Dermoscopic Characteristics of Merkel Cell Carcinoma
Dermoscopic Characteristics of Merkel Cell Carcinoma
Background Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy with a high mortality rate. Diagnosis is often delayed.
Objectives To characterize the dermoscopic features of MCC.
Methods Clinical and dermoscopic images of 12 biopsy-proven MCCs were analysed in a retrospective manner, with existing dermoscopic criteria being scored independently by three dermatologists.
Results The four most frequent clinical features were cherry red colour, shiny surface, sharp circumscription and nodular morphology. Significant dermoscopic features included linear irregular and polymorphous vessels, poorly focused vessels, milky pink areas, white areas, structureless areas and architectural disorder. Pigmented structures were absent from all lesions.
Conclusions The dermoscopic features described herein help the clinician to distinguish MCC from other benign and malignant red nodules. Increasing recognition of the presenting features will facilitate earlier diagnosis of MCC and reduced mortality.
Merkel cell carcinoma (MCC) is a rare yet aggressive cutaneous tumour of neuroendocrine lineage. A population-based study of MCC in Western Australia showed an age-standardized incidence rate of 0·82/100 000, the highest reported in the literature. For men over the age of 85 years in Western Australia the reported incidence is 28·8/100 000. Well-documented risk factors for the development of MCC include ultraviolet exposure, immunosuppression, male sex and older age. Recently, the newly discovered Merkel cell polyomavirus has been implicated in the development of MCC. A new international consensus staging system for MCC has recently been proposed with tumours stratified by size. Local disease is treated with wide excision and adjuvant radiotherapy, with consideration given to sentinel-node biopsy.
MCC typically presents as an asymptomatic, rapidly growing nonpigmented nodule. However, misdiagnosis and treatment delay are common due to similarities in clinical appearance to basal cell carcinoma (BCC) and various benign lesions. In this study, we analysed the clinical and dermoscopic appearance of 12 cases of MCC to determine the distinguishing characteristics that might permit earlier diagnosis.
Abstract and Introduction
Abstract
Background Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy with a high mortality rate. Diagnosis is often delayed.
Objectives To characterize the dermoscopic features of MCC.
Methods Clinical and dermoscopic images of 12 biopsy-proven MCCs were analysed in a retrospective manner, with existing dermoscopic criteria being scored independently by three dermatologists.
Results The four most frequent clinical features were cherry red colour, shiny surface, sharp circumscription and nodular morphology. Significant dermoscopic features included linear irregular and polymorphous vessels, poorly focused vessels, milky pink areas, white areas, structureless areas and architectural disorder. Pigmented structures were absent from all lesions.
Conclusions The dermoscopic features described herein help the clinician to distinguish MCC from other benign and malignant red nodules. Increasing recognition of the presenting features will facilitate earlier diagnosis of MCC and reduced mortality.
Introduction
Merkel cell carcinoma (MCC) is a rare yet aggressive cutaneous tumour of neuroendocrine lineage. A population-based study of MCC in Western Australia showed an age-standardized incidence rate of 0·82/100 000, the highest reported in the literature. For men over the age of 85 years in Western Australia the reported incidence is 28·8/100 000. Well-documented risk factors for the development of MCC include ultraviolet exposure, immunosuppression, male sex and older age. Recently, the newly discovered Merkel cell polyomavirus has been implicated in the development of MCC. A new international consensus staging system for MCC has recently been proposed with tumours stratified by size. Local disease is treated with wide excision and adjuvant radiotherapy, with consideration given to sentinel-node biopsy.
MCC typically presents as an asymptomatic, rapidly growing nonpigmented nodule. However, misdiagnosis and treatment delay are common due to similarities in clinical appearance to basal cell carcinoma (BCC) and various benign lesions. In this study, we analysed the clinical and dermoscopic appearance of 12 cases of MCC to determine the distinguishing characteristics that might permit earlier diagnosis.
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