The diagnostic value and histologic correlate of distinct patterns of shiny white streaks for the diagnosis of melanoma: a retrospective, case-control study

Background Shiny white streaks (SWSs) are best visualized with polarized dermoscopy and correlate with dermal fibroplasia histopathologically. SWSs have been described at higher frequencies in melanomas than in benign nevi. Objective We assessed the diagnostic value of different patterns of SWSs and their histologic correlate in melanocytic lesions. Methods Polarized dermoscopic images of 1507 histopathologically diagnosed melanocytic neoplasms were analyzed for presence and pattern of SWSs. Histology was also reviewed for correlation. Results Among 1507 melanocytic neoplasms, SWSs were observed in 31 of 144 melanomas (22%) and 22 of 1363 benign neoplasms (1.6%) ( P P  = .009), and SWSs correlated with greater Breslow depth among melanomas ( P  = .007). Limitations This study was retrospective. Conclusion Polarized dermoscopy is a valuable diagnostic tool in the identification of SWSs, a feature that is highly specific for melanoma.