Dermoscopic Predictors of Tumor Thickness in Cutaneous Melanoma: A Retrospective Analysis of 245 Melanomas.

INTRODUCTION

The literature regarding the association of dermoscopic structures with Breslow thickness in melanoma is scarce, limited to small case series, and mostly outdated.

OBJECTIVE

This study determined the dermoscopic patterns, colors and structures that are associated with melanoma in situ, thin melanomas (<0.8 mm) and thick melanomas potentially requiring sentinel lymph node biopsy according to current guidelines (≥0.8 mm).

METHODS

A retrospective evaluation of 245 dermoscopic images of primary cutaneous melanoma located on the trunk or limbs was performed by consensus of 2 dermoscopists.

RESULTS

Red-pink, blue-gray and white color, blue-white veil, shiny white streaks, irregular vessels, blue-black pigmentation, milky red areas, pseudolacunae, ulceration and rainbow pattern were associated with thickness ≥0.8 mm, whereas atypical pigmented network, regression and hypopigmented areas were significantly associated with early melanomas.

LIMITATIONS: This is a retrospective study performed in a single institution. Melanomas of special sites were excluded from our evaluation. Dermoscopy is based on subjective evaluations that depend largely on the observers' experience.

CONCLUSIONS

The identification of certain dermoscopic structures and colors might help in the discrimination between thin and thick melanomas.