Pigmented nodular melanoma: The predictive value of dermoscopic features using multivariate analysis

Background Nodular melanoma (NM), representing 10-30% of all melanomas, plays a major role in global mortality related to melanoma. Nonetheless, the literature on dermoscopy of NM is scanty. Objectives To assess odds ratios (ORs) to quantify dermoscopic features of pigmented NM vs. pigmented superficial spreading melanoma (SSM), and pigmented nodular nonmelanocytic and benign melanocytic lesions. Methods To assess the presence or absence of global patterns and dermoscopic criteria, digitized images of 457 pigmented skin lesions from patients with a histopathological diagnosis of NM (n = 75), SSM (n = 93), and nodular nonmelanocytic and benign melanocytic lesions (n = 289; namely, 39 basal cell carcinomas, 85 seborrhoeic keratoses, 81 blue naevi, and 84 compound/dermal naevi) were retrospectively collected and blindly evaluated by three observers. Results Multivariate analysis showed that ulceration (OR 4\ub707), homogeneous disorganized pattern (OR 10\ub776), and homogeneous blue pigmented structureless areas (OR 2\ub737) were significantly independent prognostic factors for NM vs. SSM. Multivariate analysis of dermoscopic features of NM vs. nonmelanocytic and benign melanocytic lesions showed that the positive correlating features leading to a significantly increased risk of NM were asymmetric pigmentation (OR 6\ub770), blue-black pigmented areas (OR 7\ub715), homogeneous disorganized pattern (OR 9\ub762), a combination of polymorphous vessels and milky-red globules/areas (OR 23\ub765), and polymorphous vessels combined with homogeneous red areas (OR 33\ub788). Conclusions Dermoscopy may be helpful in improving the recognition of pigmented NM by revealing asymmetric pigmentation, blue-black pigmented areas, homogeneous disorganized pattern and abnormal vascular structures, including polymorphous vessels, milky-red globules/areas and homogeneous red areas. What's already known about this topic? Nodular melanoma (NM) often exhibits features associated with deep tumour extension and less commonly displays the classic dermoscopic features of superficial spreading melanoma (SSM). What does this study add? The study identifies dermoscopic features that are significantly associated with pigmented NM compared with pigmented SSM and nonmelanoma nodular lesions. This study validates, with a multivariate analysis, the dermoscopic features leading to a significantly increased likelihood of a diagnosis of pigmented NM

Dermoscopic diagnosis of amelanotic/hypomelanotic melanoma

20N/Apartially_openopenPizzichetta MA; Kittler H; Stanganelli I; Ghigliotti G; Corradin MT; Rubegni P; Cavicchini S; De Giorgi V; Bono R; Alaibac M; Astorino S; Ayala F; Quaglino P; Pellacani G; Argenziano G; Guardoli D; Specchio F; Serraino D; Talamini R; Italian Melanoma Intergroup (IMI)Pizzichetta, Ma; Kittler, H; Stanganelli, I; Ghigliotti, G; Corradin, Mt; Rubegni, P; Cavicchini, S; De Giorgi, V; Bono, R; Alaibac, M; Astorino, S; Ayala, F; Quaglino, P; Pellacani, G; Argenziano, G; Guardoli, D; Specchio, F; Serraino, D; Talamini, R; Italian Melanoma Intergroup, (IMI

Healthcare and safety of patients with melanoma during the COVID-19 Pandemic in Italy

14"-"nonemixedCaini, S; Brusasco, M; Niero, G; De Giorgi, V; Lombardo, M; Massone, C; Medri, M; Palmieri, G; Pizzichetta, M A; Quaglino, P; Satta, R; Feliciani, C; Gandini, S; Stanganelli, ICaini, S; Brusasco, M; Niero, G; De Giorgi, V; Lombardo, M; Massone, C; Medri, M; Palmieri, G; Pizzichetta, M A; Quaglino, P; Satta, R; Feliciani, C; Gandini, S; Stanganelli,

Clinical genetic testing for familial melanoma in Italy: a cooperative study

BACKGROUND: The Italian Society of Human Genetics' (SIGU) recommendations on genetic counseling and testing for hereditary melanoma state that clinical genetic testing can be offered to Italian melanoma families with at least two affected members. OBJECTIVE: In the framework of a cooperative study, we sought to establish the frequency of cyclin-dependent kinase inhibitor 2A mutations in melanoma families that underwent clinical genetic counseling and testing in accordance with the SIGU recommendations at 9 centers in different Italian regions. METHODS: Cyclin-dependent kinase inhibitor 2A testing was conducted by direct sequencing and multiplex ligation-dependent probe amplification analysis in melanoma families with at least two affected members. RESULTS: A total of 33% (68/204) of the families harbored cyclin-dependent kinase inhibitor 2A mutations. In the 145 families with two affected members the mutation frequency was 25%. Three novel mutations, L94P, A86T, and c.407dupG, were identified among the cases and not in 200 controls. LIMITATIONS: We were unable to perform separate analyses for individual centers, as in some cases the number of families was too small. CONCLUSIONS: The availability of clinical genetic testing for melanoma to families with just two affected members in the same branch is justified in Italy in terms of the likelihood of identifying a mutation

Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society

Background: Thin nodular melanoma (NM) often lacks conspicuous melanoma-specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour. Objective: To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours. Methods: Retrospective, morphological case–control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed. Results: Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non-melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4-fold), white shiny streaks (2.9-fold) and irregular blue structureless area (2.4-fold) were predictors for thinner NM compared to non-melanoma nodular tumours. Overall, irregular blue structureless area (3.4-fold), dotted vessels (4.6-fold) and serpentine vessels (1.9-fold) were predictors of all NM compared to non-melanoma nodular lesions. Limitations: Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community. Conclusions: Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non-melanoma nodular tumours. © 2020 European Academy of Dermatology and Venereolog