Clinical and Dermoscopic Characteristics of Desmoplastic Melanomas

Jaimes, Natalia; Chen, Lucy L.; Dusza, Stephen W.; Carrera, Cristina; Puig, Susana; Thomas, Luc; Kelly, John W.; Dang, Lucy; Zalaudek, Iris; Braun, Ralph P.; Menzies, Scott W.; Busam, Klaus J.; Marghoob, Ashfaq A.

doi:10.1001/jamadermatol.2013.2248

Cited by 47 publications

(43 citation statements)

References 18 publications

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“…Both our study and the Jaimes et al 5 study found a high prevalence of atypical vascular structures in DM. This seemed to be one of the main differences when compared to general non-specified melanoma populations 14,15 , which had much lower frequencies of vascular structures.…”

Section: Discussionsupporting

confidence: 78%

“…This seemed to be one of the main differences when compared to general non-specified melanoma populations 14,15 , which had much lower frequencies of vascular structures. However, this difference could be related to Breslow thickness differences, as this dermoscopic feature became more frequent in the general melanoma population with increasing Breslow thickness (up to 47% for Breslow thickness >0.75mm 14 ), and our study had a mean Breslow thickness of 3.3mm (standard deviation 2.36mm) in the DM population and the Jaimes et al 5 study had a mean Breslow thickness of 3.38mm in their DM population (range 0.5–12.0mm).…”

Section: Discussionmentioning

confidence: 48%

“…3,4 In approximately three-quarters of DMs, there is an overlying melanoma in situ (MIS) (usually of lentigo maligna [LM] type) or atypical melanocytic hyperplasia. 2,5 It is important to recognize DM from other types of melanoma for two reasons. Firstly, DM has a different clinical behavior compared to other types of melanoma, which may influence management decisions.…”

Section: Introductionmentioning

confidence: 99%

“…5 Dermoscopy may provide clues toward a diagnosis of DM, such as atypical vascular structures and peppering. 5,7 …”

Section: Introductionmentioning

confidence: 99%

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Detection of desmoplastic melanoma with dermoscopy and reflectance confocal microscopy

Maher

Solinas

Scolyer

et al. 2017

Acad Dermatol Venereol

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Background Desmoplastic melanoma (DM) is frequently misdiagnosed clinically and often associated with melanoma in situ (MIS). Objective To improve the detection of DM using dermoscopy and reflectance confocal microscopy (RCM). Methods A descriptive analysis of DM dermoscopy features and a case-control study within a melanoma population for RCM feature evaluation, performed blindly, using data obtained between 2005 and 2015. After retrospectively identifying all DM cases with RCM data over the study period (n=16), a control group of non-DM melanoma patients with RCM data, in a ratio of at least 3:1, was selected. The control group was matched by age and primary tumor site location, divided into non-DM invasive melanomas (n=27) and MIS (n=27). Invasive melanomas were selected according to the melanoma subtypes associated with the DM cases. The main outcomes were the frequency of melanoma-specific features on dermoscopy for DM; and the odds ratios of RCM features to distinguish DM from MIS and/or other invasive melanomas; or MIS from the combined invasive melanoma group. Results At least 1 of the 14 melanoma-specific features evaluated on dermoscopy were found in 100% of DMs (n=15 DM with dermoscopy). Known RCM melanoma predictors were commonly found in the DMs, such as pagetoid cells (100%) and cell atypia (100%). The RCM feature of spindle cells in the superficial dermis was more common in DM compared with the entire melanoma control group (OR 3.82, 95% CI 1.01–14.90), and particularly compared to MIS (OR 5.48, 95% CI 1.11–32.36). Nucleated cells in the dermis and the RCM correlate of dermal inflammation were also significant RCM features favouring DM over MIS, as well as invasive melanoma over MIS. Conclusion Dermoscopy and RCM may be useful tools for the identification of DM. Certain RCM features may help distinguish DM from MIS and other invasive melanomas. Larger studies are warranted.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 48%

Section: Introductionmentioning

confidence: 99%

“…5 Dermoscopy may provide clues toward a diagnosis of DM, such as atypical vascular structures and peppering. 5,7 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detection of desmoplastic melanoma with dermoscopy and reflectance confocal microscopy

