Dermoscopy of Cutaneous Melanoma Metastases: A Comprehensive Literature Review.

Background: Cutaneous melanoma metastases (CMM) represent a clinically relevant manifestation of advanced melanoma and may constitute the first sign of disseminated disease. Their diagnosis is challenging because CMM shows highly variable clinical and dermoscopic presentations and frequently mimic other benign or malignant skin lesions. Although dermoscopy is routinely used to improve skin lesion assessment, dermoscopic criteria specific to CMM remain poorly defined and still non-standardized. Methods: We performed a narrative review of the literature to summarize dermoscopic features reported in CMM. MedLine (via PubMed) and Web of Science were searched up to 3 December 2025 using the keywords "dermoscopy" and "melanoma metastasis," complemented by manual reference screening. Eligible studies were English-language full-text articles in peer-reviewed journals providing a complete dermoscopic description. Extracted data included patient demographics and major dermoscopic criteria, categorized as global patterns and focal dermoscopic and vascular structures. Due to heterogeneity, results were synthesized descriptively. Results: Twenty studies were included, comprising 774 patients. Dermoscopic findings were markedly heterogeneous. Globally, lesions frequently showed homogeneous pigmentation with variable colors and included amelanotic presentations. Commonly evaluated focal features included irregular dots and globules, crystalline structures, peripheral gray dots, and lacuna-like areas. Vascular patterns were prominent, particularly serpentine and corkscrew-like vessels. Conclusions: CMM dermoscopy is characterized by substantial heterogeneity and a lack of standardized criteria. Systematic classification of recurring dermoscopic features may improve diagnostic consistency and provide an interpretable framework for future artificial intelligence-based approaches supporting non-invasive recognition of melanoma metastases.