Dermoscopy Use Leads to Earlier Cutaneous Melanoma Diagnosis in Terms of Invasiveness and Size? A Single-Center, Retrospective Experience

Abstract

Background: The incidence of cutaneous melanoma has risen in recent years. The aim of this study was to compare cutaneous melanomas diagnosed at the Dermatology Unit of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, from 2006 to 2020 and between two specific biennia, i.e., 2006–2007 and 2019–2020. Methods: Retrospective chart review, with dermoscopic image collection, of cutaneous melanomas diagnosed at the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, from 1 January 2006 to 31 December 2020 Results: A statistically significant increase was shown in the proportions of in situ melanoma and melanoma measuring less than 6 mm, i.e., small-diameter melanoma (SDM), across the studied period (p < 0.001). Moreover, in the biennium 2006–2007, among 220 melanoma diagnoses, 6 were in situ (2.7%), as compared with 68 melanomas in situ out of a total of 236 (28.8%) melanomas diagnosed in the biennium 2019–2020. A statistically significant difference in the proportion of in situ melanoma between the two biennia was demonstrated (p < 0.001). Furthermore, during the first biennium, 27/220 (12.3%) SDM were identified, as compared with 61/236 (25.9%) in the last. A statistically significant difference was shown in the proportion of SDM between the two (p < 0.001). Conclusions: The percentage of in situ melanomas and those that can be detected at a diameter <6 mm has increased. The latter has been shown to be around one-third of excised lesions, thus undermining the practicality of the ABCD mnemonic. Dermoscopic criteria for SDM are needed to help further refine melanoma diagnosis.

Melanin Stacking Differences in Pigmented and Non-Pigmented Melanomas: Quantitative Differentiation between Pigmented and Non-Pigmented Melanomas Based on Light-Scattering Properties

“…Dermoscopy is more accurate when interpreted with the patient present rather than using dermoscopy images [40]. It allows an early diagnosis of melanoma, increasing the percentage of melanomas that can be detected at a diameter less than 6 mm [41]. However, it may be necessary to measure lesion light-scattering properties non-invasively to make more definitive conclusions about the presence of a non-pigmented melanoma before it grows to a diameter and depth of more than 0.5 mm.…”

Exploring Small-Diameter Melanomas: A Retrospective Study on Clinical and Dermoscopic Features

“…Given the ongoing debates in the current literature regarding the standardization of dermatoscopic structure terminology, with some authors using descriptive terms and others employing metaphoric terms, we sought to minimize interpretational subjectivity among the authors. This was achieved by providing clear descriptions of dermatoscopic terms and adopting terminology references from the Third Consensus Conference of the International Society of Dermoscopy [19]. There was agreement in the analysis of most criteria among the evaluating dermatologists.…”

Dermoscopic predictors of melanoma in small diameter melanocytic lesions (mini‐melanoma): a retrospective multicentric study of 269 cases

“…Although a complex, debated relationship links it with the disproportionate incidence increase recorded for in situ and thin melanomas, 2 early recognition of melanoma remains of paramount importance, resulting in the reduction of morbidity, relief of psychological burden, and decrease of direct and indirect costs 3 . The wider adoption of dermoscopy, along with increased patient awareness, has had a measurable effect over the years on the characteristics of melanoma at the time of diagnosis, allowing its detection at an earlier stage, in terms of depth and horizontal diameter 4 …”

“…3 The wider adoption of dermoscopy, along with increased patient awareness, has had a measurable effect over the years on the characteristics of melanoma at the time of diagnosis, allowing its detection at an earlier stage, in terms of depth and horizontal diameter. 4 Several clues and algorithms, comprising both clinical and dermoscopic parameters, have been proposed to aid the identification of cutaneous melanoma. 5 Unfortunately, in spite of their individual strengths, these criteria may be inadequate for the diagnosis of small-diameter melanomas (SDM), or minimelanomas.…”