Dermoscopy as a Tool for Identifying Potentially Metastatic Thin Melanoma: A Clinical-Dermoscopic and...

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Thin cutaneous melanomas (≤0.8 mm) have rising incidence and contribute to mortality.
• Identifying early indicators of metastasis in thin melanomas is crucial for patient outcomes.

Purpose of the Study:

• To identify clinical, dermoscopic, and histopathological variables associated with metastasis in melanomas ≤0.8 mm.
• To compare metastatic and non-metastatic thin melanomas to find predictive factors.

Main Methods:

• Retrospective case-control study of 1396 patients with melanomas ≤0.8 mm from two Italian centers (2000-2022).
• Analysis of 16 patients with metastases compared to controls without metastases over 5 years.
• Statistical analysis using Pearson's chi-squared or Fisher's exact test.

Main Results:

• 1.1% of thin melanomas progressed to metastasis.
• Adverse clinical features included large diameter (>10 mm) and multiple colors.
• Dermoscopic findings: white patches, atypical vascular patterns, blue-gray areas, absent pigment networks.
• Histopathological indicators: regression, dermal mitoses, vertical growth phase, ulceration.
• These features were statistically significant predictors of metastasis (p < 0.05).

Conclusions:

• Specific clinical and dermoscopic traits, when combined with adverse histopathological features, may indicate a higher metastatic potential in thin melanomas.
• Early identification of these risk factors can aid in risk stratification and management of thin cutaneous melanoma.