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Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non‐melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society


Sgouros, D; Lallas, A; Kittler, H; Zarras, A; et al; Braun, R P (2020). Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non‐melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society. Journal of the European Academy of Dermatology and Venerology, 34(11):2541-2547.

Abstract

Background

Thin nodular melanoma (NM) often lacks conspicuous melanoma‐specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour.
Objective

To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours.
Methods

Retrospective, morphological case–control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed.
Results

Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non‐melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4‐fold), white shiny streaks (2.9‐fold) and irregular blue structureless area (2.4‐fold) were predictors for thinner NM compared to non‐melanoma nodular tumours. Overall, irregular blue structureless area (3.4‐fold), dotted vessels (4.6‐fold) and serpentine vessels (1.9‐fold) were predictors of all NM compared to non‐melanoma nodular lesions.
Limitations

Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community.
Conclusions

Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non‐melanoma nodular tumours.

Abstract

Background

Thin nodular melanoma (NM) often lacks conspicuous melanoma‐specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour.
Objective

To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours.
Methods

Retrospective, morphological case–control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed.
Results

Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non‐melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4‐fold), white shiny streaks (2.9‐fold) and irregular blue structureless area (2.4‐fold) were predictors for thinner NM compared to non‐melanoma nodular tumours. Overall, irregular blue structureless area (3.4‐fold), dotted vessels (4.6‐fold) and serpentine vessels (1.9‐fold) were predictors of all NM compared to non‐melanoma nodular lesions.
Limitations

Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community.
Conclusions

Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non‐melanoma nodular tumours.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Dermatology
Health Sciences > Infectious Diseases
Uncontrolled Keywords:Infectious Diseases, Dermatology
Language:English
Date:1 November 2020
Deposited On:29 Jan 2021 09:58
Last Modified:30 Jan 2021 21:00
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0926-9959
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/jdv.16815
PubMed ID:32654237

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