Document Detail

Clinical and dermoscopic characteristics of desmoplastic melanomas.
MedLine Citation:
PMID:  23325288     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe and analyze the clinical and dermoscopic characteristics of desmoplastic melanoma (DM) as a function of pathologic subtype and phenotypic traits.
DESIGN: Retrospective case series.
SETTING: Eight high-risk dermatology clinics.
PATIENTS: Patients with DM confirmed by histopathologic analysis whose records included a high-quality dermoscopic image.
MAIN OUTCOME MEASURES: Clinical, dermoscopic, and histopathologic features of DM.
RESULTS: A total of 37 DM cases were identified. The majority of patients had fair skin, few nevi, and no history of melanoma. Lentigo maligna was the most frequent subtype of melanoma associated with DM. The most frequent clinical presentation of DM was a palpable and/or indurated lesion located on sun-exposed skin. Forty-three percent of cases were classified as pure DM, and 57% as mixed DM. Pure DM lesions were thicker than mixed DM lesions (4.10 vs 2.83 mm) (P = .22) and were less likely to have an associated epidermal non-DM component (63% vs 100%) (P = .004). Dermoscopically, DMs had at least 1 melanoma-specific structure, the most frequent being atypical vascular structures. Peppering was more frequently seen in pure DM (44% in pure DM vs 24% in mixed DM) (P = .29). In contrast, crystalline structures, polymorphous vessels, and vascular blush were more commonly seen in mixed DM.
CONCLUSIONS: Though DM can be difficult to diagnose based on clinical morphologic characteristics alone, dermoscopy has proved to be a useful aid during the evaluation of clinically equivocal lesions or those lesions with a benign appearance. The most common dermoscopic clues observed in DMs included atypical vascular structures, peppering, and occasionally other melanoma-specific structures.
Natalia Jaimes; Lucy Chen; Stephen W Dusza; Cristina Carrera; Susana Puig; Luc Thomas; John W Kelly; Lucy Dang; Iris Zalaudek; Ralph P Braun; Scott W Menzies; Klaus J Busam; Ashfaq A Marghoob
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  JAMA dermatology     Volume:  149     ISSN:  2168-6084     ISO Abbreviation:  JAMA Dermatol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-06-11     Completed Date:  2013-07-30     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  101589530     Medline TA:  JAMA Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  413-21     Citation Subset:  AIM; IM    
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MeSH Terms
Age Distribution
Aged, 80 and over
Dermoscopy / methods*
Diagnosis, Differential
Melanoma / epidemiology,  pathology*
Middle Aged
Nevus, Spindle Cell / epidemiology,  pathology*
Retrospective Studies
Sex Distribution
Skin Neoplasms / epidemiology,  pathology*
World Health

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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