Dermoscopy of Acral Melanoma: A Multicenter Study on Behalf of the International Dermoscopy Society

Abstract

Background: Most studies on dermoscopy of acral lesions were conducted in Asian populations. In this study, we analyzed these features in a predominantly Caucasian population. Objective: Estimate the prevalence of dermoscopic features in acral lesions, and assess their level of agreement between observers. Methods: In this retrospective multicenter study, 167 acral lesions (66 melanomas) were evaluated for 13 dermoscopic patterns by 26 physicians, via a secured Internet platform. Results: Parallel furrow pattern, bizarre pattern, and diffuse pigmentation with variable shades of brown had the highest prevalence. The agreement for lesion patterns between physicians was variable. Agreement was dependent on the level of diagnostic difficulty. Conclusion: Lesions with a diameter >1 cm were more likely to be melanoma. We found as well that a benign pattern can be seen in parts of melanomas. For this reason one should evaluate an acral lesion for the presence of malignant patterns first.

The BRAAFF checklist: a new dermoscopic algorithm for diagnosing acral melanoma

“…Similarly, a fibrillar pattern was associated with a threefold probability of a naevus, but they were also present in 7·6% of AMs. In line with our findings, the observation that ‘benign’ criteria might be focally present in AM has been highlighted recently by a collaborative study of the International Dermoscopy Society, which included mainly invasive AMs …”

“…In line with our findings, the observation that 'benign' criteria might be focally present in AM has been highlighted recently by a collaborative study of the International Dermoscopy Society, which included mainly invasive AMs. 34 Irregular diffuse pigmentation (IDP, also called blotches) has also been described as a common dermoscopic criterion of AM, and it has been suggested to typify mainly invasive tumours. 9,15,17,27 Phan et al found IDP to represent the most common AM pattern in a series of AMs in Europe, 27 whereas in a recent multicentre study the frequency of IDP was significantly lower.…”

Educational and practice gaps in the management of volar melanocytic lesions

“…Multiple studies have found a positive correlation between size and malignancy in melanocytic lesions with non-benign volar dermoscopic patterns. 10, 12, 22 The 7-mm cutoff should be used when deciding to biopsy indeterminate lesions. Previous reports have demonstrated that parallel ridge, multi-component, and irregular diffuse pigmentation are all malignant patterns on the volar surface.…”

“…1 The benign and malignant patterns of AMN and AM have been defined in a series of retrospective studies. [2][3][4][5][6][7][8][9][10][11] Several clinically useful patterns have been described, including benign, malignant and indeterminate patterns. Benign patterns include parallel furrow, lattice-like and regular fibrillar.…”

Comparison of dermatoscopic images of acral lentiginous melanoma and acral melanocytic nevus occurring on body weight-bearing areas

“…FP is regarded as a benign pattern [8]. However, ALM on the body weight-loading area of the sole also shows fibrillar area at least partly and often shows irregular FP.…”