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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
REVIEWS CUTANEOUS MALIGNANCY UPDATE: MELANOMA IN 2007
Giornale Italiano di Dermatologia e Venereologia 2007 April;142(2):99-108
Dermoscopic patterns of melanoma. The Good, The Bad, and The Gray
Wang S. Q., Scope A., Marghoob A. A.
Dermatology Service Memorial Sloan-Kettering Cancer Center, New York, NY USA
Dermoscopy is an effective tool for differentiating melanoma from benign melanocytic nevi. A number of score-based and gestalt-based algorithms are available to help accomplish the task of correctly identifying melanoma while at the same time correctly classifying most clinically atypical nevi as benign lesions, which need not be biopsied. We describe a simple and easy approach to learn pattern analysis that can be utilized to help clinicians differentiate melanoma from benign nevi. Most melanocytic nevi manifest one of nine well defined benign patterns. These benign patterns are symmetric, uniform and organized and include the: (1) diffuse reticular network, (2) patchy reticular network, (3) peripheral reticular network with central hypopigmentation, (4) peripheral reticular network with central hyperpigmentation, (5) peripheral reticular network with central globules, (6) globular, (7) peripheral globules with central reticular network or starburst, (8) homogeneous, and the (9) symmetric multi-component pattern. Melanoma on the other hand tend to reveal a pattern that deviates from the above mentioned benign patterns by manifesting asymmetry and an architecture that is disordered. Most melanomas will also contain at least one of the following eight local features: atypical network, streaks, atypical dots or globules, negative pigment network, off center blotch, blue-white veil, and atypical vascular structures. Thus, by simply knowing a set of nine benign nevus pattern and eight local melanoma specific features one can start implementing dermoscopy into the daily routine practice.