Melanoma with peripheral globules: Clinical and dermatoscopic features

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• The characteristics of nevi with peripheral globules are understood, but those of melanomas with peripheral globules require further clarification.
• Peripheral globules in melanocytic lesions are a known feature, but their association with melanoma versus nevi is not fully established.

Purpose of the Study:

• To compare the dermatoscopic features of nevi and melanomas exhibiting peripheral globules.
• To identify dermatoscopic criteria that differentiate melanomas from nevi in lesions with peripheral globules.

Main Methods:

• A retrospective analysis of 401 melanocytic lesions with peripheral globules was conducted.
• Dermatoscopic patterns and structures, including peripheral globules, were evaluated.
• Statistical modeling (generalized estimating equation) was used to identify features associated with melanoma.

Main Results:

• Melanomas were more frequently found on lower extremities (P < .01) and presented with a disorganized pattern, unlike nevi on the trunk (organized pattern).
• The presence of blotches, atypical dots and globules, or atypical vessels significantly increased the likelihood of melanoma (P < .01).

Conclusions:

• Melanocytic lesions with peripheral globules on the lower extremities pose a higher risk for melanoma.
• The identification of blotches, atypical dots and globules, or atypical vessels in such lesions warrants further investigation for melanoma.