Dermoscopic Vascular Patterns in Nodular “Pure” Amelanotic Melanoma

Cavicchini, S.; Tourlaki, Athanasia; Bottini, Silvia

doi:10.1001/archderm.143.4.556

Cited by 26 publications

(30 citation statements)

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“…These patterns were usually combined with additional (one to two) vascular features. These findings reinforce the impression that MCC should be considered as a dermoscopic differential diagnosis of amelanotic presentations of melanoma including desmoplastic melanoma [10,11,12,13,14,15,16,17,18,19]. …”

Section: Discussionsupporting

confidence: 78%

Dermoscopy of Merkel Cell Carcinoma

et al. 2012

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Introduction: Merkel cell carcinoma (MCC) is an aggressive cutaneous tumor whose clinical presentation, usually a pink nodule, is not specific. We aimed in this study to determine the dermoscopic criteria encountered in MCC. Methods: From our image database we selected the patients diagnosed with MCC and scored the dermoscopic criteria shown by these tumors. Results: Ten patients coming from three different academic hospitals were studied. Vascular structures were the more relevant dermoscopic features. In 8 out of 10 (80%) patients a polymorphic vascular pattern was seen, composed of milky-red clods/areas in association with one or more additional vascular structures. Conclusion: Although an overlap existed between the dermoscopic features observed in MCC and amelanotic melanoma, the presence of a polymorphous vascular pattern may constitute an additional clinical clue to accurately diagnose this rare tumor.

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Section: Discussionsupporting

confidence: 78%

Dermoscopy of Merkel Cell Carcinoma

et al. 2012

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“…2 Unlike the extensive literature on the dermoscopy of melanoma in general, there is a relative paucity of dermoscopy literature on the subtype NM, [4][5][6] with many observations grouped with those of other invasive melanomas 7 or small case series. 8,9 In this study, we documented the dermoscopy features of a large series of NM; we describe that here and validate criteria used for their dermoscopic diagnosis.…”

Section: N O D U L a R M E L A N O M Amentioning

confidence: 88%

Dermoscopic Evaluation of Nodular Melanoma

Menzies¹,

Moloney²,

Byth³

et al. 2013

JAMA Dermatol

106

104

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Importance: Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical.Objective: To determine the dermoscopy features of NM.Design: Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/ hypomelanotic or pigmented to assess outcomes.Setting: Predominantly hospital-based clinics from 5 continents.Main Outcome Measures: Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma.Results: Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, bluewhite veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (Ͼ98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM.Conclusions and Relevance: When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.

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“…Vascular patterns (linear irregular vessels or the combination of dotted and linear irregular vessels) were the only dermoscopic criteria reliably seen in the ‘truly’ amelanotic melanomas and were felt to be useful in distinguishing amelanotic/hypomelanotic melanoma permitting a correct diagnosis in 4 of 10 cases. The presence of vascular patterns with a peripheral pigment network has been identified as being of diagnostic importance for melanoma [32,33,34,35,36,37,38], and in pure amelanotic melanomas milky red globules and/or areas with irregular linear vessels may be useful [38]. Validation of these dermoscopic criteria in amelanotic melanoma is pending, given the rarity of these lesions and the lack of large-scale prospective studies.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study

Langley

Walsh²,

Sutherland³

et al. 2007

Dermatology

111

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Background: The diagnosis of melanoma at an early, curable stage is an important challenge for clinicians. Confocal scanning laser microscopy (CSLM) is a high-resolution, noninvasive technology that may facilitate improved diagnostic accuracy over clinical examination. The aim of this study was to evaluate the diagnostic accuracy of CSLM compared to dermoscopy in a prospective examination of benign and malignant melanocytic lesions. Methods: 125 patients with suspicious pigmented lesions were prospectively recruited to undergo a clinical, dermoscopic and CSLM examination. A diagnosis was made preoperatively with each technique, and the lesion was then excised and diagnosed using histopathology. Results: 125 patients with 125 lesions were studied comprising 88 melanocytic nevi and 37 melanomas. Dermoscopy had a sensitivity of 89.2%, a specificity of 84.1%, a positive predictive value of 70.2% and a negative predictive value of 94.9%. CSLM was found to have a sensitivity of 97.3%, a specificity of 83.0%, a positive predictive value of 70.6% and a negative predictive value of 98.6%. No melanomas were misidentified when both techniques were used together. Conclusions: CSLM had a relatively higher sensitivity than dermoscopy; however, the specificity was similar with CSLM and dermoscopy. These results suggest that dermoscopy and CSLM are complementary.

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Dermoscopic Vascular Patterns in Nodular “Pure” Amelanotic Melanoma

Cited by 26 publications

References 0 publications

Dermoscopy of Merkel Cell Carcinoma

Dermoscopy of Merkel Cell Carcinoma

Dermoscopic Evaluation of Nodular Melanoma

The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study

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