Dermoscopy aids in detecting paediatric melanoma
Dermoscopy plus conventional and modified clinical ABCD criteria (amelanotic, bleeding bump, colour uniformity, de novo at any diameter) improves diagnosis of paediatric melanoma (PM), suggests a recent study. Dermoscopy helps in differentiating spitzoid from nonspitzoid melanomas.
“On the basis of its clinical, dermoscopic and histopathological characteristics, PM can be classified as spitzoid or nonspitzoid,” according to researchers.
Nospitzoid melanomas (n=37; 72.3 percent) were detected in patients with a mean age of 16.3 years (range, 8‒20) and correlated with a high-risk phenotype and a pre-existing nevus (62.2 percent). Spitzoid melanomas (n=15; 27.7 percent) presented in patients at a mean age of 12.5 years (range, 2‒19) and were mostly de novo lesions (73.3 percent) located on the limbs (73.3 percent).
Less than one-fourth of PMs met the modified clinical ABCD criteria, but nearly half (40 percent) of spitzoid melanomas did. Dermoscopic melanoma criteria were found in all cases.
Nospitzoid melanomas were likely to be multicomponent (58.3 percent) or have nevus-like (25 percent) dermoscopic patterns. Spitzoid melanomas tended to have atypical vascular patterns with shiny white lines (46.2 percent) or an atypical pigmented spitzoid pattern (30.8 percent). A good correlation existed between spitzoid subtype histopathologically and dermoscopically (κ=0.66).
Researchers performed a retrospective study of 52 melanoma cases diagnosed in patients before the age of 20 years to analyse the clinicodermoscopic characteristics of PM. It was, however, limited by the failure to re-review the pathologic findings.
“Knowledge regarding the morphologic spectrum of PM is sparse, and this may in part contribute to delay in detection and thicker tumours,” researchers said.