The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions

Yevgeniy Balagula, Ralph P. Braun, Harold S. Rabinovitz, Stephen W. Dusza, Alon Scope, Tracey N. Liebman, Ines Mordente, Katherine Siamas, Ashfaq A. Marghoob

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy. Objectives: We sought to estimate the prevalence and assess the clinical significance of CS in melanocytic and nonmelanocytic lesions. Methods: This was a prospective observational study in which dermatoscopic assessment of lesions was recorded in consecutive patients examined during a 6-month period. In addition, a data set of biopsy-proven melanomas was retrospectively analyzed. Results: In all, 11,225 lesions in 881 patients were prospectively examined. Retrospectively, 229 melanomas imaged with polarized dermatoscopy were analyzed. In the prospective data set, a median of 12.7 lesions (range, 1-54) were evaluated per patient. None of clinically diagnosed Clark nevi (n = 9750, 86.8%) demonstrated CS. Overall, CS were observed in 206 (1.8%) lesions, most commonly dermatofibromas and scars among nonbiopsied lesions. A total of 265 (2.4%) lesions were biopsied, including 20 melanomas and 36 nevi. Among biopsied malignant lesions, CS were most commonly observed in basal cell carcinoma (47.6%) and invasive melanomas (84.6%). Melanomas were more likely to have CS than biopsied nevi (odds ratio = 9.7, 95% confidence interval 2.7-34.1). In the retrospective data set, CS were more commonly observed among invasive melanomas (41%) compared with in situ melanomas (17%) (odds ratio = 3.4, 95% confidence interval 1.9-6.3, P

Original languageEnglish (US)
JournalJournal of the American Academy of Dermatology
Volume67
Issue number2
DOIs
StatePublished - Aug 2012
Externally publishedYes

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Melanoma
Dermoscopy
Nevus
Odds Ratio
Confidence Intervals
Nevi and Melanomas
Benign Fibrous Histiocytoma
Basal Cell Carcinoma
Cicatrix
Observational Studies
Prospective Studies
Biopsy
Datasets

Keywords

  • basal cell carcinoma
  • crystalline/chrysalis structures
  • dermatofibroma
  • invasive melanoma
  • matrix remodeling
  • polarized dermatoscopy

ASJC Scopus subject areas

  • Dermatology

Cite this

The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions. / Balagula, Yevgeniy; Braun, Ralph P.; Rabinovitz, Harold S.; Dusza, Stephen W.; Scope, Alon; Liebman, Tracey N.; Mordente, Ines; Siamas, Katherine; Marghoob, Ashfaq A.

In: Journal of the American Academy of Dermatology, Vol. 67, No. 2, 08.2012.

Research output: Contribution to journalArticle

Balagula, Yevgeniy ; Braun, Ralph P. ; Rabinovitz, Harold S. ; Dusza, Stephen W. ; Scope, Alon ; Liebman, Tracey N. ; Mordente, Ines ; Siamas, Katherine ; Marghoob, Ashfaq A. / The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions. In: Journal of the American Academy of Dermatology. 2012 ; Vol. 67, No. 2.
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abstract = "Background: Crystalline/chrysalis structures (CS) are white shiny streaks that can only be seen with polarized dermatoscopy. Objectives: We sought to estimate the prevalence and assess the clinical significance of CS in melanocytic and nonmelanocytic lesions. Methods: This was a prospective observational study in which dermatoscopic assessment of lesions was recorded in consecutive patients examined during a 6-month period. In addition, a data set of biopsy-proven melanomas was retrospectively analyzed. Results: In all, 11,225 lesions in 881 patients were prospectively examined. Retrospectively, 229 melanomas imaged with polarized dermatoscopy were analyzed. In the prospective data set, a median of 12.7 lesions (range, 1-54) were evaluated per patient. None of clinically diagnosed Clark nevi (n = 9750, 86.8{\%}) demonstrated CS. Overall, CS were observed in 206 (1.8{\%}) lesions, most commonly dermatofibromas and scars among nonbiopsied lesions. A total of 265 (2.4{\%}) lesions were biopsied, including 20 melanomas and 36 nevi. Among biopsied malignant lesions, CS were most commonly observed in basal cell carcinoma (47.6{\%}) and invasive melanomas (84.6{\%}). Melanomas were more likely to have CS than biopsied nevi (odds ratio = 9.7, 95{\%} confidence interval 2.7-34.1). In the retrospective data set, CS were more commonly observed among invasive melanomas (41{\%}) compared with in situ melanomas (17{\%}) (odds ratio = 3.4, 95{\%} confidence interval 1.9-6.3, P",
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AU - Scope, Alon

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AU - Siamas, Katherine

AU - Marghoob, Ashfaq A.

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