Faculty Collaboration Database

The diagnostic value and histologic correlate of distinct patterns of shiny white streaks for the diagnosis of melanoma: A retrospective, case-control study. J Am Acad Dermatol 2018 May;78(5):913-919

Date

11/16/2017

Pubmed ID

29138058

Pubmed Central ID

PMC7480004

DOI

10.1016/j.jaad.2017.11.021

Scopus ID

2-s2.0-85042865582 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

BACKGROUND: Shiny white streaks (SWSs) are best visualized with polarized dermoscopy and correlate with dermal fibroplasia histopathologically. SWSs have been described at higher frequencies in melanomas than in benign nevi.

OBJECTIVE: We assessed the diagnostic value of different patterns of SWSs and their histologic correlate in melanocytic lesions.

METHODS: Polarized dermoscopic images of 1507 histopathologically diagnosed melanocytic neoplasms were analyzed for presence and pattern of SWSs. Histology was also reviewed for correlation.

RESULTS: Among 1507 melanocytic neoplasms, SWSs were observed in 31 of 144 melanomas (22%) and 22 of 1363 benign neoplasms (1.6%) (P < .001). The sensitivity and specificity of SWSs for melanoma were 22% and 98%, respectively. Diffuse SWSs exhibited the greatest diagnostic value for melanoma, with sensitivity of 11.8% and specificity of 99.5%. Focal central and peripheral SWSs were comparable in diagnostic significance. The presence of SWSs was highly uncommon in dysplastic nevi, whereas in certain benign subgroups of nevi such as Spitz nevi and atypical genital special site nevi, SWSs were not uncommon. Diffuse SWSs correlated with greater breadth of deep fibroplasia than focal SWSs (P = .009), and SWSs correlated with greater Breslow depth among melanomas (P = .007).

LIMITATIONS: This study was retrospective.

CONCLUSION: Polarized dermoscopy is a valuable diagnostic tool in the identification of SWSs, a feature that is highly specific for melanoma.

Author List

Verzi AE, Quan VL, Walton KE, Martini MC, Marghoob AA, Garfield EM, Kong BY, Isales MC, VandenBoom T, Zhang B, West DP, Gerami P

Author

Kara E. Young MD Associate Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Biopsy, Needle
Case-Control Studies
Dermoscopy
Diagnosis, Differential
Dysplastic Nevus Syndrome
Female
Humans
Immunohistochemistry
Male
Melanocytes
Melanoma
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Nevus, Epithelioid and Spindle Cell
Nevus, Pigmented
Retrospective Studies
Skin Neoplasms