Dermoscopy of desmoplastic melanoma: Report of six cases

Department of Dermatology, Lyon 1 University, Hôpital de l'Hôtel Dieu, 69288 Lyon Cedex 02, France.
British Journal of Dermatology (Impact Factor: 4.28). 06/2008; 159(2):360-3. DOI: 10.1111/j.1365-2133.2008.08687.x
Source: PubMed


Desmoplastic melanoma (DM) is a rare variant of cutaneous melanoma. Its diagnosis is often delayed by an unusual clinical presentation. The dermoscopic features of DM have not yet been described.
To define the dermoscopic features of DM. Patients and methods A single-institution register-based retrospective study of six cases of histology-proven desmoplastic melanoma for which dermoscopy data were available. The criteria we studied included: network, dots and globules, streaks, regression features, ulceration, number of colours, blue/white veil, and vascular pattern.
Only three cases exhibited one classical feature for a melanocytic lesion; other cases were recognized on the basis of the presence of figures of regression (all six), i.e. white scar-like areas and 'peppering' (three of six), multiple (> 4) colours (five of six), and of melanoma-related vascular patterns (five) such as linear-irregular vessels (four) and milky-red areas (two).
We believe that dermoscopy could help in the accurate diagnosis of this rare neoplasm. In the absence of a pigmented network, attention should be given to the identification of features of regression and to melanoma-associated vascular patterns.

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    • "During observations carried out by Zaballos et al. [16] concerning 412 dermatofibromas, a pigment network were observed in 71% of lesions and white scar-like areas were noted in a total of 57% of lesions [16]. What is more, the presence of white scar-like areas should always suggest the necessity of ruling out melanoma through a dermoscopic examination – especially its desmoplastic type [17] or the fully regressive melanoma [18]. Scar-like white areas are a usual histological suggestion of fibrosis [3]. "
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    • "Therefore, it can be clinically misdiagnosed as basal cell carcinoma, scar, dermatofibroma, nevus or cyst. In a recently published series, there was no clinical suspicion of melanoma in up to 2/3 of affected patients.4 "
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