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Combining Reflectance Confocal Microscopy with Optical Coherence Tomography for Noninvasive Diagnosis of Skin Cancers via Image Acquisition
Published on: August 18, 2022
Dermoscopic features of difficult melanoma
Maria A Pizzichetta1, Ignazio Stanganelli, Riccardo Bono
1Centro di Riferimento Oncologico, CRO, Aviano, Italy. pizzichetta@cro.it
Summary
Dermoscopic diagnosis of cutaneous melanoma (CM) can be challenging, with 17.5% of cases identified as dermoscopically difficult melanomas (DDM). Recognizing DDM requires careful evaluation of specific criteria and the "ugly duckling" sign.
Area of Science:
- Dermatology
- Oncology
- Medical Imaging
Background:
- Cutaneous melanoma (CM) diagnosis via dermoscopy is sometimes difficult due to a lack of specific melanoma features.
- Certain CM present challenges in dermoscopic identification.
Purpose of the Study:
- To assess if classic dermoscopic melanoma-specific criteria can diagnose CM.
- To evaluate dermoscopically difficult melanomas (DDM) in a multicenter study.
Main Methods:
- Retrospective analysis of 508 CM dermoscopic images.
- Identification of dermoscopic criteria associated with DDM.
- Examination of the relationship between dermoscopic diagnosis, diagnostic difficulty, and melanoma thickness.
Main Results:
- 17.5% (89/508) of CM were classified as DDM.
- Increased risk of DDM associated with streaks, irregular/absent regular pigmentation, absence of blue-whitish veil, absence of regression structures, and hypopigmentation.
- Statistical significance noted for identified risk factors (ORs and CIs provided).
Conclusions:
- A notable proportion of melanomas present diagnostic challenges even with dermoscopy.
- Recognizing DDM necessitates a detailed comparative analysis of all nevi (ugly duckling sign) and awareness of recent changes.
