More than one shade of pink as a marker of early amelanotic/hypomelanotic melanoma

• Published in: Journal of dermatology 2024-07, Vol.51 (7), p.999-1003
• Main Authors: Pizzichetta, M. A., Corsetti, P., Stanganelli, I., Ghigliotti, G., Cavicchini, S., De Giorgi, V., Bono, R., Astorino, S., Ribero, S., Argenziano, G., Alaibac, Polesel, J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; amelanotic melanoma; Basal cell carcinoma; benign melanocytic lesion; Carcinoma, Basal Cell - diagnosis; Carcinoma, Basal Cell - diagnostic imaging; Carcinoma, Basal Cell - pathology; Concise Communication; Dermoscopy; Diagnosis, Differential; Female; Humans; Keratosis; Lesions; Male; Melanoma; Melanoma - diagnosis; Melanoma - diagnostic imaging; Melanoma - pathology; Melanoma, Amelanotic - diagnosis; Melanoma, Amelanotic - pathology; Middle Aged; Multivariate analysis; non‐melanocytic lesion; Pigmentation; Retrospective Studies; Shade; Skin - diagnostic imaging; Skin - pathology; Skin cancer; Skin Neoplasms - diagnosis; Skin Neoplasms - diagnostic imaging; Skin Neoplasms - pathology
• ISSN: 0385-2407; 1346-8138; 1346-8138
• DOI: 10.1111/1346-8138.17200

Amelanotic/hypomelanotic melanoma (AHM) may be difficult to diagnose because of a lack of pigmentation. To evaluate whether dermoscopy can be useful for the diagnosis of early AHM, 133 digital dermoscopic images of lesions histopathologically diagnosed as amelanotic/hypomelanotic superficial spreading melanoma with ≤1 mm thickness (AHSSMs) (n = 27), amelanotic/hypomelanotic non‐melanocytic lesions (AHNMLs) (e.g., seborrhoeic keratosis and basal cell carcinoma) (n = 79), and amelanotic/hypomelanotic benign melanocytic lesions (AHBMLs) (e.g., compound and dermal nevi) (n = 27), were dermoscopically assessed by three blinded dermatologists. Using multivariate analysis, we found a significantly increased risk of diagnosing AHSSM versus AHNML and AHBML when the lesion was characterized by the presence of more than one shade of pink (odds ratio [OR] 37.11), irregular dots/globules (OR 23.73), asymmetric pigmentation (OR 8.85), and structureless pattern (OR 7.33). In conclusion, dermoscopy may improve early AHM detection, discriminating AHSSM from amelanotic/hypomelanotic non melanoma lesions.