Dermatoscopy turns histopathologist's attention to the suspicious area in melanocytic lesions

Background: Histopathologically, the diagnosis of nevus-associated melanoma or melanoma close to a common nevus can be missed if the specimen is cut i n a nonrepresentative area or if the section shows only the associated comm on nevus. Objective: To find out whether dermatoscopy of suspicious areas within a ne vus can improve the histological diagnosis of malignant melanocytic lesions of the skin. Materials: The study was based on dermatoscopic images of more than 2060 be nign and 115 malignant pigmented lesions and a collection of corresponding histopathologic slides. Methods: The dermatoscopic images and the corresponding histopathologic dia gnoses were compared. in case of differences, the histopathologic findings were reevaluated and compared with the dermatoscopic findings. Results: Three cases were identified in which melanoma could have been hist opathologically missed as a result of improper sectioning. After the dermat oscopic findings were evaluated, the specimens were reembedded and further sections were obtained. Finally, nevus-associated melanoma or melanoma clos e to a common nevus was diagnosed. Conclusions: Specific dermatoscopic patterns of malignancy can be found in highly suspicious areas, eg, broadened networks, radial streaming, pseudopo ds, or dots located at the periphery. The dermatoscopic-histopathologic cor relation can improve the diagnosis of melanoma. Therefore, the clinician sh ould point to the most suspicious area with a drawing or image, and the sus pected diagnosis of melanoma and the history of the lesion should be also m entioned.