Age-related dermatoscopic features of excised melanomas versus nevi in 832 high risk patients

Melanocytic nevi show distinct age-related dermoscopic patterns. However, data on age-related patterns of melanomas are lacking. This study aimed to identify age-related static and dynamic dermoscopic patterns of melanomas.

Explorative cross-sectional cohort study between October 1996 and May 2012, including 832 patients at increased melanoma risk monitored by total body photography (TBP) and sequential digital dermoscopy (SDD). Patients were categorized into age groups I: < 31 years (n = 308), II: 31-50 years (n = 340), and III: > 50 years (n = 184). Dermoscopic features of melanoma-suspicious lesions were prospectively characterized before excision.

During the study, 1,770 of 14,896 monitored lesions were excised. Histopathology confirmed 190 (10.7%) melanomas. In comparison to melanomas of other age groups, we found "signature features" for age group I: "blue whitish veil" and "symmetrical enlargement without globules", age group II: appearance of "irregular pigmentation" and "irregular dots/globules", and age group III: "regression structures" and appearance of "atypical pigment network", "atypical vascular pattern", and "blue whitish veil". In contrast, unique age-related features of excised nevi were "symmetrical enlargement with globules" in age group I, and "no enlargement" in age group III.

Our explorative study identified a number of age-related static and dynamic dermoscopic features that might be helpful to detect melanomas.