Dermoscopy of Naevus-associated Melanomas

Abstract

In order to determine dermoscopic parameters, a case-control test set of naevus-associated melanomas vs de novo melanomas paired by Breslow thickness and histopathological subtype was analysed by 2 blinded experienced dermoscopists, according to presence of naevus, pattern analysis and ABCD dermoscopy score. The ability to identify naevus-associated melanomas by pattern analysis was low for both blinded dermoscopists (κ < 0.2). Dermoscopy features associated with naevus-associated melanomas were: presence of negative pigment network (OR 9.915, CI 95% 2.182-45.049), globules (OR 2.383, CI 95% 1.15-4.95) and streaks (OR 2.439, CI 95% 1.271-4.680). In contrast, the presence of blue-white veil was related to absence of associated naevus (OR 0.520, CI 95% 0.273-0.991). With the results obtained, 2 different algorithms were proposed. The use of the proposed algorithms could help raise awareness of naevus-associated melanomas and avoid the possibility of incorrectly diagnosing a naevus-associated melanoma if partial biopsies are performed.

Recognition of early melanoma: a monocentric dermoscopy follow‐up study comparing de novo melanoma with nevus‐associated melanoma

“…Note the late appearance ( appearance at follow-up. These observations are in agreement with previous studies reporting negative pigment network (qualified here as white lines) as being more associated with NAMs 26,27 and the appearance of blue-white structures, dark blotches (qualified here as brown-black structureless areas), and negative network as being the most prevalent changes occurring in slowgrowing melanomas. [19][20][21] Regarding structureless blue-white areas, we did observe them as a changing feature in almost half of the lesions but indifferently in NAMs and DNMs.…”

Nevus‐associated melanoma: An observational retrospective study of 22 patients evaluated with dermoscopy and reflectance confocal microscopy

“…Concerning dermoscopy, the features more commonly found are negative network (the most specific criteria according to some authors), globules, peripheral streaks, atypical network, and regression structures (white or peppering) . Atypical vascularization, asymmetrical pigment blotches, and blue‐whitish veil are less likely to appear in NAM, as it happens in our work. Even uncommon in NAM, the presence of red color or shiny white streaks should alert us that we are facing thicker melanomas in accordance with our analysis (Table ).…”

Dermoscopy: A Review of the Structures That Facilitate Melanoma Detection

“…The negative network is frequently observed in melanomas arising in association with nevi. 41 The presence of a negative network has been found to have a 1.4 to 1.8 OR for melanoma. Negative network 1.4-1.8 30,31 Sensitivity: 22.0%-34.6% 27,31 Specificity: 77.2%-95.0% 27,31 Atypical streaks 1.5-5.8 [21][22][23][24]30 Sensitivity: 4.8%-23.0% [22][23][24][25][26][27] Specificity: 32%-58% [23][24][25][26][27][28] Atypical dots/globules 1.7-4.8 21,22,24 Sensitivity: 13.0%-39.6% [22][23][24][25] Specificity: 74.3%-92.0% [22][23][24][25] Blue-white veil 1.74-13.0 21,23,30 Sensitivity: 11.4%-92.0% 22,23,[25][26][27] Specificity: 74%-99% 22,23,[25][26]…”