Complex dermoscopic pattern: a potential risk marker for melanoma.

Overview

BACKGROUND: Dysplastic naevi have repeatedly been shown to be an independent risk factor for melanoma; however, risk estimates vary. Dermoscopy has allowed for more elaborate classification of naevi based on global patterns. OBJECTIVES: To assess dermoscopic images of naevi from patients with melanoma and controls to explore dermoscopic patterns that are associated with melanoma risk. METHODS: Dermoscopic images of naevi from the backs of 20 patients with melanoma and 20 age- and sex-matched controls were reviewed for dermoscopic patterns and structures. An unblinded review of 187 naevi of patients and 150 naevi of controls was completed. Complex global dermoscopic pattern was defined in naevi presenting both network and globules, with or without structureless areas. RESULTS: Complex global dermoscopic pattern was observed more frequently in melanoma patients than controls (odds ratio, OR 2.9, P = 0.003). As for specific dermoscopic structures, presence of globules was observed more frequently in patients than controls (OR 2.3, P = 0.0001), whereas presence of dots was inversely associated with case status (OR 0.5, P = 0.002). CONCLUSIONS: These pilot data suggest that dermoscopic pattern may serve as a more robust and specific marker of melanoma risk than clinical naevus phenotype.