H. P. Soyer, G. Argenziano, R. Hofmann-Wellenhof, R. H. Johr (Eds.) Color Atlas of Melanocytic Lesions of the Skin
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
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
© Springer-Verlag Berlin Heidelberg 2007
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
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
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, illustra- tions 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 diag- nostic 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
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, ita- ly, and the United States. our idea was to write a color atlas of melanocytic skin lesions, with particular emphasis on the morphological di- mension, using a systematic and logical ap- proach. 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−patho- logical 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 der- matology 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
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
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
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: caber@med.miami.edu 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: econnelly@med.miami.edu
G. Argenziano
Department of Dermatology Second University of Naples Nuovo Policlinico − Edificio 13 Via Pansini 5
80131 Naples
E-mail: argenziano@tin.it C. Benvenuto-Andrade research Dermatologist
Photomedicine and Telemedicine laboratory Federal University of rio Grande do Sul Porte alegre
Brazil
E-mail: cris@fornix.com.br
A. Blum
associate Professor of Dermatology Seestraße 3a
78464 Konstanz Germany
E-mail: a.blum@derma.de R.P. Braun
Department of Dermatology University Hospital Zurich 8091 Zurich
Switzerland
E-mail: braun@melanoma.ch H. Cabo
Section of Dermatology
instituto de investigaciones Médicas
“a. lanari”
University of Buenos aires argentina
E-mail: hcabo@fibertel.com.ar 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
E-mail: lorenzo.cerroni@meduni-graz.at
S. Chimenti
Department of Dermatology University of rome “Tor Vergata”
PTV − Policlinico di Tor Vergata Viale oxford 81
00133 rome italy
E-mail: chimenti@dermatologica.it A. Di Stefani
Department of Dermatology University of rome “Tor Vergata”
PTV − Policlinico di Tor Vergata Viale oxford 81
00133 rome italy
E-mail: alessandro.distefani@tin.it M. Farber
Department of Dermatology
New York University School of Medicine 550 First avenue
New York, NY 10016
USaE-mail: michele.farber@duke.edu
G. Ferrara
Pathologic anatomy Service Gaetano rummo General Hospital Via dell’angelo 1
82100 Benevento italy
E-mail: gerardo.ferrara@libero.it R. Fink-Puches
Department of Dermatology Medical University Graz auenbruggerplatz 8 8036 Graz
austria
E-mail: regina.fink@meduni-graz.at R.J. Friedman
oncology Section
Department of Dermatology
New York University School of Medicine 550 First avenue
New York, NY 10016
USaE-mail: rfriedmanmdceo@hotmail.com
J.S. Giacomel Private Practice 11 Mends Street South Perth
Western australia 6151 australia
E-mail: jasongiacomel@optusnet.com.au C.M. Giorgio
Department of Dermatology Second University of Naples Via S. Pansini 5
80131 Naples italy
E-mail: caterinagiorgio@libero.it S. González
Dermatology Service
Memorial Sloan-Kettering Cancer Center New York, NY 10022
USaE-mail: gonzals6@mskcc.org
D. Gutkowicz-Krusin Electro-optical Sciences, inc.
1 Bridge Street irvington, NY 10533
USaE-mail: gutkowicz@eosciences.com
A. Halpern
Dermatology Service
Memorial Sloan-Kettering Cancer Center New York, NY 10022
USaE-mail: halperna@mskcc.org
E.R. Heilman
Department of Dermatology
SUNY Health Science Center at Brooklyn Brooklyn, N.Y.
USaE-mail: eheilman@ameripath.com
XIV List of Contributors
R. Hofmann-Wellenhof Department of Dermatology Medical University of Graz auenbruggerplatz 8 8036 Graz
austria
E-mail: rainer.hofmann@meduni-graz.at R.H. Johr
Pigmented lesion Clinic School of Medicine University of Miami Miami, Fl 33136
USaE-mail: rjohrmd@bellsouth.net
M. Kimoto
Department of Dermatology Keio University School of Medicine 35 Shinanomachi, Shinjyuku-ku Tokyo 160-8582
Japan
E-mail: kimotoma@1998.jukuin.keio.ac.jp S. Kitchener
Primary Care Skin Cancer Medicine Unit School of Medicine
University of Queensland Herston road
Herston 4006 australia
E-mail: s.kitchener@uq.edu.au H. Kittler
Department of Dermatology Medical University of Vienna Waehringer Guertel 18−20 1090 Vienna
austria
E-mail: harald.kittler@meduniwien.ac.at H. Koga
Department of Dermatology
Shinshu University School of Medicine 3-1-1 asahi
Matsumoto 390-8621 Japan
E-mail: koga@hsp.md.shinshu-u.ac.jp
A.W. Kopf
The ronald o. Perelman Department of Dermatology
New York University School of Medicine 550 First avenue
New York, NY 10016
USaE-mail: akopf@compuserve.com
