The introduction of dermoscopy has improved the accuracy of diagnosis of melanoma. However, early stage melanoma can be difficult to diagnose. Eighty-nine cases of thin melanoma with a Breslow thickness ≤1 mm located on the lower limb and diagnosed between 2008 and 2016 were assessed using 4 dermoscopic algorithms: (i) modified pattern analysis; (ii) ABCD rule of dermoscopy; (iii) 7-point checklist; and (iv) Men-zies’ method. Two groups of early stage melanomas of the legs were identified: “difficult to diagnose mela-nomas” (DDM) and “non-difficult to diagnose melano-mas” (NDDM). In our series the dermoscopic features of DDM were difficult to differentiate from melanocytic naevi, and the reticular pattern was the most frequently observed. “Depigmentation” was the only specific criterion associated with DDM. The sensitivity of diagnostic systems for thin melanomas of the lower limbs was lower than in previous studies. This result could be related to the lower mean Breslow thickness of the invasive melanomas in our sample and the high number of melanomas in situ. In conclusion, early stage melanoma of the legs may be difficult to detect at clinical examination or with dermoscopic examination alone. Focusing on depigmentation in dermoscopy associated with anamnestic features could be a useful tool to detect difficult thin melanomas. In addition, sequential dermoscopy is recommended for high-risk patients with previous melanomas or atypical mole syndrome.

Dika, E., Chessa, M.A., Ribero, S., Fanti, P.A., Gurioli, C., Lambertini, M., et al. (2017). Diagnostic efficacy of digital dermoscopy and clinical findings in thin melanoma of the lower limbs. ACTA DERMATO-VENEREOLOGICA, 97(9), 1100-1107 [10.2340/00015555-2705].

Diagnostic efficacy of digital dermoscopy and clinical findings in thin melanoma of the lower limbs

Dika, Emi;Chessa, Marco Adriano;Fanti, Pier Alessandro;Gurioli, Carlotta;Lambertini, Martina;Baraldi, Carlotta;Patrizi, Annalisa
2017

Abstract

The introduction of dermoscopy has improved the accuracy of diagnosis of melanoma. However, early stage melanoma can be difficult to diagnose. Eighty-nine cases of thin melanoma with a Breslow thickness ≤1 mm located on the lower limb and diagnosed between 2008 and 2016 were assessed using 4 dermoscopic algorithms: (i) modified pattern analysis; (ii) ABCD rule of dermoscopy; (iii) 7-point checklist; and (iv) Men-zies’ method. Two groups of early stage melanomas of the legs were identified: “difficult to diagnose mela-nomas” (DDM) and “non-difficult to diagnose melano-mas” (NDDM). In our series the dermoscopic features of DDM were difficult to differentiate from melanocytic naevi, and the reticular pattern was the most frequently observed. “Depigmentation” was the only specific criterion associated with DDM. The sensitivity of diagnostic systems for thin melanomas of the lower limbs was lower than in previous studies. This result could be related to the lower mean Breslow thickness of the invasive melanomas in our sample and the high number of melanomas in situ. In conclusion, early stage melanoma of the legs may be difficult to detect at clinical examination or with dermoscopic examination alone. Focusing on depigmentation in dermoscopy associated with anamnestic features could be a useful tool to detect difficult thin melanomas. In addition, sequential dermoscopy is recommended for high-risk patients with previous melanomas or atypical mole syndrome.
2017
Dika, E., Chessa, M.A., Ribero, S., Fanti, P.A., Gurioli, C., Lambertini, M., et al. (2017). Diagnostic efficacy of digital dermoscopy and clinical findings in thin melanoma of the lower limbs. ACTA DERMATO-VENEREOLOGICA, 97(9), 1100-1107 [10.2340/00015555-2705].
Dika, Emi; Chessa, Marco Adriano; Ribero, Simone; Fanti, Pier Alessandro; Gurioli, Carlotta; Lambertini, Martina; Baraldi, Carlotta; Patrizi, Annalisa...espandi
File in questo prodotto:
File Dimensione Formato  
4985.pdf

accesso aperto

Tipo: Versione (PDF) editoriale
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione - Non commerciale (CCBYNC)
Dimensione 1.12 MB
Formato Adobe PDF
1.12 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/618115
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 4
social impact