Association between the dermoscopic morphology of peripheral globules and melanocytic lesion diagnosis

Abstract

Background The presence of peripheral globules is associated with enlarging melanocytic lesions; however, there are numerous patterns of peripheral globules distribution and it remains unknown whether specific patterns can help differentiate enlarging naevi from melanoma. Objective To investigate whether morphological differences exist between the peripheral globules seen in different subsets of naevi and in melanoma. Methods A cross‐sectional study of clinical notes that mentioned peripheral globules, in addition to all melanoma images with peripheral globules on the International Skin Imaging Collaboration archive. Dermoscopic images were reviewed and annotated. Associations between diagnosis and categorical features were measured with odds ratios. Non‐parametric tests were used for continuous factors. Results 184 lesions with peripheral globules from our clinic were included in the analysis; only 6 of these proved to be melanoma. 109 melanomas with peripheral globules from the International Skin Imaging Collaboration archive were added to the analysis. Melanomas were more common on the extremities and among older individuals. Melanomas were more likely to display atypical, tiered and/or focal peripheral globules. Only 5% of melanomas lacked dermoscopic melanoma‐specific structures compared to 48% of naevi. Conclusions Melanocytic lesions with atypical or asymmetrically distributed peripheral globules, especially when located on the extremities, should raise suspicion for malignancy. Melanocytic lesions with typical and symmetrically distributed peripheral globules, and with no other concerning dermoscopic features, are unlikely to be malignant.

[Translated article] SARS-CoV-2 Spike-like Pigmented Peripheral Structures: A Dermoscopic Finding in Dysplastic Nevi and Incipient Melanomas

“…Reiter et al 6 did not include lesions with pseudopods in their study. While pseudopods are also round or oval structures that project outwards from the edge of lesions, they are not globules in the strict sense of the word (the last edition of the Merriam-Webster dictionary defines globule as "a tiny globe or ball especially of a liquid").…”

“…Peripheral globules are occasionally seen in melanoma. In a recent dermoscopic study of the morphology and distribution of peripheral globules in melanocytic lesions, Reiter et al 6 suggested that lesions with asymmetrically distributed globules or globules with varying shapes, sizes, and colors should be biopsied or closely monitored–especially pigmented lesions on the extremities—as they may be signs of an incipient melanoma.…”

Ensemble learning of deep learning and traditional machine learning approaches for skin lesion segmentation and classification

“…In this research, we have used two datasets to train and evaluate the performance of proposed system. First one is International Skin Imaging Collaboration (ISIC) which is largest publicity available dataset with considerable amount of instances 45 . It contains three different classes having label of melanoma, nevus and SK.…”

Dermoscopic Criteria, Histopathological Correlates and Genetic Findings of Thin Melanoma on Non-Volar Skin

“…Recent studies confirmed that regular peripheral globules are a dermoscopic feature that is mostly associated with benign melanocytic lesions. Melanocytic lesions with atypical or asymmetrically distributed peripheral globules, especially when located on the extremities, should raise suspicion for malignancy [81].…”