 Early Evolution of Melanoma

(Small-Diameter Melanoma) . . . 213 Robert J. Friedman, Melanie Warycha,

Michele Farber, Dina Gutkowicz- Krusin, Harold Rabinovitz, David Polsky, Margaret Oliviero, Darrell S. Rigel, Lori Kels,

Edward R. Heilman, Alfred W. Kopf IV.5 False-Negative Melanomas . . . 221 Robert Johr and Giuseppe Argenziano IV.6 Genital Melanoma . . . 229 Ingrid H. Wolf

IV.7 Melanoma of the Face . . . 233 Ulrike Weigert and Wilhelm Stolz IV.8 Melanoma of the Trunk

and limbs including Superficial and Nodular Melanoma . . . 237 Josep Malvehy and Susana Puig IV.9 Cutaneous Metastatic Melanoma . . 260 Maria Antonietta Pizzichetta

IV.10 Scalp Melanoma . . . 265 Iris Zalaudek, Jason Giacomel,

Bernd Leinweber

IV.11 Nail apparatus Melanoma (Subungual Melanoma,

Nail Matrix Melanoma) . . . 270

Luc Thomas

V.1 Pigmented Basal Cell Carcinoma . . 279 Scott W. Menzies

V.2 Dermatofibroma . . . 286 Domenico Piccolo and Ketty Peris V.3 lentigines including lentigo

Simplex, reticulated lentigo

and actinic lentigo . . . 290 Paolo Carli and Camilla Salvini V.4 Squamous Cell Carcinoma

including actinic Keratosis, Bowens Disease, Keratoacanthoma, and its Pigmented Variants . . . 295 Iris Zalaudek, Jason Giacomel,

Bernd Leinweber

V.5 Vascular lesions . . . 303 Fezal Özdemir

V.6 Seborrheic Keratosis including lichen Planus-like Keratosis . . . 313 Robert Johr

Subject Index . . . 329

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List of Contributors

C. Aber

Division of Pediatric Dermatology Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Cedars Medical Center 1295 NW 14th Street, Suite K Miami, Florida 33125

E-mail: [email protected] E. Alvarez Connelly

Division of Pediatric Dermatology Department of Dermatology and Cutaneous Surgery

University of Miami, Miller School of Medicine Cedars Medical Center

1295 NW 14th Street, Suite K Miami, Florida 33125

USaE-mail: [email protected]

G. Argenziano

Department of Dermatology Second University of Naples Nuovo Policlinico − Edificio 13 Via Pansini 5

80131 Naples

E-mail: [email protected] C. Benvenuto-Andrade research Dermatologist

Photomedicine and Telemedicine laboratory Federal University of rio Grande do Sul Porte alegre

Brazil

E-mail: [email protected]

A. Blum

associate Professor of Dermatology Seestraße 3a

78464 Konstanz Germany

E-mail: [email protected] R.P. Braun

Department of Dermatology University Hospital Zurich 8091 Zurich

Switzerland

E-mail: [email protected] H. Cabo

Section of Dermatology

instituto de investigaciones Médicas

“a. lanari”

University of Buenos aires argentina

E-mail: [email protected] P. Carli †

Dipartimento di Scienze Dermatologiche Universita’ di Firenze

Via degli alfani, 37 50121 Florence italy

† Deceased L. Cerroni

Department of Dermatology Medical University of Graz auenbruggerplatz 8 8036 Graz

austria

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S. Chimenti

Department of Dermatology University of rome “Tor Vergata”

PTV − Policlinico di Tor Vergata Viale oxford 81

00133 rome italy

E-mail: [email protected] A. Di Stefani

Department of Dermatology University of rome “Tor Vergata”

PTV − Policlinico di Tor Vergata Viale oxford 81

00133 rome italy

E-mail: [email protected] M. Farber

Department of Dermatology

New York University School of Medicine 550 First avenue

New York, NY 10016

G. Ferrara

Pathologic anatomy Service Gaetano rummo General Hospital Via dell’angelo 1

82100 Benevento italy

E-mail: [email protected] R. Fink-Puches

Department of Dermatology Medical University Graz auenbruggerplatz 8 8036 Graz

austria

E-mail: [email protected] R.J. Friedman

oncology Section

New York, NY 10016

J.S. Giacomel Private Practice 11 Mends Street South Perth

Western australia 6151 australia

E-mail: [email protected] C.M. Giorgio

Department of Dermatology Second University of Naples Via S. Pansini 5

80131 Naples italy

E-mail: [email protected] S. González

Dermatology Service

Memorial Sloan-Kettering Cancer Center New York, NY 10022

D. Gutkowicz-Krusin Electro-optical Sciences, inc.

1 Bridge Street irvington, NY 10533

A. Halpern

Dermatology Service

Memorial Sloan-Kettering Cancer Center New York, NY 10022

E.R. Heilman

SUNY Health Science Center at Brooklyn Brooklyn, N.Y.

