title: Microscopic in vivo description of cellular architecture of dermoscopic pigment network in nevi and melanomas.
abstract: OBJECTIVE
  To characterize the microscopic aspects of the dermoscopic pigment network in vivo, by means of confocal scanning laser microscopy.
  
  
  METHODS
  Confocal imaging was performed on melanocytic lesions characterized by pigment network at dermoscopy. Some confocal architectural and cytologic features, as observed at the dermoepidermal junction, were morphologically described and quantified by means of a dedicated program.
  
  
  METHODS
  University medical department.
  
  
  METHODS
  We studied confocal images of 15 melanomas, 15 dermoscopic atypical nevi, and 15 common nevi.
  
  
  METHODS
  Features referring to aspect, size, regularity, homogeneity, and infiltration of dermal papillae and to cellular size, regularity, and atypia were described by 2 observers on confocal images. Mean dermal papillary diameter, mean cell area, and shape irregularity were quantified by drawing papillae and cell contours on confocal images and measured with the use of a computer program.
  
  
  RESULTS
  Pigment network in melanomas consisted of large basal cells that circumscribed small to medium-sized dermal papillae with marked cellular atypia, sometimes infiltrating dermal papillae. On the other hand, common acquired nevi were characterized by lack of atypical cells and edged dermal papillae. Atypical nevi presented intermediate characteristics between clearly benign and malignant lesions.
  
  
  CONCLUSIONS
  Cellular atypia was the most sensitive feature for melanoma diagnosis, whereas the presence of nucleated cells infiltrating dermal papillae was the most specific one.
authors.affiliation: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. pellacani.giovanni@unimo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellacani
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Cesinaro
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
authors.forename: Costantino
authors.initials: C
authors.lastname: Grana
authors.forename: Stefania
authors.initials: S
authors.lastname: Seidenari
mesh_terms: D001707:Biopsy, Needle; D015331:Cohort Studies; D046169:Dermoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008544:Melanocytes / Q000473:pathology / Q000648:ultrastructure; D008545:Melanoma / Q000175:diagnosis / Q000473:pathology* / Q000648:ultrastructure; D018613:Microscopy, Confocal; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000473:pathology* / Q000648:ultrastructure; D011336:Probability; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000648:ultrastructure; D012880:Skin Pigmentation; D018709:Statistics, Nonparametric