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      Dermoscopy of venous lake on the lips: A comparative study with labial melanotic macule

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      PLoS ONE
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          Abstract

          Background

          Venous lake (VL) is a common vascular tumor occurring on the lips in the elderly. VL is sometimes difficult to distinguish from melanotic lesions such as labial melanotic macule (LMM) or oral malignant melanoma. However, the dermoscopic features of VL have not been sufficiently established in the literature.

          Objective

          This study was aimed at investigating the dermoscopic features of VL on the lips, and to compare the dermoscopic features of VL with those of LMM.

          Methods

          We retrospectively investigated the dermoscopic findings of histopathologically proven cases of VL and LMM.

          Results

          The structureless pattern (78.6%) and globules/clods (42.9%) were the common patterns in VL cases. Purple was the most frequent color (78.6%), followed by red (42.9%) and blue (42.9%). The structureless pattern (p = 0.003) and the colors purple (p = 0.000), red (p = 0.003), and blue (p = 0.018) were significantly more common in VL than in LMM. In contrast, lines (p = 0.000) and dots (p = 0.044) as patterns, and brown (p = 0.000) and gray (p = 0.044) colors were significantly more frequent in LMM. White structures were more common in VL than in LMM (p = 0.001).

          Conclusion

          Structureless patterns or globules/clods with purple, red, or blue coloration can be useful findings when differentiating VLs from LMM on dermoscopy. Therefore, dermoscopic evaluation is a helpful noninvasive ancillary tool in the diagnosis of VL.

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          Most cited references25

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          Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy

          Evolving dermoscopic terminology motivated us to initiate a new consensus.
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            Dermoscopy of pyogenic granuloma: a morphological study.

            Pyogenic granuloma is a common, benign, vascular lesion of the skin and mucous membranes which is a simulator of amelanotic/hypomelanotic melanoma and other tumours. To determine the diagnostic significance of dermoscopic structures and patterns associated with pyogenic granulomas in a large series of cases. Digital dermoscopic images of histopathologically proven cases of 122 pyogenic granulomas and 140 other tumours (28 amelanotic melanomas, seven melanoma metastases, 22 basal cell carcinomas and 83 other tumours) were collected from university hospitals in Spain, Italy, Austria and Turkey. The frequency, sensitivity, specificity, positive predictive value, negative predictive value, intraobserver agreement and interobserver agreement of the dermoscopic structures and patterns associated with pyogenic granulomas were calculated. Vascular structures were observed in 45% of pyogenic granulomas (sensitivity of 45·1% and specificity of 17·9%; both P < 0·001). Seven exclusive patterns were made up from the combination of the structures 'reddish homogeneous area' (RHA), 'white collarette' (WC), 'white rail lines' (WRL) and 'vascular structures' (VS). The pattern composed of RHA, WC and WRL showed the highest sensitivity (22·1%; P < 0·001) and a specificity of 100% (P < 0·001) for pyogenic granulomas. Two other patterns (RHA + WC and RHA + WC + WRL + VS) showed 100% specificity when compared with melanoma (P < 0·001 and P < 0·05, respectively). Even though some dermoscopic patterns are useful in the recognition of pyogenic granulomas, dermoscopy is not a substitute for histology, mostly when vessels are present, as melanoma cannot be ruled out. © 2010 The Authors. BJD © 2010 British Association of Dermatologists.
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              Dermoscopy of pigmented lesions of the mucosa and the mucocutaneous junction: results of a multicenter study by the International Dermoscopy Society (IDS).

              To better characterize the dermoscopic patterns of mucosal lesions in relation to the histopathologic characteristics. Retrospective and observational study. Fourteen referral pigmented lesion clinics in 10 countries. A total of 140 pigmented mucosal lesions (126 benign lesions, 11 melanomas, 2 Bowen disease lesions, and 1 metastasis) from 92 females (66%) and 48 males (34%) were collected from October 2007 through November 2008. Scoring the dermoscopic patterns (dots, globules, or clods, circles, lines, or structureless) and colors (brown, black, blue, gray, red, purple, and white) and correlation with the histopathologic characteristics. Based on univariate analysis and 2 diagnostic models, the presence of structureless zones inside the lesions with blue, gray, or white color (the first model) had a 100% sensitivity for melanoma and 92.9% sensitivity for any malignant lesion, and 82.2% and 83.3% specificity for benign lesions in the group with melanoma lesions and the group with malignant lesions, respectively. Based on the colors (blue, gray, or white) only (the second model), the sensitivity for the group with melanoma was 100% and for the group with any malignant lesion was 92.9%, and the specificity was 64.3% and 65.1%, respectively. Patients with malignant lesions were significantly older than patients with benign lesions (mean [SD] ages, 60.1 [22.8] years vs 43.2 [17.3] years, respectively). The combination of blue, gray, or white color with structureless zones are the strongest indicators when differentiating between benign and malignant mucosal lesions in dermoscopy.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                31 October 2018
                2018
                : 13
                : 10
                : e0206768
                Affiliations
                [1 ] Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
                [2 ] Institute of Human-Environment Interface Biology, Seoul National University, Seoul, Korea
                University of Queensland Diamantina Institute, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-0207-2107
                http://orcid.org/0000-0002-0734-2850
                Article
                PONE-D-18-23840
                10.1371/journal.pone.0206768
                6209377
                30379954
                075384e2-b7c4-40ae-a039-918c4c82b4e4
                © 2018 Lee, Mun

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 13 August 2018
                : 18 October 2018
                Page count
                Figures: 2, Tables: 3, Pages: 8
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Earth Sciences
                Marine and Aquatic Sciences
                Bodies of Water
                Lakes
                Ecology and Environmental Sciences
                Aquatic Environments
                Freshwater Environments
                Lakes
                Earth Sciences
                Marine and Aquatic Sciences
                Aquatic Environments
                Freshwater Environments
                Lakes
                Biology and Life Sciences
                Anatomy
                Head
                Face
                Lips
                Medicine and Health Sciences
                Anatomy
                Head
                Face
                Lips
                Biology and Life Sciences
                Anatomy
                Digestive System
                Mouth
                Lips
                Medicine and Health Sciences
                Anatomy
                Digestive System
                Mouth
                Lips
                Medicine and Health Sciences
                Diagnostic Medicine
                Signs and Symptoms
                Lesions
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Lesions
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Melanomas
                Medicine and Health Sciences
                Diagnostic Medicine
                Engineering and Technology
                Equipment
                Optical Equipment
                Lasers
                People and Places
                Population Groupings
                Age Groups
                Elderly
                Medicine and Health Sciences
                Diagnostic Medicine
                Cancer Detection and Diagnosis
                Medicine and Health Sciences
                Oncology
                Cancer Detection and Diagnosis
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

                Uncategorized
                Uncategorized

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