Negative pigment network: an additional dermoscopic feature for the diagnosis of melanoma

Pizzichetta, Maria A., Talamini, Renato, Marghoob, Ash A., Soyer, H. Peter, Argenziano, Giuseppe, Bono, Riccardo, Corradin, M. Teresa, De Giorgi, Vincenzo, Gonzalez, Marian A., Kolm, Isabel, Kopf, Andrew W., Malvehy, Joseph, Nami, Niccolo, Oliviero, Margaret, Pellacani, Giovanni, Puig, Susana, Rabinovitz, Harold, Rubegni, Pietro, Seidenari, Stefania, Stanganelli, Ignazio, Veronesi, Andrea, Zalaudek, Iris, Zampieri, Pierfrancesco and Menzies, Scott W. (2013) Negative pigment network: an additional dermoscopic feature for the diagnosis of melanoma. Journal of the American Academy of Dermatology, 68 4: 552-559. doi:10.1016/j.jaad.2012.08.012

Author Pizzichetta, Maria A.
Talamini, Renato
Marghoob, Ash A.
Soyer, H. Peter
Argenziano, Giuseppe
Bono, Riccardo
Corradin, M. Teresa
De Giorgi, Vincenzo
Gonzalez, Marian A.
Kolm, Isabel
Kopf, Andrew W.
Malvehy, Joseph
Nami, Niccolo
Oliviero, Margaret
Pellacani, Giovanni
Puig, Susana
Rabinovitz, Harold
Rubegni, Pietro
Seidenari, Stefania
Stanganelli, Ignazio
Veronesi, Andrea
Zalaudek, Iris
Zampieri, Pierfrancesco
Menzies, Scott W.
Title Negative pigment network: an additional dermoscopic feature for the diagnosis of melanoma
Journal name Journal of the American Academy of Dermatology   Check publisher's open access policy
ISSN 0190-9622
Publication date 2013
Year available 2012
Sub-type Article (original research)
DOI 10.1016/j.jaad.2012.08.012
Volume 68
Issue 4
Start page 552
End page 559
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Mosby
Collection year 2014
Language eng
Formatted abstract
Background: The negative pigment network (NPN) is seen as a negative of the pigmented network and it is purported to be a melanoma-specific structure.

Objectives: We sought to assess the frequency, sensitivity, specificity, and odds ratios (ORs) of NPN between melanoma cases and a group of control lesions.

Methods: Digitalized images of skin lesions from 679 patients with histopathological diagnosis of dermatofibroma (115), melanocytic nevus (220), Spitz nevus (139), and melanoma (205) were retrospectively collected and blindly evaluated to assess the presence/absence of NPN.

Results: The frequency of occurrence of NPN was higher in the melanoma group (34.6%) than in Spitz nevus (28.8%), melanocytic nevus (18.2%), and dermatofibroma (11.3%) groups. An OR of 1.8 emerged for the diagnosis of melanoma in the presence of NPN as compared with nonmelanoma diagnosis. Conversely, for melanocytic nevi and dermatofibromas the OR was very low (0.5 and 0.3, respectively). For Spitz nevi the OR of 1.1 was not statistically significant. When comparing melanoma with dermatofibroma, melanocytic nevus, and Spitz nevus, we observed a significantly higher frequency of multicomponent pattern (68.1%), asymmetric pigmentation (92.9%), irregularly distributed NPN (87.3%), and peripheral location of NPN (66.2%) in melanomas.

Limitations: Further studies can provide the precise dermoscopic-histopathologic correlation of NPN in melanoma and other lesions.

Conclusions: The overall morphologic pattern of NPN, such as the irregular distribution and the peripheral location of NPN, along with the multicomponent pattern and the asymmetric pigmentation could be used as additional features in distinguishing melanoma from Spitz nevus and other benign lesions.
Keyword Dermoscopy
Melanocytic nevus
Negative pigment network
Spitz nevus
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 11 October 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 15 times in Scopus Article | Citations
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Created: Sun, 14 Apr 2013, 11:10:24 EST by Nicole Lin on behalf of Medicine - Princess Alexandra Hospital