Super‐high magnification dermoscopy can aid the differential diagnosis between melanoma and atypical naevi

Abstract

Summary Background Dermoscopy is the most widely used noninvasive imaging technique for the clinical diagnosis of melanoma (MM). Super‐high (× 400) magnification dermoscopy (D400) has recently been developed; compared with traditional dermoscopy, it can reveal additional features, down to the identification of single melanocytes in the skin. Objectives To evaluate which structures are visible at D400 and to compare them in atypical naevi and MMs. Methods A prospective observational multicentre study was conducted. We enrolled patients who were identified as having atypical melanocytic skin lesions by clinical and/or × 20 magnification dermoscopy (D20) examination, and who were assigned to either excision or follow‐up. Lesions were imaged by videodermoscopy at D20 and D400. The presence of pigmented cells and their features were assessed at D400. Results In total, there were 79 patients with 57 naevi and 31 MMs. Of the total 88 lesions, 63 (71.6%) were given a histological diagnosis, while the others were followed up for ≥ 12 months, during which they showed no change and were all diagnosed as naevi. Pigmented cells were identified in > 90% of the lesions at D400. Compared with naevi, MMs had a higher frequency of scattered, large, irregular (in shape and size), dendritic/roundish, violet/blue pigmented cells under D400 (P < 0.001). Moreover, dots (P < 0.01), out‐of‐focus blue structureless areas (P < 0.01) and vessels (P < 0.001) were also more frequent in MMs than in naevi at D400. Conclusions This study showed that D400 can reveal many elements not otherwise visible in traditional D20 dermoscopy, such as pigmented cells and their morphology, which could be useful for the diagnosis of MM.

Optical Super-high Magnification Dermoscopy Findings of Halo Naevus

“…OSHMD can help to distinguish between naevus and melanoma, due to its high resolution, and the potential to capture details not achievable in standard dermoscopy, including differentiation of the morphology and even the colours of the cells ( 5 , 6 ). The current case showed depigmented hair and whitish areas around regular melanocytes, favouring the diagnosis of halo naevus.…”

Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

“…New digital dermatoscopes will integrate additional capabilities in terms of magnification (i.e., super high (×400)), multiple light sources (UV, fluorescence and multispectral) and AI tools [ 19 , 80 , 81 , 82 , 83 , 84 , 85 ].…”

Dermoscopic findings of the evolving pigmented Spitz nevus in a child

“…After three years, the lesion displayed a uniform blue-brown color with streaks distributed at the periphery (Figure 1D). The high magnification dermoscopy revealed peripherally distributed brown roundish cells [1] (Figure 1E, F, 400x, FotoFinder GmBH). The patient underwent excision of the lesion and histopathological diagnosis of Spitz nevus was established.…”