Dermoscopy as a Tool for Estimating Breslow Thickness in Melanoma

Multispectral Imaging Algorithm Predicts Breslow Thickness of Melanoma

“…Shape descriptors efficiently differentiated high and low-risk melanomas, namely over 2 mm vs. less than 1 mm. SMMs are more common among thin melanomas ( p < 0.001) and NMs are more common among patients with thick melanomas ( p < 0.001) [ 51 ].The combination of shape descriptors and intensity values was sensitive and specific enough for the melanoma classification algorithm to sort melanomas into the three categories, with a sensitivity of 78.00%, specificity of 89.00% with a substantial agreement (κ = 0.67; 95% CI, 0.58–0.76). Circularity, the sphericity of lesions was the most suitable shape descriptor to classify melanomas into a low- and high-risk group as the second step.…”

“…Both can help the specialists estimate melanoma tumor thickness and can aid the differentiation of nevi from melanomas. However, dermoscopy is a tool designed for healthcare professionals with dedicated training [ 13 , 51 , 69 ]. In contrast, MSI requires no previous training and may be used as smartphones attachment to estimate tumor thickness.…”

The Many Roles of Dermoscopy in Melanoma Detection

“…Dermoscopy helps increase the diagnostic accuracy of melanoma and may be of help in estimating the tumoral thickness [ 13 ]. Each dermoscopic color has a histopathological correspondent that can help estimate the depth of the pigments and the tumoral thickness: black—melanin found in the stratum corneum, dark/light brown—melanin found in the epidermis or the dermal/epidermal junction, grey—melanin found in the dermis (mostly superficial dermis), blue—melanin found in the deep dermis, yellow/orange—serum/keratin in the epidermis, white—fibrosis, collagen located in the dermis, red—blood found in the vessels in the superficial dermis, purple—low oxygen levels in the blood vessels (the color of blood varies from red to purple/blue, depending on the degree of oxygenation)—located in the deep dermis [ 1 , 10 ].…”

“…If we were to consider the dermoscopic colors, with blue meaning melanin located in the dermis, the tumor would have a Clark Level IV—IB > 4.0 mm [ 1 , 10 , 14 , 15 ]. As for the dermoscopic structures, the tumors should be located somewhere between the epidermis and superficial dermis, meaning a Clark Level of I-II—IB ≤ 1.00, 1.1–2.00 mm [ 12 , 13 ]. The histopathological results of this tumor showed the following: Clark Level II, IB = 0.5 mm, with a pT1a stage.…”

“…This tumor had the following colors: black/brown—melanin found in the epidermis, grey—melanin in the superficial dermis, blue—correlated with the deep dermis, and white—fibrosis, collagen located in the dermis [ 1 , 10 ]. Dermoscopic structures: blue-white veil—associated with atypical melanocytes/melanophages located in the dermis [ 13 ], irregular dots/globules—melanin located in the epidermis [ 15 ], eccentric hyperpigmentation—melanin found at the dermal-epidermal junction (DEJ) [ 15 ], regression structures—fibrosis located in the dermis. Based on the dermoscopic findings, the tumor should be located somewhere between the epidermis and the dermis, with a Clark Level of I–II—IB ≤ 1.00–2.00 mm.…”