Images in Dermatology
Perifollicular Radial Lines and Medusa Head-Like Structures: Signs Suggesting Lentigo Maligna
Imágenes perifoliculares radiales y en cabeza de medusa como signo de sospecha de lentigo maligno
R. Gamo Villegas
, M.U. Floristán Muruzábal, A. Pampín Franco
Corresponding author
Fundación Hospital Alcorcón, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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A mayor aumento se observa mejor la infiltración granulomatosa de las glándulas ecrinas (hematoxilina/eosina X100), b). Histopatología de las lesiones del muslo con infiltración de glándulas ecrinas por granulomas sarcoideos (hematoxilina/eosina X100), c). Histopatología de las lesiones ictiosiformes pretibiales mostrando hiperqueratosis ortoqueratósica y granulomas sarcoideos dérmicos (hematoxilina/eosina X100), d). e) Tinción inmunohistoquímica para CD136 que muestra una elevada densidad de células CD163 positivas en el área intersticial que rodea los granulomas epitelioides (CD136X100).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Marcoval, C. Moreno-Vílchez, J. Molinero Caturla, R.M. Penín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Marcoval" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Moreno-Vílchez" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Molinero Caturla" ] 3 => array:2 [ "nombre" => "R.M." 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Pampín Franco" "autores" => array:3 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Gamo Villegas" "email" => array:2 [ 0 => "reyesgamo2000@yahoo.es" 1 => "reyesgamo@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M.U." "apellidos" => "Floristán Muruzábal" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Pampín Franco" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Fundación Hospital Alcorcón, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Imágenes perifoliculares radiales y en cabeza de medusa como signo de sospecha de lentigo maligno" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 568 "Ancho" => 752 "Tamanyo" => 89458 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In dermoscopsy, perifollicular radial lines are seen as pigmented lines arranged radially around a follicle. Under confocal microscopy, they are correlated with atypical junctional thickening arranged around a follicle and are known as medusa head-like structures. They are characteristic of facial and extrafacial lentigo maligna.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a 44-year-old woman who came to the clinic with repigmentation of a lesion on the left cheek that had been treated with laser 2 years previously. We observed a macular lesion measuring 2<span class="elsevierStyleHsp" style=""></span>cm with poorly defined borders. Dermoscopy revealed asymmetrical follicular pigmentation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, red arrow), brown dots (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, yellow arrows), and perifollicular radial structures (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, red rectangles).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Confocal microscopy revealed abundant perifollicular dendritic cells in the epidermis and atypical junctional thickening arranged around the follicle at the dermal–epidermal junction (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, yellow rectangles).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Lentiginous melanoma associated with chronic sun damage may present perifollicular radial lines and blurring of the reticle in dermoscopy as an incipient sign of melanoma (especially when not located on the face).</p><p id="par0025" class="elsevierStylePara elsevierViewall">Perifollicular radial lines in dermoscopy and medusa head-like structures in confocal microscopy play an essential role in the diagnosis of this type of melanoma.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 568 "Ancho" => 752 "Tamanyo" => 89458 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011400000008/v2_202310161122/S0001731023005355/v2_202310161122/en/main.assets" "Apartado" => array:4 [ "identificador" => "41021" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes en Dermatología" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000008/v2_202310161122/S0001731023005355/v2_202310161122/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023005355?idApp=UINPBA000044" ]
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