Dermoscopic Predictors of Tumor Thickness in Cutaneous Melanoma: A Retrospective Analysis of 245 Melanomas

Introduction: The literature regarding the association of dermoscopic structures with Breslow thickness in melanoma is scarce, limited to small case series, and mostly outdated. Objective: This study determined the dermoscopic patterns, colors and structures that are associatedwith melanoma in situ, thin melanomas (<0.8 mm) and thick melanomas potentially requiring sentinellymph node biopsy according to current guidelines (≥0.8 mm). Methods: A retrospective evaluation of 245 dermoscopic images of primary cutaneous melanomalocated on the trunk or limbs was performed by consensus of 2 dermoscopists. Results: Red-pink, blue-gray and white color, blue-white veil, shiny white streaks, irregular vessels,blue-black pigmentation, milky red areas, pseudolacunae, ulceration and rainbow pattern were associated with thickness ≥0.8 mm, whereas atypical pigmented network, regression and hypopigmentedareas were significantly associated with early melanomas. Limitations: This is a retrospective study performed in a single institution. Melanomas of specialsites were excluded from our evaluation. Dermoscopy is based on subjective evaluations that dependlargely on the observers’ experience. Conclusions: The identification of certain dermoscopic structures and colors might help in the discrimination between thin and thick melanomas.