Significance of Dermoscopic Patterns in Detecting Malignant Melanoma on Acral Volar Skin

Abstract

To determine diagnostic variables such as sensitivity and specificity of the major dermoscopic patterns observed in melanocytic lesions on acral volar skin, with particular attention to the significance of the parallel ridge pattern and irregular diffuse pigmentation in detecting acral melanoma.

Specific Dermoscopy Patterns and Amplifications of the Cyclin D1 Gene to Define Histopathologically Unrecognizable Early Lesions of Acral Melanoma In Situ

“…All 8 cases designated as melanoma in situ showed either the PRP or irregular diffuse pigmentation, both of which are highly specific to melanoma in situ on acral volar skin. 6,8 Nine nevi showed benign dermoscopic patterns such as a parallel furrow pattern, a fibrillar or filamentous pattern, or a latticelike pattern. 5,7 However, the remaining 16 lesions (group 2) were difficult to classify histopathologically; 13 showed only a slight increase of nonatypical melanocytes in the basal cell layer of the epidermis (Table, cases 9-21; Figure 3).…”

“…Dermoscopic examinations were performed as described previously. 6 The excised specimens were fixed in 10% buffered formalin and embedded in paraffin. All the pathology slides were evaluated using the standard criteria, 14 and the difficult cases were reviewed by an expert dermatopathologist (T.S.…”

“…The PRP is characterized by accentuated bandlike pigmentation on the ridge of the skin markings that are arranged in parallel on glabrous skin. 8 A very recent multicenter study 6 shows that the PRP is extremely specific and sensitive in detecting melanoma in situ affecting acral volar skin. In this context, it is interesting that amplifications of CCND1 were detected only in the group 2A cases that revealed the PRP on dermoscopy.…”

“…1 In the past 2 decades, our group has characterized the clinical and histopathological features of malignant melanomas affecting the soles of the feet and has proposed several clinical and histopathological guidelines for the early detection of plantar melanomas. [2][3][4] More recently, we and others [5][6][7] introduced dermoscopic evaluation in the diagnosis of the pigmented lesions on acral volar skin and found that the recognition of several dermoscopic patterns is immensely helpful in differentiating melanomas from benign melanocytic nevi.…”

High-frequency 30-MHz sonography in preoperative assessment of tumor thickness of primary melanoma: usefulness in determination of surgical margin and indication for sentinel lymph node biopsy

“…The second step is dermoscopic evaluation, which is essential in diagnosing melanoma, particularly early melanoma affecting the acral volar skin. 18 The third step is the sonographic evaluation of the tumor thickness by using 30-MHz sonography, which allows us to determine an adequate surgical margin for the primary melanoma, along with the indication for sentinel lymph node biopsy. This strategy is highly recommended because it is essentially noninvasive.…”