DERMATOSCOPIE 7 ITEM CHECKLIST home ICD10: n.v.t.

Dal Pozzo et al. hebben een algoritme bedacht voor dermatoscopie bij melanoom, waarbij ze alleen scoren op 7 kenmerken:

1. Irregular pigment network (2 punten)
2. Regression-erythema (2 punten)
3. Unhomogeneity (2 punten)
4. Sharp margin (2 punten)
5. Pseudopods (1 punt)
6. Radial streaming (1 punt)
7. Gray-blue veil (1 punt)

Bij 3 punten is er verdenking op een melanoom. Met deze 7 kenmerken (dermatoscopy 7-item-checklist) bereikten ze een sensitiviteit van 94.6%, en een specificiteit van 85.5%.


7 item checklist
Figure 1. Irregular pigment network shows broad mesh and varying features in the same lesions, melanoma, level II, thickness 0.23 mm.



7 item checklist
Figure 2. Regression-erythema is a white pinkish depigmented area possibly with a few angiectases, melanoma, level II, thickness 0.59 mm.



7 item checklist
Figure 3. Unhomogeneity is an asymmetrical or irregular distribution in the lesion of at least two dermoscopic features not necessarily predictive of malignancy. In this lesion globules and a pigment network show an asymmetrical distribution, melanoma, level II, thickness 0.62 mm.



7 item checklist
Figure 4. Sharp margin: abrupt cessation of the dermoscopic features at the periphery of the lesion not < 1/4 of the margin, melanoma, level II, thickness 0.42 mm.



7 item checklist
Figure 5. Pseudopods: this lesion presents irregularly distributed pseudopods, melanoma, level II, thickness 0.54 mm.



7 item checklist
Figure 6. Radial streaming are thin, closely spaced, parallel pigmented streaming irradiating from the rim of the lesion, melanoma, level II, thickness 0.20 mm.



7 item checklist
Figure 7. Gray-blue veil: a blue or gray-faded blue area with ill-defined margins, asymmetrically located inside the lesion, melanoma, level II, thickness 0.98 mm.



7 item checklist
7 item checklist
7 item checklist
7 item checklist
7 item checklist


Referenties
1. Dal Pozzo V, Benelli C, Roscetti E. The seven features for melanoma: a new dermoscopic algorithm for the diagnosis of malignant melanoma. European Journal of Dermatology 1999;9:303-308.


Auteur(s):
dr. Jan R. Mekkes. Dermatoloog, AMC, Amsterdam.

31-12-2009 (JRM) - www.huidziekten.nl W3C-html-4.01-valid



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