Amelanotic melanoma and pyogenic granuloma. Peculiarities of the differential diagnosis

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Abstract

INTRODUCTION: Nodular melanoma is a rapidly progressive skin tumour with a high risk of methastasis even on early stages. This fact leads to necessity of non-invasive procedures, which can verify this diagnosis before surgery. Nodular forms of amelanotic melanoma can be hardly diagnosed because of their unusual diagnostic and dermatoscopic features.

CASE REPORT: Pyogenic granuloma is the most difficult disease for differential diagnosis. It is a benign vascular formation, which mimics nodular amelanotic melanoma.

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About the authors

Azizzhon D. Zikiryachodzhaev

P.A. Hertsen Moscow Oncology Research Center, Moscow, Russian Federation

Email: ivertieva@gmail.com
ORCID iD: 0000-0001-7141-2502
Russian Federation, Moscow

E. K. Saribekyan

P.A. Hertsen Moscow Oncology Research Center, Moscow, Russian Federation

Email: ivertieva@gmail.com
ORCID iD: 0000-0002-1559-1304
Russian Federation, Moscow

E. Yu. Vertieva

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: ivertieva@gmail.com
ORCID iD: 0000-0002-1088-2911

MD, PhD

Russian Federation, Moscow

I. S. Pestin

P.A. Hertsen Moscow Oncology Research Center, Moscow, Russian Federation

Email: ivertieva@gmail.com
Russian Federation, Moscow

References

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  5. Zaballos P, Carulla M, Ozdemir F, Zalaudek I, Bañuls J, Llambrich A, et al. Dermoscopy of pyogenic granuloma: a morphological study. Br J Dermatol. 2010;163(6):1229-37. doi: 10.1111/j.1365-2133.2010.10040.x
  6. Lacarrubba F, Caltabiano R, Micali G. Dermoscopic and histological correlation of an atypical case of pyogenic granuloma. Pediatr Dermatol. 2013;30(4):499-501. doi: 10.1111/pde.12123
  7. Papageorgiou C, Ioannides D, Apalla Z. Dermoscopy of difficult-to-diagnose Melanomas. Serbian J Dermatol Venereol. 2016;8(3):121-7.
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Supplementary files

Supplementary Files
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1. Fig. 1. Patient M., 58 years old. Pyogenic granuloma. a - macroscopic picture; a node of bright red color, soft consistency, there is a hemorrhagic discharge on the surface; b - dermatoscopic picture: red homogeneous zones, weakly expressed white bridges, blue homogeneous pigmentation along the periphery.

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2. Fig. 2. Histological specimen. A tumor with an ulcerated skin surface (blue arrow), multilobular vascular structures (green arrow). Staining with hematoxylin and eosin. x 100.

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3. Fig. 3. Histological specimen. The tumor is represented by full-blooded capillaries (blue arrow). There is a pronounced mixed cell inflammation in the stroma (green arrow). Staining with hematoxylin and eosin. x 200.

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4. Fig. 4. 4. Patient L., 32 years old. Pyogenic granuloma during pregnancy, 34 weeks. a - pink knot with hemorrhagic crust on the surface; b - dermatoscopic picture: milky-red globular zones, white bridges, ulceration zone.

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5. Fig. 5. Histological specimen. Tumor with adjacent tissues. Hyperplasia of the epithelium over the tumor. Expanded full-blooded tumor capillaries. Staining with hematoxylin and eosin. x 50.

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6. Fig. 6. Patient Sh., 78 years old. Nodular non-pigmented melanoma of the skin of the left cheek. a - a knot of dense consistency with an erosive surface; b - dermatoscopy of non-pigmented melanoma: polymorphic atypical vessels.

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