Hintergrund Und Ziele: Hautläsionen mit blauer Färbung werden häufig chirurgisch entfernt, um Malignität auszuschließen zu können. Das Ziel der vorliegenden Studie war es, die Bedeutung der blauen Färbung zu untersuchen.
Methoden: Wir untersuchten dermatoskopische Bilder retrospektiv auf blaue Farbe und klassifizierten sie gemäß der Musteranalyse.
Ergebnisse: Von 1.123 pigmentierten Hautläsionen wiesen 144 (12,8 %) eine blaue Färbung auf. Von diesen waren 92 (63,9 %) bösartig. Unter den Läsionen mit Blaufärbung waren Nävi (n = 35, 24,3 %) und seborrhoische Keratosen (n = 8, 5,6 %) die häufigsten gutartigen Diagnosen. Von 103 (71,5 %) Läsionen mit einem strukturlosen blauen Muster waren acht (7,8 %) vollständig blau gefärbt und 95 (92,2 %) teilweise blau, davon zeigten 81 (78,6 %) periphere oder fleckige und 14 (13.6 %) eine zentrale Blaufärbung. Die meisten Läsionen mit peripherer oder fleckiger blauer Färbung waren Melanome (n = 47, 58 %), wohingegen die meisten Läsionen mit zentraler Blaufärbung Nävi darstellten (n = 9, 64,3 %). Von 28 Läsionen mit blauen Schollen waren 17 (60,7 %) Basalzellkarzinome. Bezüglich der Malignität war der positive prädiktive Wert der blauen Farbe 63,9 % (95 % KI: 56,0-71,8 %).
Schlussfolgerungen: Unter blaugefärbten bösartigen Läsionen ist eine strukturlose periphere oder fleckige blaue Farbe ein Hinweis auf Melanome, während blaue Schollen auf ein Basalzellkarzinom hinweisen. Als Fallstricke können sich seborrhoische Keratosen erweisen, die eine Blaufärbung zeigen können, sowie einige Nävi, vor allem kombinierte.
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