Dermoscopic Patterns of Acral Melanocytic Nevi and Melanomas in a White Population in Central Italy

Abstract

Benign melanocytic lesions on acral sites, which are common in all populations, may be difficult to differentiate clinically from early acral melanoma.^1-3 For this reason, Saida et al⁴ recommended surgical excision of any acquired melanocytic lesion larger than 7 mm in diameter on the volar skin. Dermoscopy is a noninvasive technique that enables clinicians to differentiate nevi from melanomas in the early stage.^5-7 Specific dermoscopic patterns of nevi and melanomas located on the palms and soles were initially described in Japanese studies showing that dermoscopic examination can increase accuracy in the diagnosis of pigmented acral melanocytic skin lesions.^8-12 Acral melanoma was described as having a multicomponent dermoscopic pattern, characterized by the following features: parallel ridge pattern, irregular diffuse pigmentation, abrupt edges, serrated pattern, peripheral irregular dots and globules, and/or blue-white veil.^9-12 The presence of the parallel ridge pattern, in which pigmentation is seen on the ridges of the skin markings, was associated with acral melanoma in situ, and the presence of irregular diffuse pigmentation was considered highly suggestive of invasive acral melanoma.^9-12