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Cancers (Basel). 2021 Dec 03;13(23). doi: 10.3390/cancers13236095.

Dermoscopy of Small Diameter Melanomas with the Diagnostic Feasibility of Selected Algorithms-A Clinical Retrospective Multicenter Study.

Cancers

Monika Slowinska, Grazyna Kaminska-Winciorek, Elzbieta Kowalska-Oledzka, Iwona Czarnecka, Robert Czarnecki, Anna Nasierowska-Guttmejer, Elwira Paluchowska, Witold Owczarek

Affiliations

  1. Department of Dermatology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland.
  2. Evimed Medical Center, Private Dermatologic Practice, JP Woronicza 16, 02-625 Warsaw, Poland.
  3. The Skin Cancer and Melanoma Team, The Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland.
  4. All4Skin, Center of Diagnostics and Treatment of Skin Diseases, Armii Krajowej 194/1, 40-750 Katowice, Poland.
  5. Department of Cardiology, LUX MED Oncology Limited Liability Company, Fieldorfa 40, 04-125 Warsaw, Poland.
  6. Department of Pathomorphology, Central Clinical Hospital of Ministry of Internal Affairs and Administrative, Woloska 137, 02-507 Warsaw, Poland.
  7. Faculty of Medicine, Lazarski University, Swieradowska 43, 02-662 Warsaw, Poland.

PMID: 34885203 DOI: 10.3390/cancers13236095

Abstract

OBJECTIVE: The aim of the study was to verify two hypotheses. The first concerned the possibility of diagnostic dermoscopic differentiation between cutaneous melanomas of the histopathological category in situ (pTis) and thin melanomas (pT1a) in terms of their diameter. The second assessed the diagnostic feasibility of two dermoscopic algorithms aiming to detect ≤ 5.0 mm-sized melanomas histopathologically confirmed as pTis and pT1a.

METHODS: Dermoscopic images of consecutive cases of histopathologically confirmed melanomas were evaluated by three independent investigators for the presence of the predefined criteria. The melanomas were subdivided according to their diameter into small melanomas, so-called micromelanomas (microM)-sized ≤ 5.0 mm and >5.0 mm, according to published definitions of small melanocytic lesions. The Triage Amalgamated Dermoscopic Algorithm (TADA) and the revisited 7-point checklist of dermoscopy (7-point) algorithm were chosen for the diagnostic feasibility. Odds ratios and corresponding 95% confidence limits (CL) were calculated using the logistic regression adjusted for age for the melanoma-specific dermoscopic structures, the dermoscopic patterns and the diagnostic feasibility of the 7-point checklist and TADA algorithms. The

RESULTS: In total, 106 patients with 109 melanomas, 50 sized ≤ 5.0 mm and 59 exceeding the diameter of 5.0 mm, were retrospectively analyzed. The prevalent general pattern of microM was the spitzoid one (48% vs. 11.86%,

CONCLUSION: In the dermoscopy, 40% of micromelanomas histopathologically staged as pTis and pT1a did not reveal melanoma-specific patterns. Among the general melanocytic patterns, the spitzoid one was the most frequently found in melanomas sized ≤ 5.0 mm. The 7-point checklist and TADA dermoscopic algorithms were helpful in the identification of the majority of melanomas sized ≤ 5.0 mm.

Keywords: 7-point checklist of dermoscopy; Triage Amalgamated Dermoscopic Algorithm; dermoscopy; diagnostic algorithm; micromelanoma; secondary melanoma prevention; small-sized melanoma

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