Dermatoskopi Johan Heilborn Verksamhetschef Hudcentrum Hagastaden - PowerPoint PPT Presentation

Dermatoskopi Johan Heilborn Verksamhetschef Hudcentrum Hagastaden

Strategier för tidig upptäckt av melanom

Vid klinisk undersökning av nevi finns det en gråzon där man inte säkert kan skilja beniga nevi från malignt melanom avvikande malign benign Viktigt att identifiera maligna melanom i ett tidigt skede - fokus på pigmentlesioner i denna gråzon

Beslutstöd för val av pigmenterad lesion för excision ” Change ” Den fula ankungen ” Recognition “ ABCDE kriterier Dermatoskopi

Dermatoskopi

Pattern Pattern Analysis Recognition

Revised pattern analysis

Content 1. Elements basic 2. Patterns basic 3. Colors 4. Clues to specific diagnoses 5. Algorithm for a specific diagnosis

Content 1. Elements basic 2. Patterns basic 3. Colors 4. Clues to specific diagnoses 5. Algorithm for a specific diagnosis

1. Elements basic

Content 1. Elements basic 2. Patterns basic 3. Colors 4. Clues to specific diagnoses 5. Algorithm for a specific diagnosis

2. Patterns basic Lines Pseudopods Circles Clods Dots 13

2. Patterns basic Pattern formed by lines Reticular Branched Parallell Radial Curved 14

2. Patterns basic Pattern formed by other elements 15

Important notes A pattern is formed by multiple elements of • the same type A pattern covers a significant part of the • lesion ( ∼ 20%). One or two dots are not a pattern! Structureless is the absence of basic • elements 16

Where there is only one pattern there cannot be asymmetry of pattern 17

Symmetry or asymmetry of patterns If multiple patterns are present they can be arranged symmetrically or asymmetrically 18

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Content 1. Elements basic 2. Patterns basic 3. Colors 4. Clues to specific diagnoses 5. Algorithm for a specific diagnosis

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If multiple colors are present they can be arranged symmetrically or asymmetrically

Chaos & Clues

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Simple Pattern Analysis (Chaos & Clues) CHAOS (Asymmetry of pattern or Asymmetry of color) AND one CLUE to melanoma = Melanoma

Symmetry or asymmetry of colors If multiple colors are present they can be arranged symmetrically or asymmetrically 26

We can use CHAOS to screen many lesions in a short time 27

Clues to Melanoma 1. Thick reticular lines 2. Grey or blue structures (dots, clods, lines, circles) 3. Pseudopods or radial lines at the periphery 4. Black dots in the periphery 5. Eccentric structureless zone (any color) 6. Polymorphous vascular pattern 7. White lines 8. Parallel lines, ridges 9. Angulated lines (Polygones) 28

johan.heilborn@hudcentrum.se