DermatopathologyMelanocytes in nonlesional sun-exposed skin: A multicenter comparative study
Section snippets
Data collection
Patients, from age 18 to 105 years, who were undergoing Mohs micrographic and reconstructive surgery for basal cell and squamous cell carcinoma of the face and neck were enrolled from Mayo Clinic, Jacksonville, FL (n = 50) and Mayo Clinic, Rochester, MN (n = 50). Patients with a history of radiation to the head and neck were excluded. The patients’ age, sex, type of tumor excised, personal history of dysplastic nevi or melanoma, and history of intense sun exposure in the 2 weeks before surgery
Results
A total of 100 study participants were recruited and enrolled, 50 each at Florida and Minnesota. Seventeen of the enrolled participants lived in a different state from the site at which they were recruited; these patients were included in the analysis. Table I shows a summary of the patient characteristics both overall and by site. There were no striking differences by site except that there were considerably more squamous cell carcinomas in Minnesota than in Florida.
Table II shows summaries of
Discussion
In the absence of quantitative guidelines for melanocyte density in sun-exposed skin, the histologic interpretation critical to appropriate diagnosis and therapy is often made subjectively. By better defining the normal degree of variability of melanocyte density and other features in practical and easily applicable terms, we aimed to delineate characteristics of nonlesional sun-exposed skin that would aid physicians facing this dilemma.
Similar to the previous study published by the principal
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Cited by (39)
Histopathologic and Molecular Diagnosis of Melanoma
2021, Clinics in Plastic SurgeryCitation Excerpt :Even when the microscopic findings are definitive in the center of the lesion, the proliferation of junctional melanocytes often gradually diminishes at the periphery, and blends with adjacent melanocytic hyperplasia (MH), making it difficult to define the boundary of the LM (Fig. 3). Although an increased density of junctional melanocytes can be observed in either LM or MH, nesting is not expected in MH, and pagetoid scatter is rare; therefore, when present, these features favor a diagnosis of LM.20,21 Routine sectioning (breadloafing) of tissue specimens results in histologic visualization of only a small percentage of the total peripheral margin; therefore, methods of more comprehensive assessment have been utilized for lentigo maligna specimens.
Premature cell senescence in human skin: Dual face in chronic acquired pigmentary disorders
2020, Ageing Research ReviewsCitation Excerpt :In older people, apart from a decreased number, melanocytes present a larger morphology, more dendritic and reduced tyrosinase activity (Yamaguchi et al., 2007; Tobin, 2011). Melanocyte dropout is less in sun-exposed areas, but these cells are functionally impaired and irregularly spaced, producing an irregular pigmentation on sun exposure (Hendi et al., 2006; and 2011). Thus, paradoxically, despite a decrease of active melanocytes, older skin has irregular pigmentation frequently associated with focal hyperpigmentation (solar lentigines) in sun-exposed areas of the skin (Gilchrest, 1979).
Mohs micrographic surgery for melanoma: A prospective multicenter study
2019, Journal of the American Academy of DermatologyCitation Excerpt :The Mohs layer specimen was then processed using frozen sectioned tissue stained with hematoxylin and eosin and MART-1.12 Positive margins were defined as previously described13-15 and marked on the map. The involved margin was excised with an additional margin of not less than 2 mm and most typically 3 mm of normal-appearing skin.
Follicular involvement is frequent in lentigo maligna: Implications for treatment
2019, Journal of the American Academy of DermatologyCitation Excerpt :The diagnosis of LM and LMM relies on a multitude of histologic features, and it is important to recognize that follicular involvement alone does not confirm the diagnosis. The presence of superficial follicular involvement has been noted in normal-appearing, yet sun-damaged skin,17 as well as in other types of melanoma such as the rare variant follicular melanoma1,18,19 and folliculotropic metastases of melanoma.18 However, we advocate that the overall importance of follicular involvement within a confirmed diagnosis of LM not be underestimated, as it may ultimately affect treatment success.
Lentigo Maligna (Melanoma In Situ)
2019, Pathology of Melanocytic TumorsReference values for skin microanatomy: A systematic review and meta-analysis of ex vivo studies
2017, Journal of the American Academy of DermatologyCitation Excerpt :Results of analyses for GET3,10,11,14-22,27,47-49,53,54 and SCT3,12,23,26,30,37,42,46,53 by anatomic location are in Supplemental Figs 1 and 2 (both available at http://www.jaad.org). Nine studies with 25 observations of MD by anatomic location were included (Fig 4).4,25,40,44,45,50-52,56 The overall estimate of MD was 955.05 cells/mm2 (95% CI, 880.89-1029.21).
The first two authors contributed equally to this work.
Supported by Mayo Clinic, Jacksonville, FL, and Rochester, MN.
Conflicts of interest: None declared.
Reprints not available from the authors.