Identification of Novel Dermoscopic Patterns for “Featureless Melanoma”: Clinical-Pathological Correlation

Citation: Lampitelli S, Cantisani C, Chello C, Rega F, Farnetani F, Pellacani G. Identification of Novel Dermoscopic Patterns for “Featureless Melanoma”: Clinical-Pathological Correlation. Dermatol Pract Concept. 2023;13(2):e2023080. DOI: https://doi.org/10.5826/dpc.1302a80

Accepted: September 15, 2022; Published: April 2023

Copyright: ©2023 Lampitelli, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Carmen Cantisani, UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome viale del Policlinico 155, 00161 Rome Italy. tel: +39-0649976993 Email: c.cantisani@policlinicoumberto1.it; carmencantisanister@gmail.com

Abstract

Introduction:Diagnosis of melanoma can be sometimes very difficult because of its phenotypic and histological heterogeneity.Difficult-to-diagnose melanoma can be represented by mucosal melanoma, pink lesions, amelanotic melanoma (amelanotic lentigo maligna, amelanotic acral melanoma, desmoplastic melanoma), melanoma arising on sun-damaged facial skin, and “featureless melanoma”.Objective:The aim of the study was to improve the identification of featureless melanoma (scoring 0-2 according to 7-point-checklist)describing the variegated dermoscopical features and their histo-pathological correlation.Methods:Study samples included all melanomas excised based on clinical and/or dermoscopic findings in the period between January 2017 and April 2021.Before excisional biopsy, all lesions were recorded by means of digital dermoscopy at the department of Dermatology.Only lesions with a diagnosis of melanoma and a high quality of dermoscopic images were included in this study. After clinical and dermoscopic evaluation of 7-point checklist score, single dermoscopic and histological features were considered for lesions with a score of 2 or lower and a diagnosis of melanoma (corresponding to dermoscopic featureless melanoma).Results:A total of 691 melanomas fulfilled inclusion criteria and were retrieved from the database. The 7-point checklist evaluation identified 19 “negative-featureless” melanoma.The 100% of the lesions with score 1 showed a globular pattern. Conlusions:Dermoscopy is still the best diagnostic method for melanoma. The 7-point checklist provides a simplification of standard pattern analysis because of the algorithm based on a scoring system and the lower number of features to recognize. In the daily practice it is more comfortable for many clinicians to keep in mind a list of principles that may help in the decision.

Keywords : 7-point checklist, dermoscopy, difficult featureless melanoma

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