Maher

Solinas

Scolyer

et al. 2017

Acad Dermatol Venereol

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“…Multiple colors (at least 4) are often considered a dermoscopic criterion of melanoma, also in the desmoplastic type. 24,25 Reflectance confocal microscopy…”

Section: 11mentioning

confidence: 99%

Modern non-invasive diagnostic techniques in the detection of early cutaneous melanoma

Kardynał¹,

Olszewska

2014

J Dermatol Case Rep

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Over the past few years melanoma has grown into a disease of socio-economic importance due to the increasing incidence and persistently high mortality rates. Melanoma is a malignant tumor with a high tendency to metastasize. Therefore, an extremely important part of the therapeutic process is to identify the disease at an early stage: in situ or stage I. Many tools for early diagnosis of melanoma are available today, including dermoscopy, videodermoscopy and in vivo reflectance confocal microscopy. Other methods such as high frequency ultrasound, optical coherence tomography and electrical impedance spectroscopy may serve as additional diagnostic aids. Modern imaging techniques also allow the monitoring of melanocytic skin lesions over months or years to detect the moment of malignant transformation. This review summarizes the current knowledge about modern diagnostic techniques, which may aid early diagnosis of

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Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

et al. 2020

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The clinical and dermoscopic features of the vast majority of uncommon variants of cutaneous melanoma have been rarely reported, leading to difficulty in making accurate diagnoses.OBJECTIVE To define the main clinical and dermoscopic features of the most frequently reported but uncommon histologic variants of cutaneous melanoma.EVIDENCE REVIEW A 2-step systematic review of the literature was performed (from inception to November 2018) using PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. The first step identified those uncommon variants of melanoma for which at least 1 case reporting dermoscopy was described in the literature. The keywords searched were melanoma, uncommon, rare, dermoscopy, and dermatoscopy. In the second step, each previously identified uncommon variant was searched for in the same databases by combining the following terms with melanoma, dermoscopy, and dermatoscopy: amelanotic, hypopigmented, animal, melanocytoma, balloon, desmoplastic, follicular, nested, nevoid, dermal, spitz*, spindle, and verrucous. The institution's database was also searched from January 2012 to September 2019 for histopathologically confirmed cases of the same melanoma variants. Each reviewer also assessed the quality of reporting in the included articles based on previously described guidelines.FINDINGS In total, 62 articles met the inclusion criteria, reporting 433 melanoma cases. An additional 56 cases of uncommon melanoma variants were retrieved from the institution's database for a total of 489 cases: 283 cases of amelanotic superficial spreading melanoma, 18 cases of animal-type and pigmented epithelioid melanocytoma, 7 cases of balloon cell melanoma, 71 cases of desmoplastic melanoma, 3 cases of follicular melanoma, 10 cases of nested melanoma, 33 cases of nevoid melanoma, 2 cases of primary dermal melanoma, 57 cases of spitzoid melanoma, and 5 cases of verrucous melanoma. These variants of melanoma occurred more frequently in women than men (147 cases vs 132 cases). Clinically, these tumors were mainly palpable (162 of 217 [74.7%]) or amelanotic (283 of 489 [57.9%]) lesions that could resemble other benign or malignant skin conditions; dermoscopy typically revealed a homogeneous pinkish background, white structures, and polymorphic vessels. The mean age of all included was 58 years (range, 1-89 years).CONCLUSIONS AND RELEVANCE Uncommon melanoma variants may resemble both inflammatory disorders and other cutaneous neoplasms, representing a diagnostic pitfall even for the most experienced dermatologist. The purpose of this systematic review was to provide an extensive and detailed overview of specific clinical and dermoscopic features of each uncommon melanoma variant, highlighting the main criteria for differentiating these variants from other benign or malignant skin lesions.

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Clinical and Dermoscopic Characteristics of Desmoplastic Melanomas

Cited by 47 publications

References 18 publications

Detection of desmoplastic melanoma with dermoscopy and reflectance confocal microscopy

Detection of desmoplastic melanoma with dermoscopy and reflectance confocal microscopy

Modern non-invasive diagnostic techniques in the detection of early cutaneous melanoma

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

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