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: bernd.leinweber@meduni-graz.at G.P. Lozzi
Department of Dermatology University of l’aquila, italy Via Vetoio − Coppito 2 67100 l’aquila
italy
E-mail: gilozzi@inwind.it J. Malvehy
Melanoma Unit
Department of Dermatology Hospital Clinic
Villarroel 170 08036 Barcelona Spain
E-mail: jmalvehy@clinic.ub.es A.A. Marghoob
Section of Dermatology
Memorial Sloan-Kettering Cancer Center 160 East 53rd Street, 2nd floor
New York, NY 10022
USaE-mail: marghooa@mskcc.org
List of Contributors XV
C. Massone
Department of Dermatology Medical University Graz auenbruggerplatz 8 a-8036 Graz austria
E-mail: cesare.massone@klinikum-graz.at S.W. Menzies
Sydney Melanoma Diagnostic Centre 2nd Floor, Gloucester House
royal Prince alfred Hospital Missenden road
Camperdown NSW 2050 australia
E-mail: scott.menzies@email.cs.nsw.gov.au E. Moscarella
Department of Dermatology Second University of Naples Via S. Pansini 5
80131 Naples italy
E-mail: elvyra@tim.it M. Oliviero
Department of Dermatology
University of Miami School of Medicine Miami, Fl 33324
USaE-mail: m.oliviero@dermnetwork.org
F. Özdemir
Department of Dermatology Medical Faculty
Ege University 35100 Bornova izmir Turkey
E-mail: ozdemirfezal@gmail.com K. Peris
Department of Dermatology University of l’aquila Via Vetoio − Coppito 2 67100 l’aquila
italy
E-Mail: peris@univaq.it
D. Piccolo
Department of Dermatology University of l’aquila Via Vetoio − Coppito 2 67100 l’aquila
italy
E-Mail: telederm@univaq.it 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: pizzichetta@cro.it D. Polsky
Department of Dermatology
New York University School of Medicine 550 First avenue
New York, NY 10016
USaE-mail: david.polsky@med.nyu.edu
H.S. Rabinovitz
Skin and Cancer associates 201 N.W. 82nd avenue Plantation, Fl 33324
USaE-mail: harold@admcorp.com
D.S. Rigel
Department of Dermatology
New York University School of Medicine adjunct Clinical Professor
Department of Dermatology Mount Sinai School of Medicine New York, NY
USaE-mail: dsrigel@prodigy.net
S. Puig
Melanoma Unit
Department of Dermatology Hospital Clínic
Villarroel 170 08036 Barcelona Spain
E-mail: spuig@clinic.ub.es
XVI List of Contributors
T. Saida
Department of Dermatology
Shinshu University School of Medicine 3-1-1 asahi
Matsumoto 390-8621 Japan
E-mail: tosaida@hsp.md.shinshu-u.ac.jp C. Salvini
Department of Dermatological Sciences University of Florence
Via della Pergola 58−60 50121 Florence
italy
E-mail: camillasalvini@katamail.com J.-H. Saurat
Pigmented Skin lesion Unit Department of Dermatology University Hospital Geneva 24 rue Micheli Du Crest 1211 Geneva 14
Switzerland
E-mail: jean.saurat@medecine.unige.ch 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
USaE-mail: lschachn@med.miami.edu
L. Schneider-Kels
Department of Dermatology
New York University School of Medicine 550 First avenue
New York, NY 10016
USaE-mail: lorihs@alumni.upenn.edu
A. Scope
Section of Dermatology
Memorial Sloan-Kettering Cancer Center 160 East 53rd Street, 2nd floor
New York, NY 10022 USaE-mail: scopea@mskcc.org
J. Smolle
institute of Medical informatics, Statistics and Documentation Medical University of Graz Billrothgasse 18a/7 8010 Graz
austria
E-mail: josef.smolle@meduni-graz.at 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: wilhelm.stolz@kms.mhn.de 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: masarutanaka@1984.jukuin.keio.ac.jp L. Thomas
Department of Dermatology Hotel Dieu
69288 lyon Cedex 02 France
E-mail: luc.thomas@chu-lyon.fr S.Q. Wang
Department of Dermatology Mayo Mail Code 98
420 Delaware Street S.E.
Minneapolis, MN 55455 USaE-mail: sqwang01@yahoo.com
List of Contributors XVII
The Queensland institute of Dermatology
Brisbane, QlD 4102
Princess alexandra Hospital
E-mail: p.soyer@ug.edu.au
M. Warycha
Department of Dermatology
New York University School of Medicine 550 First avenue
New York, NY 10016
USaE-mail: maw276@med.nyu.edu
U. Weigert
abteilung für Dermatologie, allergologie und Umweltmedizin Krankenhaus München Schwabing Kölner Platz 1
80804 München Germany
E-mail: derma@kms.mhn.de I.H. Wolf
Department of Dermatology Medical University Graz auenbruggerplatz 8 8036 Graz
austria
E-mail: ingrid.wolf@meduni-graz.at H. Woolery-Lloyd
Department of Dermatology and Cutaneous Surgery School of Medicine University of Miami Miami, Fl 33136
USaE-mail: woolerylloyd@yahoo.com
E.M.T. Wurm
Department of Dermatology Medical University of Graz auenbruggerplatz 8 8036 Graz
austria
E-mail: lissy.wurm@gmail.com Y. Yamazaki
Department of Dermatology
Shinshu University School of Medicine 3-1-1 asahi
Matsumoto 390-8621 Japan
E-mail: y.yamazaki@sihp.jp I. Zalaudek
Department of Dermatology Medical University Graz auenbruggerplatz 8 8036 Graz
austria
E-mail: iris.zalaudek@meduni-graz.at
XVIII List of Contributors