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DERMATOSCOPIA PRÁCTICA
Claves dermatoscópicas en lentigo maligno extrafacial
Dermoscopic Features of Extrafacial Lentigo Maligna
C. Sarró-Fuente
Corresponding author
claudia.sarro@salud.madrid.org

Autor para correspondencia.
, R. Gamo-Villegas, U. Floristán-Muruzábal
Servicio de Dermatología del Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Un var&#243;n de 77 a&#241;os fue evaluado en la consulta de dermatolog&#237;a y&#44; en la exploraci&#243;n&#44; se observ&#243; una mancha marr&#243;n claro de 1&#44;5 cm con una pigmentaci&#243;n exc&#233;ntrica localizada en la regi&#243;n pectoral derecha &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Diagn&#243;stico</span><p id="par0010" class="elsevierStylePara elsevierViewall">La exploraci&#243;n dermatosc&#243;pica mostr&#243; la presencia de &#225;reas borradas con l&#237;neas blancas y una vascularizaci&#243;n at&#237;pica en el centro y un ret&#237;culo fino t&#237;pico en periferia &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Comentario</span><p id="par0015" class="elsevierStylePara elsevierViewall">Se evalu&#243; la lesi&#243;n con microscop&#237;a confocal en la que se evidenci&#243; una epidermis con abundantes c&#233;lulas dendr&#237;ticas y numerosos engrosamientos junturales en la uni&#243;n dermoepid&#233;rmica &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; La lesi&#243;n se extirp&#243; y el diagn&#243;stico histol&#243;gico fue de un lentigo maligno extrafacial &#40;LME&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Los LME son melanomas de patr&#243;n lentiginoso asociados a da&#241;o solar cr&#243;nico<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a>&#46; Su incidencia est&#225; aumentando en Espa&#241;a debido&#44; entre otras cosas&#44; a la gran esperanza de vida y a la mejor identificaci&#243;n cl&#237;nica de estas lesiones y de sus caracter&#237;sticas dermatosc&#243;picas<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#8211;4</span></a>&#46; Se ha descrito en la literatura un modelo de progresi&#243;n cl&#237;nica y su representaci&#243;n dermatosc&#243;pica &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41; basado en los hallazgos encontrados por microscop&#237;a confocal en este tipo de lesiones<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;5</span></a>&#46; En primer lugar aparecen zonas con disrupci&#243;n del ret&#237;culo&#46; Posteriormente aparecen &#225;reas borradas&#44; alrededor de las cuales se pueden observar puntos de pigmento y estructuras triangulares&#44; que van progresando a l&#237;neas anguladas y en zigzag&#46; Por &#250;ltimo&#44; y m&#225;s propio de las lesiones m&#225;s evolucionadas&#44; aparecen grandes &#225;reas borradas con una vascularizaci&#243;n at&#237;pica&#46; En estas lesiones suelen persistir restos de un ret&#237;culo fino en la periferia que da la pista acerca del car&#225;cter melanoc&#237;tico de la lesi&#243;n<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a>&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Por tanto&#44; es en los estadios m&#225;s precoces &#40;cuando solo hay disrupci&#243;n del ret&#237;culo&#41; y en los estadios finales &#40;cuando apenas quedan estructuras&#41; cuando resulta m&#225;s dif&#237;cil realizar un diagn&#243;stico&#46; En este &#250;ltimo escenario la identificaci&#243;n de las lesiones es de vital importancia&#44; por lo que recomendamos prestar especial atenci&#243;n a la vascularizaci&#243;n at&#237;pica y a las l&#237;neas blancas&#44; as&#237; como a los restos de ret&#237;culo en periferia que suelen presentar estas lesiones&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Financiaci&#243;n</span><p id="par0030" class="elsevierStylePara elsevierViewall">Art&#237;culo no financiado&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicto de intereses</span><p id="par0035" class="elsevierStylePara elsevierViewall">Los autores declaran no tener conflicto de inter&#233;s&#46;</p></span></span>"
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Article information
ISSN: 00017310
Original language: Spanish
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