A series of small-diameter melanomas on the legs: dermoscopic clues for early recognition

Salerni, Gabriel; Alonso, Carlos; Fernández-Bussy, Ramón

doi:10.5826/dpc.0504a08

Cited by 10 publications

(24 citation statements)

References 13 publications

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“…Many of the reported cases are similar to those reported by Salerni et al . [ 28 ], who reported 8 melanomas, with an average of 3.7mm in diameter, 7 of which were in the lower limbs, without suspicious clinical criterion, found through the routine use of dermoscopy in all lesions and monitoring high risk patients with digital dermoscopy.…”

Section: Discussionmentioning

confidence: 99%

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Campos-do-Carmo¹,

Nobre

Cuzzi

et al. 2021

PLoS ONE

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Early diagnosis when melanoma is still small and thin is essential for improving mortality and morbidity. However, the diagnosis of small size melanoma might be particularly difficult, not only clinically but also dermoscopically. This study aimed to define clinical and dermatoscopic parameters in the diagnosis of suspicious pigmented cutaneous lesions with a diameter of ≤ 6mm and determine the sensitivity, specificity, positive and negative predictive values as well as the accuracy of each clinical and dermatoscopic criterion. This is a transversal, descriptive and analytical study of dermatoscopic analysis with the gold standard being the pathologic examination obtained from the excisional biopsy of suspicious melanocytic lesions with a diameter of ≤ 6mm. Trunk and limb lesion data from a public health service and a private clinic were prospectively collected from 2011 to 2017 by a unique observer. In total, 481 melanocytic lesions were included, with 73.8% being ≤ 4mm in diameter. Overall, 123 were diagnosed as melanoma, 56.0% in situ and 22.0% as thin melanomas (Breslow index 0.1 to 1.0mm). Melanoma presented symmetry in 53.7% of cases, regular borders in 54.5% and a single color in 60.2%. Regarding evolution, 13.8% of melanomas versus 10.9% of benign lesions (p = 0.116) were new by comparing photos from baseline with photos from the follow-up. The majority of melanomas (65%) were found on the limbs compared to 37.2% of the benign lesions at this location (p<0.001). A multiple logistic regression model adjusted for age, gender and location was created. The independent variables associated with the diagnosis of melanoma ≤ 6mm, adjusted for age, gender and location, were: streaks (adjusted Odds Ratio [aOR] 2.5; 95% CI 1.3–4.7; p = 0.006), and the presence of a structureless area (aOR 2.2, 95% CI 1.2–4.0, p = 0.011). Conversely, a symmetric typical pigment network was a protection variable (aOR 0.4, 95% 0.7–0.9, p = 0.040). In conclusion, dermatoscopic criteria have been identified which help to diagnose cases of small size melanoma. These include streaks and structureless areas that can be taken, particularly in consideration for the diagnosis of this subset of small difficult melanomas.

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Section: Discussionmentioning

confidence: 99%

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Campos-do-Carmo¹,

Nobre

Cuzzi

et al. 2021

PLoS ONE

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“…G. Salerni и соавт. [7] описали 8 случаев меланомы кожи диаметром от 2,5 до 4,5 мм. Клинически только две опухоли имели неровные края, а три были асимметричны и имели полихромную окраску.…”

Section: рис 7 пациент №10unclassified

“…В четырех случаях показанием для удаления послужили задокументированные изменения наблюдаемых образований. По результатам гистологического исследования, все опухоли были представлены поверхностно-распространяющейся формой меланомы, а шесть образований были in situ [7]. В зарубежной литературе [8][9][10] встречаются описания единичных случаев меланомы кожи диаметром не более 2 мм.…”

Section: рис 7 пациент №10unclassified

Experience in the diagnosis of skin melanoma smaller than 6 mm in diameter

Sergeev¹,

Mordovtseva²

2018

Klin. dermatol. venerol.

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Несмотря на новые возможности адъювантной терапии меланомы кожи, своевременная диагностика этой опухоли остается ключевым прогностическим фактором, влияющим на общую выживаемость. В статье приводится описание серии случаев меланомы кожи диаметром менее 6 мм. Клинические, дерматоскопические и гистологические проявления ранних меланом отличаются от привычных при этой злокачественной опухоли. Так, все образования лишены полихромии и окрашены только в два цвета. Такие типичные для меланомы признаки, как неправильная форма и неравномерна окраска, встречаются всего в 67 и 58% случаев соответственно. Среднее значение дерматоскопического алгоритма диагностики меланомы ABCD составило 4,2 балла, 7-балльного алгоритма Argenziano-2,2 балла. Чувствительность указанных алгоритмов составила 16 и 50% соответственно. Отличительными особенностями гистологической картины стали слабовыраженный полиморфизм ядер, отсутствие особенностей роста, характерных для наиболее часто встречающихся форм меланомы, незначительный педжетоидный рост и отсутствие/низкий митотический индекс. Ранняя диагностика рака кожи в настоящее время невозможна без комплексной оценки новообразования кожи, учитывающей клиническую картину, данные дерматоскопического осмотра и результаты гистологического исследования, а потому требует междисциплинарного подхода.

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“…Small-diameter melanocytic lesions are difficult to interpret due to the lack of classic clinical criteria (ABCDE) and/or dermoscopic features suggestive of malignancy. 1,2 Moreover, small-diameter lesions are often erroneously misdiagnosed as benign, causing a delay in the diagnosis of melanoma. 3 These lesions are not well described in the literature, and are defined in different studies as measuring less than 2 (minute melanomas) 4,5 to 6 mm in diameter and are commonly termed micromelanomas or minimelanomas.…”

Section: Introductionmentioning

confidence: 99%

“…3 These lesions are not well described in the literature, and are defined in different studies as measuring less than 2 (minute melanomas) 4,5 to 6 mm in diameter and are commonly termed micromelanomas or minimelanomas. 2,[6][7][8] It has been shown that the prevalence of melanomas measuring less than 6 mm could range from 2.2% to 22%. 1 Digital follow-up (DFU) and confocal microscopy have both been shown to be helpful in the diagnosis of early melanomas which might not meet the specific criteria for malignancy.…”

Section: Introductionmentioning

confidence: 99%

Dermoscopic, confocal and histopathologic characteristics of small‐diameter melanomas (minimelanoma): a cross sectional study

et al. 2021

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A series of small-diameter melanomas on the legs: dermoscopic clues for early recognition

Cited by 10 publications

References 13 publications

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil

Experience in the diagnosis of skin melanoma smaller than 6 mm in diameter

Dermoscopic, confocal and histopathologic characteristics of small‐diameter melanomas (minimelanoma): a cross sectional study

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