Dermoscopic clues in the diagnosis of amelanotic and hypomelanotic malignant melanoma

Steglich, Raquel Bissacotti; Meotti, Carolina Degeon; Ferreira, Mariana Silveira; Lovatto, Louise; Carvalho, André Vicente Esteves de; Castro, Carlos Gustavo Carneiro de

doi:10.1590/s0365-05962012000600019

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…In total, 62 articles were included in this systematic review, reporting on 433 melanoma cases. Of these articles, 30 reported on amelanotic melanoma (275 cases), 6 on animal-type or pigmented epithelioid melanocytoma (PEM) (7 cases), 4 on balloon cell melanoma (5 cases), 4 on desmoplastic melanoma (66 cases), 1 on follicular melanoma (1 case), 4 on nested melanoma (6 cases), 5 on nevoid melanoma (31 cases), 1 on primary dermal melanoma (1 case), 3 on spitzoid melanoma (28 cases), and 4 on verrucous melanoma (4 cases) . One study reported both amelanotic and spitzoid melanoma cases .…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the superficial spreading melanoma (SSM) variant, only a few cases appear to be completely amelanotic on clinical and dermoscopic examination. By systematically searching the literature, we identified 30 studies reporting the clinical and dermoscopic features of 275 amelanotic SSMs . We found 8 additional amelanotic cases from our database, for a total of 283 SSMs.…”

Section: Resultsmentioning

confidence: 99%

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Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

et al. 2020

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The clinical and dermoscopic features of the vast majority of uncommon variants of cutaneous melanoma have been rarely reported, leading to difficulty in making accurate diagnoses.OBJECTIVE To define the main clinical and dermoscopic features of the most frequently reported but uncommon histologic variants of cutaneous melanoma.EVIDENCE REVIEW A 2-step systematic review of the literature was performed (from inception to November 2018) using PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. The first step identified those uncommon variants of melanoma for which at least 1 case reporting dermoscopy was described in the literature. The keywords searched were melanoma, uncommon, rare, dermoscopy, and dermatoscopy. In the second step, each previously identified uncommon variant was searched for in the same databases by combining the following terms with melanoma, dermoscopy, and dermatoscopy: amelanotic, hypopigmented, animal, melanocytoma, balloon, desmoplastic, follicular, nested, nevoid, dermal, spitz*, spindle, and verrucous. The institution's database was also searched from January 2012 to September 2019 for histopathologically confirmed cases of the same melanoma variants. Each reviewer also assessed the quality of reporting in the included articles based on previously described guidelines.FINDINGS In total, 62 articles met the inclusion criteria, reporting 433 melanoma cases. An additional 56 cases of uncommon melanoma variants were retrieved from the institution's database for a total of 489 cases: 283 cases of amelanotic superficial spreading melanoma, 18 cases of animal-type and pigmented epithelioid melanocytoma, 7 cases of balloon cell melanoma, 71 cases of desmoplastic melanoma, 3 cases of follicular melanoma, 10 cases of nested melanoma, 33 cases of nevoid melanoma, 2 cases of primary dermal melanoma, 57 cases of spitzoid melanoma, and 5 cases of verrucous melanoma. These variants of melanoma occurred more frequently in women than men (147 cases vs 132 cases). Clinically, these tumors were mainly palpable (162 of 217 [74.7%]) or amelanotic (283 of 489 [57.9%]) lesions that could resemble other benign or malignant skin conditions; dermoscopy typically revealed a homogeneous pinkish background, white structures, and polymorphic vessels. The mean age of all included was 58 years (range, 1-89 years).CONCLUSIONS AND RELEVANCE Uncommon melanoma variants may resemble both inflammatory disorders and other cutaneous neoplasms, representing a diagnostic pitfall even for the most experienced dermatologist. The purpose of this systematic review was to provide an extensive and detailed overview of specific clinical and dermoscopic features of each uncommon melanoma variant, highlighting the main criteria for differentiating these variants from other benign or malignant skin lesions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

et al. 2020

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“…Steglich et al stated that melanoma initially shows dotted vessels and that with greater thickness, vascular polymorphism increases, with hairpin and linear-irregular vessels associated with milky-red areas. Dotted vessels may be the only clue to suspect non-pigmented melanoma [ 36 ]. Similar to thin amelanotic melanomas on non-glabrous skin showing only dotted vessels under dermoscopy, VPRP may be an important alerting sign for early diagnosis of ALM.…”

Section: Discussionmentioning

confidence: 99%

Acral lentiginous melanoma in the Turkish population and a new dermoscopic clue for the diagnosis

Özdemir

Errico

Yaman

et al. 2018

Dermatol Pract Concept

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BackgroundThe incidence of acral lentiginous melanoma (ALM) in the white population is low. Dermoscopy enhances diagnosis of ALM; however, diagnostic accuracy may sometimes be poor due to the considerable proportion of amelanotic ALM variants.ObjectivesTo calculate the proportion of ALM among all melanoma subtypes and to determine the frequency of dermoscopic features of ALM in the Turkish population.MethodsOut of 612 melanomas, there were 70 cases of ALM, of which 46 showed sufficient image quality for retrospective study of dermoscopic features. Data from patients and their lesions was classified according to clinical features and histopathologic parameters. The dermoscopic variables evaluated were based on pertinent literature on dermoscopy of acral melanocytic neoplasms.ResultsThe prevalence of ALM among all melanoma subtypes was 11.4%. Parallel-ridge pattern (PRP) was detected in 60.8% of cases and irregular diffuse pigmentation (IDP) in 28.3%. The ALMs were amelanotic in 24%, showing an atypical vascular pattern in all cases; a new dermoscopic pattern, named “vascularized parallel-ridge pattern” (VPRP), was detected in 13% of ALMs. Irregular lines were observed in 81.8% of subungual melanomas and were often associated with a multicolored background.ConclusionsALM has site-specific dermoscopic patterns, with PRP being the most prevalent pattern. The newly described VPRP pattern may be an additional clue for ALM diagnosis, especially in thin amelanotic melanomas.

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“…The melanoma reported here was a hypopigmented superficial spreading melanoma (SSM) with a dominant nodule, which was notable because of its dominant structureless yellow color. In one series of four cases of AHM with dermatoscopic images, all cases had significant pink or red color and none had any yellow color [ 4 ]. Although this lesion fulfilled the definition of AHM, according to revised pattern analysis (RPA), the presence of any pigment should lead to a diagnostic analysis based on pigmented structures [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Non-choroidal yellow melanoma showing positive staining with Sudan Black consistent with the presence of lipofuscin: a case report

Penouil

Gourhant²,

Segretin³

et al. 2014

Dermatol Pract Concept

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A case of a predominantly yellow primary superficial spreading melanoma arising on the back of a 44-year-old woman is presented. Possible causes of the clinical and dermatoscopic yellow color are discussed. Staining with the histochemical stain, Sudan Black, revealed a differential uptake compared to a closely matched control melanoma. We speculate that the clinical and dermatoscopic yellow color could be due to the presence of increased amounts of the pigment lipofuscin, which is known to produce subtle orange color in some choroidal melanomas.

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Dermoscopic clues in the diagnosis of amelanotic and hypomelanotic malignant melanoma

Cited by 9 publications

References 8 publications

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

Acral lentiginous melanoma in the Turkish population and a new dermoscopic clue for the diagnosis

Non-choroidal yellow melanoma showing positive staining with Sudan Black consistent with the presence of lipofuscin: a case report

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