Abstract
BackgroundThe latest AJCC classification has included the number of mitoses as a factor for upstaging thin melanomas. Meanwhile, while dermoscopy has often been used to predict melanoma thickness, its value in predicting number of mitoses remains unknown. ObjectiveOur aim is to evaluate the correlation between dermoscopic features and the presence of mitoses in a consecutive cohort of thin melanomas. MethodsA case control study has been performed to identify specific dermoscopic parameters that could differentiate thin melanomas with 1 or more mitoses per mm2 from those without mitoses. ResultsOf 177 melanomas equal to or thinner than 1mm, 131 (74%) lesions had no mitoses and 46 (36%) lesions had at least 1 mitosis×mm2. Dermoscopic features associated with the presence of 1 or more mitoses were the following: peripheral streaks (OR 4.11; 95% CI 1.94–8.71) and black colour (OR 4.70; 95% CI; 2.28–9.68). In contrast, atypical pigment network (OR (0.30; 95% CI 0.15–0.61)) and brown colour (OR 0.36; 95% CI 0.18–0.75) were associated to melanomas without mitoses. The same variables were also associated to the increasing number of mitoses at linear regression. ConclusionBlack colour and peripheral streaks can predict the presence of mitoses in thin melanoma, while atypical pigment network and brown colour are associated to thin melanoma without mitoses.
Highlights
Dermoscopy is a pivotal imaging tool that is currently regarded as gold standard for the preoperative diagnosis of melanoma [1]
Another study assessing the value of dermoscopy to predict sentinel lymph node (SLN) positivity [3] demonstrated that the presence of ulceration and blotches and the absence of pigment network were more likely associated to SLN positivity
The purpose of the current study is to evaluate the correlation between dermoscopic features and the presence of mitoses in a consecutive cohort of thin melanomas
Summary
Dermoscopy is a pivotal imaging tool that is currently regarded as gold standard for the preoperative diagnosis of melanoma [1]. No studies have been performed to evaluate a possible correlation between certain morphologic features of thin melanoma and the presence of mitoses as measured on histopathology. While dermoscopy has often been used to predict melanoma thickness, its value in predicting number of mitoses remains unknown. Dermoscopic features associated with the presence of 1 or more mitoses were the following: peripheral streaks (OR 4.11; 95% CI 1.94–8.71) and black colour (OR 4.70; 95% CI; 2.28–9.68). Atypical pigment network (OR (0.30; 95% CI 0.15–0.61)) and brown colour (OR 0.36; 95% CI 0.18–0.75) were associated to melanomas without mitoses. Conclusion: Black colour and peripheral streaks can predict the presence of mitoses in thin melanoma, while atypical pigment network and brown colour are associated to thin melanoma without mitoses
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