Clinical and dermoscopic characterization of pediatric and childhood melanomas. Multicenter study of 52 cases

Publication date: Available online 9 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Cristina Carrera, Alon Scope, Stephen W. Dusza, Giuseppe Argenziano, Gianluca Nazzaro, Alice Phan, Isabelle Tromme, Pietro Rubegni, Josep Malvehy, Susana Puig, Ashfaq A. Marghoob
BackgroundKnowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse and this may in part contribute to delay in detection and thicker tumors.Objectiveto analyze the clinical-dermoscopic characteristics of PM.Methodsretrospective study of 52 melanomas diagnosed before age of 20.ResultsBased on clinical, dermoscopic and histopathological characteristics, PM can be classified as Spitzoid and Non-Spitzoid Non-Spitzoid (37, 72.3%) melanomas presented at a mean age of 16.3 (8-20) and were associated with a high-risk phenotype and a preexisting nevus (62.2%). Spitzoid melanomas (15, 27.7%) were diagnosed at a mean age of 12.5 (2-19) and were mostly de novo lesions (73.3%) located on the limbs (73.3%). While less than 25% of PM fulfilled the modified clinical ABCD criteria, 40% of spitzoid melanomas did. Non-Spitzoid tended to be multicomponent (58.3%) or nevus-like patterns (25%). Dermoscopic melanoma criteria were found in all cases. Spitzoid melanomas revealed atypical vascular patterns with shiny-white lines (46.2%) or atypical pigmented spitzoid pattern (30.8%). There was good correlation between Spitzoid subtype histopathologically and dermoscopically (kappa 0.66).LimitationsRetrospective study without re-review of pathology.ConclusionDermoscopy in addition to conventional and modified clinical ABCD criteria helps in detecting PM. Dermoscopy assists in differentiating Spitzoid from non-Spitzoid melanomas.