The following is a summary of “Melanoma clinicopathological groups characterized and compared with dermoscopy and reflectance confocal microscopy,” published in the February 2024 issue of Dermatology by Faldetta, et al.

The correlation between dermoscopic and reflectance confocal microscopy (RCM) features of melanoma within distinct morphologic groups has yet to be thoroughly explored. For a retrospective analysis, researchers sought to describe and compare dermoscopic and RCM features of cutaneous melanomas with histopathological confirmation.

Consecutive melanomas evaluated with RCM from 2015 to 2019 were included in this single-center study. Lesions were clinically classified into typical, nevus-like, amelanotic/nonmelanoma skin cancer (NMSC)-like, seborrheic keratosis (SK)-like, and lentigo/lentigo maligna (LM)-like. Dermoscopic and RCM features, common in facial and nonfacial melanomas, were recorded. Clusters were compared with typical lesions using multivariate logistic regression.

Among 583 melanoma lesions, significant differences between clusters were observed compared to typical lesions. Amelanotic/NMSC-like lesions displayed three common dermoscopic patterns (>50% of lesions): atypical network, atypical vascular pattern + regression structures. Nevus-like and SK-like lesions and lentigo/LM-like lesions consistently displayed two patterns: atypical network + regression structures and non-evident follicles + heavy pigmentation intensity. RCM results were more uniform, with almost all lesions consistent with a melanoma diagnosis.

RCM showed promise in enhancing the ability to consistently and accurately diagnose melanoma independently of clinical and dermoscopic features.

Reference: jaad.org/article/S0190-9622(23)03014-1/fulltext