Search

Malignant melanomas (MM) are characterized by hypervascularisation which may affect MM blood flow and its oscillatory dynamic. The hypothesis of this study was that the blood flow assessment at the level of skin melanocytic lesions may aid in differentiating between benign skin naevi and MM. Fifty one subjects with clinically and dermatoscopically atypical naevi and 23 subjects with clinically and dermatoscopically typical benign naevi underwent blood flow (BF) measurement at the level of the lesion of interest (central and margin lesion site) and at the level of a clinically healthy skin site, contra lateral to the lesion of interest, using a single point laser-Doppler fluxmetry (LDF). After LDF, atypical naevi were excised and underwent histological examination and immuno-histo-chemistry microvessel count. At the histological examination, MM was demonstrated in 9 lesions, atypical benign naevus in 31 lesions and typical benign naevus in 11 lesions. No significant difference in BF was found between clinically benign naevi, histologically benign naevi and histologically atypical naevi (Wilcoxon test), which were then included in a single control group (CG) of 65 naevi. Compared to CG naevi, MM showed a significantly higher BF (at the level of both central and margin lesion site) and a significantly higher ratio in BF between lesion margin site and contra lateral skin site (LMS/CLS ratio), as well as between central lesion site and contra lateral skin site (Wilcoxon test). A LMS/CLS ratio > 1 was observed in 100% of MM and in 60% of CG naevi, with a sensitivity of 100 (95% C.I.: 65.5- 100), a specificity of 40 (95% C.I.: 28.8-52.9) and a ROC area of 0.70 (95% C.I.: 0.64 - 0.76). The results of this study show that MM have a significantly greater BF compared to benign naevi (both typical and atypical) and suggest that a > 1 LMS/CLS BF ratio could be a suitable cut-off for selecting naevi to be examined by histology in order to exclude MM. This last result should be confirmed in a larger group of MM patients. [ABSTRACT FROM AUTHOR]