Dermoscopy and early melanoma [Dermatoskopija i rani melanom]

Ćurković, Danijela and Paštar, Zrinjka and Kostović, Krešimir (2015) Dermoscopy and early melanoma [Dermatoskopija i rani melanom]. Collegium Antropologicum, 39 (3). pp. 791-795. ISSN 0350-6134

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Abstract

The lack of effective therapies for patients with advanced melanoma establishes an early recognition as the aim of clinical and dermoscopic examination, which is the most important factor for improving patient survival and decreases the treatment and management costs. Melanoma in situ is the earliest stage of melanoma. The features of early melanomas, especially in those lesions smaller than 3mm, can be very subtle clinically, dermoscopically and pathohistologically, and it is often impossible to discriminate between a melanoma and nevus. Clinically, de novo melanomas are small brown to black macula with an irregular outline. In melanomas developing in a nevus, there is an asymmetry of the lesion with marked change in color and/or shape of the pre-existing nevus. Dermoscopically, early stages of melanoma show the same global features as thicker melanomas, but in a more subtle way. Asymmetry is the most important parameter; multiple colors are rare. Significant local melanoma-specific criteria, especially when present at the periphery, are irregular pigment network, irregular streaks, and irregular dots/globules, while blue-white structures are rarely found.

Abstract in Croatian

DERMATOSKOPIJA I RANI MELANOM ----- Obzirom na nedostatak učinkovite terapije za uznapredovali melanom, rano prepoznavanje melanoma je osnovni cilj kliničkog i dermoskopskog pregleda, jer je to najvažniji čimbenik za unapređenje preživljavanja pacijenata s melanomom. Melanom in situ je najranija faza melanoma. Značajke ranog melanoma, posebno u promjenama manjima od 3 mm, mogu biti vrlo suptilne klinički, dermoskopski i patohistološki, a često je nemoguće izdiferencirati melanom od nevusa. Klinički, de novo melanomi su male smeđe do crne makule s nepravilnim rubovima. U melanomima koji se razvijaju iz nevusa postoji asimetrija promjene sa značajnom promjenom u boji i/ili obliku već postojećeg nevusa. Dermoskopski, rane faze melanoma pokazuju iste, ali diskretnije globalne/osnovne karkateristike kao deblji/uznapredovali melanomi. Asimetrija je najvažniji parametar; više boja je rijetkost. Značajni lokalno-specifični kriteriji melanoma, posebno kada su prisutni na periferiji, su nepravilna pigmentna mreža, nepravilni pigmentni izdanci i nepravilne točkaste strukture, a plavo-bijele strukture se rijetko nalaze.

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