Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr;68(4):552-559.
doi: 10.1016/j.jaad.2012.08.012. Epub 2012 Oct 9.

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

Maria A Pizzichetta  1 , Renato Talamini  2 , Ash A Marghoob  3 , H Peter Soyer  4 , Giuseppe Argenziano  5 , Riccardo Bono  6 , M Teresa Corradin  7 , Vincenzo De Giorgi  8 , Marian A Gonzalez  9 , Isabel Kolm  10 , Andrew W Kopf  11 , Joseph Malvehy  12 , Niccolò Nami  13 , Margaret Oliviero  10 , Giovanni Pellacani  14 , Susana Puig  12 , Harold Rabinovitz  10 , Pietro Rubegni  13 , Stefania Seidenari  14 , Ignazio Stanganelli  15 , Andrea Veronesi  2 , Iris Zalaudek  16 , Pierfrancesco Zampieri  9 , Scott W Menzies  17
Affiliations

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

Maria A Pizzichetta et al. J Am Acad Dermatol. 2013 Apr.

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.

PubMed Disclaimer