XIV List of Contributors

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R. Hofmann-Wellenhof Department of Dermatology Medical University of Graz auenbruggerplatz 8 8036 Graz

austria

E-mail: [email protected] R.H. Johr

Pigmented lesion Clinic School of Medicine University of Miami Miami, Fl 33136

M. Kimoto

Department of Dermatology Keio University School of Medicine 35 Shinanomachi, Shinjyuku-ku Tokyo 160-8582

Japan

E-mail: [email protected] S. Kitchener

Primary Care Skin Cancer Medicine Unit School of Medicine

University of Queensland Herston road

Herston 4006 australia

E-mail: [email protected] H. Kittler

Department of Dermatology Medical University of Vienna Waehringer Guertel 18−20 1090 Vienna

austria

E-mail: [email protected] H. Koga

Shinshu University School of Medicine 3-1-1 asahi

Matsumoto 390-8621 Japan

A.W. Kopf

The ronald o. Perelman Department of Dermatology

New York, NY 10016

J. Kreusch

Dermatological Practice Skin Cancer Diagnostic Center Moislinger allee 95

23558 luebeck Germany

E-mail: juergen.kreusch @web.de B. Leinweber

Department of Dermatology Medical University of Graz, austria auenbruggerplatz 8

8036 Graz austria

E-mail: [email protected] G.P. Lozzi

Department of Dermatology University of l’aquila, italy Via Vetoio − Coppito 2 67100 l’aquila

italy

E-mail: [email protected] J. Malvehy

Melanoma Unit

Department of Dermatology Hospital Clinic

Villarroel 170 08036 Barcelona Spain

E-mail: [email protected] A.A. Marghoob

Memorial Sloan-Kettering Cancer Center 160 East 53rd Street, 2nd floor

New York, NY 10022

List of Contributors XV

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C. Massone

Department of Dermatology Medical University Graz auenbruggerplatz 8 a-8036 Graz austria

E-mail: [email protected] S.W. Menzies

Sydney Melanoma Diagnostic Centre 2nd Floor, Gloucester House

royal Prince alfred Hospital Missenden road

Camperdown NSW 2050 australia

E-mail: [email protected] E. Moscarella

Department of Dermatology Second University of Naples Via S. Pansini 5

80131 Naples italy

E-mail: [email protected] M. Oliviero

University of Miami School of Medicine Miami, Fl 33324

F. Özdemir

Department of Dermatology Medical Faculty

Ege University 35100 Bornova izmir Turkey

E-mail: [email protected] K. Peris

Department of Dermatology University of l’aquila Via Vetoio − Coppito 2 67100 l’aquila

italy

E-Mail: [email protected]

D. Piccolo

Department of Dermatology University of l’aquila Via Vetoio − Coppito 2 67100 l’aquila

italy

E-Mail: [email protected] M.A. Pizzichetta

Division of Medical oncology C oncology Prevention

Centro di riferimento oncologico National Cancer institute

Via Pedemontana occidentale 12 33081 aviano –PN

italy

E-mail: [email protected] D. Polsky

New York, NY 10016

H.S. Rabinovitz

Skin and Cancer associates 201 N.W. 82nd avenue Plantation, Fl 33324

D.S. Rigel

New York University School of Medicine adjunct Clinical Professor

Department of Dermatology Mount Sinai School of Medicine New York, NY

S. Puig

Melanoma Unit

Department of Dermatology Hospital Clínic

Villarroel 170 08036 Barcelona Spain

XVI List of Contributors

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T. Saida

E-mail: [email protected] C. Salvini

Department of Dermatological Sciences University of Florence

Via della Pergola 58−60 50121 Florence

italy

E-mail: [email protected] J.-H. Saurat

Pigmented Skin lesion Unit Department of Dermatology University Hospital Geneva 24 rue Micheli Du Crest 1211 Geneva 14

Switzerland

E-mail: [email protected] L.A. Schachner

Division of Pediatric Dermatology

University of Miami, Miller School of Medicine Department of Dermatology and Cutaneous Surgery

1600 NW 10th avenue rosenstiel Bldg. room 2023a Miami Fl 33136

L. Schneider-Kels

New York, NY 10016

A. Scope

Memorial Sloan-Kettering Cancer Center 160 East 53rd Street, 2nd floor

New York, NY 10022 USaE-mail: [email protected]

J. Smolle

institute of Medical informatics, Statistics and Documentation Medical University of Graz Billrothgasse 18a/7 8010 Graz

austria

E-mail: [email protected] H.P. Soyer

School of Medicine University of Queensland

australia

W. Stolz

abteilung für Dermatologie, allergologie und Umweltmedizin Krankenhaus München Schwabing Kölner Platz 1

80804 Munich Germany

E-mail: [email protected] M. Tanaka

Department of Dermatology Tokyo Women’s Medical University Medical Center East

2-1-10 Nishi-ogu, arakawa-ku Tokyo 116-8567

Japan

E-mail: [email protected] L. Thomas

Department of Dermatology Hotel Dieu

69288 lyon Cedex 02 France

E-mail: [email protected] S.Q. Wang

Department of Dermatology Mayo Mail Code 98

420 Delaware Street S.E.

Minneapolis, MN 55455 USaE-mail: [email protected]

List of Contributors XVII

The Queensland institute of Dermatology

Brisbane, QlD 4102

Princess alexandra Hospital

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M. Warycha

New York, NY 10016

U. Weigert

abteilung für Dermatologie, allergologie und Umweltmedizin Krankenhaus München Schwabing Kölner Platz 1

80804 München Germany

E-mail: [email protected] I.H. Wolf

austria

E-mail: [email protected] H. Woolery-Lloyd

Department of Dermatology and Cutaneous Surgery School of Medicine University of Miami Miami, Fl 33136

E.M.T. Wurm

Department of Dermatology Medical University of Graz auenbruggerplatz 8 8036 Graz

austria

E-mail: [email protected] Y. Yamazaki

E-mail: [email protected] I. Zalaudek

austria

XVIII List of Contributors