Dermoscopic features in different dermatopathological stages of cutaneous melanomas

Due to the rising incidence of cutaneous melanoma there is a great need for the development of new diagnostic techniques as well as the improvement of those that are already well known, such as dermoscopy. Since early detection and a proper technique for excising the tumor are crucial for patients' survival, early staging of the tumor is very important.

To investigate whether there is a significant difference between the presence of selected dermoscopic features compared to the location on the skin and pathology results: Breslow's depth, mitotic index and ulceration.

We examined videodermoscopic images of cutaneous melanomas in 81 patients and compared their features with the histological results such as Breslow's depth, mitotic index and ulceration. In the study, we divided and compared the tumors in groups: in situ and invasive, ≤ 1.0 mm and > 1.0 mm thick on the Breslow scale.

In the study we observed statistically significantly higher prevalence of pseudopods (30.5%) and multicomponent pattern (69.5%) in invasive melanomas in comparison to in situ melanomas (9.1% and 36.4% respectively). White regression structures were more commonly described in invasive melanomas thicker than 1.0 mm on Breslow's scale. Atypical blood vessels and nodules were more specific to invasive melanomas with ulcerations and mitotic index ≥ 1. The atypical pigment network was more specific for thin invasive melanomas.

Presence of pseudopods, a multicomponent pattern, white regression structures, atypical blood vessels and nodules on dermoscopy suggest invasive (high stage) melanoma.