Dermoscopic criteria for melanoma in situ are similar to those for early invasive melanoma

BACKGROUND. Dermoscopy is a noninvasive technique that increases the diagno stic accuracy of pigmented skin lesions, particularly improving the diagnos is of patients with cutaneous melanoma in situ (CMIS) and early invasive me lanoma. To establish reliable and reproducible dermoscopic criteria for the diagnosis of CMIS, the authors conducted a retrospective clinical study of 37 patients with CMIS and 53 patients with invasive cutaneous melanomas (I CM). METHODS. The 37 patients with CMIS were divided into three groups: those wi th CMIS lesions measuring less than or equal to 5 mm in greatest dimension (8 patients), those with CMIS lesions measuring from > 5 mm to less than or equal to 10 mm in greatest dimension (20 patients), and those with CMIS le sions measuring > 10 mm in greatest dimension (9 patients). The 53 patients with ICM were divided into two groups according to Breslow index: those wi th ICM lesions measuring less than or equal to 0.75 mm in tumor thickness ( 19 patients) and those with ICM lesions measuring > 0.75 mm in tumor thickn ess (34 patients). Lesions were examined with a dermatoscope and were photo graphed at a magnification of x10. Dermoscopic criteria were evaluated from examination of the photomicrographs. RESULTS. Blue-whitish veil, gray-blue areas, black dots, and irregular exte nsions and branched streaks were the most relevant dermoscopic criteria for CMIS and were present in 78%, 76%, 73%, and 62% of lesions, respectively. Brown globules, irregular pigment network, pseudopods, and depigmentation w ere present in 57%, 54%, 54%, and 51% of CMIS lesions, respectively. White scar-like areas and linear and/or dotted vascular patterns, two criteria th at are associated frequently with ICM, were not found in our patients with CMIS. No clinically significant differences were observed between the three groups of CMIS patients. CONCLUSIONS, Dermoscopic criteria for CMIS were similar to those for ICM, a lthough white scar-like areas and linear and/or dotted vascular patterns we re observed only in patients with ICM. Dermoscopic criteria appeared to be independent of CMIS lesions size. (C) 2001 American Cancer Society.