A tiny invasive melanoma: a case report with dermatoscopy and dermatopathology

We present a case of an early invasive melanoma (Breslow thickness 0.25 mm), 1.6 mm in diameter on the arm of a 38-year-old woman. She was under surveillance due to having multiple (>100) nevi, and the melanoma was assessed as a new lesion by the examining doctor. Clinically the lesion was hyper-pigmented compared with surrounding nevi and dermatoscopically it had a clue of pseudopods/lines radial, but they were arranged in an arguably symmetrical circumferential pattern around a structureless blue-gray center. Generally melanomas are expected to be dermatoscopically asymmetrical, but we believe that this case illustrates the fact that small melanomas may be recognized by clues such as pseudopods/lines radial and dermatoscopic gray even when they have not yet developed unequivocal asymmetry.