Clinical and dermoscopic characteristics of desmoplastic melanomas Journal Article

Authors: Jaimes, N.; Chen, L.; Dusza, S. W.; Carrera, C.; Puig, S.; Thomas, L.; Kelly, J. W.; Dang, L.; Zalaudek, I.; Braun, R. P.; Menzies, S. W.; Busam, K. J.; Marghoob, A. A.
Article Title: Clinical and dermoscopic characteristics of desmoplastic melanomas
Abstract: 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 37DMcases 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. ©2013 American Medical Association. All rights reserved.
Keywords: adult; clinical article; controlled study; human tissue; aged; genetic trait; clinical feature; histopathology; anamnesis; disease association; malignant lentigo; steroid; retrospective study; morphology; desmoplastic melanoma; crystal structure; papule; symptomatology; laser surgery; skin nodule; cryotherapy; skin color
Journal Title: JAMA Dermatology
Volume: 149
Issue: 4
ISSN: 2168-6068
Publisher: American Medical Association  
Date Published: 2013-01-16
Start Page: 413
End Page: 421
Language: English
DOI: 10.1001/jamadermatol.2013.2248
PROVIDER: scopus
PUBMED: 23325288
Notes: --- - "Export Date: 3 June 2013" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Stephen Dusza
    255 Dusza
  2. Ashfaq A Marghoob
    507 Marghoob
  3. Klaus J Busam
    661 Busam