Dermoscopic evaluation of nodular melanoma

Menzies, Scott W., Moloney, Fergal J., Byth, Karen, Avramidis, Michelle, Argenziano, Giuseppe, Zalaudek, Iris, Braun, Ralph P., Malvehy, Josep, Puig, Susana, Rabinovitz, Harold S., Oliviero, Margaret, Cabo, Horacio, Bono, Riccardo, Pizzichetta, Maria A., Claeson, Magdalena, Gaffney, Daniel C., Soyer, H. Peter, Stanganelli, Ignazio, Scolyer, Richard A., Guitera, Pascale, Kelly, John, McCurdy, Olivia, Llambrich, Alex, Marghoob, Ashfaq A., Zaballos, Pedro, Kirchesch, Herbert M., Piccolo, Domenico, Bowling, Jonathan, Thomas, Luc, Terstappen, Karin, Tanaka, Masaru, Pellacani, Giovanni, Pagnanelli, Gianluca, Ghigliotti, Giovanni, Carlos Ortega, Blanca, Crafter, Greg, Ortiz, Ana Maria Perusquia, Tromme, Isabelle, Karaarslan, Isil Kilinc, Ozdemir, Fezal, Tam, Anthony, Landi, Christian, Norton, Peter, Kacar, Nida, Rudnicka, Lidia, Slowinska, Monika, Simionescu, Olga, Di Stefani, Alessandro, Coates, Elliot and Kreusch, Juergen (2013) Dermoscopic evaluation of nodular melanoma. JAMA Dermatology, 149 6: 699-709. doi:10.1001/jamadermatol.2013.2466

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Author Menzies, Scott W.
Moloney, Fergal J.
Byth, Karen
Avramidis, Michelle
Argenziano, Giuseppe
Zalaudek, Iris
Braun, Ralph P.
Malvehy, Josep
Puig, Susana
Rabinovitz, Harold S.
Oliviero, Margaret
Cabo, Horacio
Bono, Riccardo
Pizzichetta, Maria A.
Claeson, Magdalena
Gaffney, Daniel C.
Soyer, H. Peter
Stanganelli, Ignazio
Scolyer, Richard A.
Guitera, Pascale
Kelly, John
McCurdy, Olivia
Llambrich, Alex
Marghoob, Ashfaq A.
Zaballos, Pedro
Kirchesch, Herbert M.
Piccolo, Domenico
Bowling, Jonathan
Thomas, Luc
Terstappen, Karin
Tanaka, Masaru
Pellacani, Giovanni
Pagnanelli, Gianluca
Ghigliotti, Giovanni
Carlos Ortega, Blanca
Crafter, Greg
Ortiz, Ana Maria Perusquia
Tromme, Isabelle
Karaarslan, Isil Kilinc
Ozdemir, Fezal
Tam, Anthony
Landi, Christian
Norton, Peter
Kacar, Nida
Rudnicka, Lidia
Slowinska, Monika
Simionescu, Olga
Di Stefani, Alessandro
Coates, Elliot
Kreusch, Juergen
Title Dermoscopic evaluation of nodular melanoma
Journal name JAMA Dermatology   Check publisher's open access policy
ISSN 2168-6068
Publication date 2013-06
Sub-type Article (original research)
DOI 10.1001/jamadermatol.2013.2466
Open Access Status File (Publisher version)
Volume 149
Issue 6
Start page 699
End page 709
Total pages 11
Place of publication Chicago, IL, United States
Publisher American Medical Association
Collection year 2014
Language eng
Formatted abstract
Importance Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical.

Objective To determine the dermoscopy features of NM.

Design Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/hypomelanotic or pigmented to assess outcomes.

Setting Predominantly hospital-based clinics from 5 continents.

Main Outcome Measures Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma.

Results Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, blue-white veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (>98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM.

Conclusions and Relevance When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.
Keyword Skin-lesions
Microscopic fFeatures
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 19 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 23 times in Scopus Article | Citations
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