“Nodular melanoma: five consecutive cases in a general practice with polarized and non-polarized dermatoscopy and dermatopathology” is a case series that explores the use of dermatoscopy and dermatopathology in diagnosing nodular melanoma. Nodular melanoma is a hazardous form of skin cancer that can proliferate and be challenging to diagnose. The authors present five cases of nodular melanoma diagnosed in general practice using both polarized and non-polarized dermatoscopy and dermatopathology.
The authors discuss the importance of early detection and diagnosis of nodular melanoma, as it can potentially metastasize and become life-threatening. They suggest that using both polarized and non-polarized dermatoscopy can aid in the early detection of nodular melanoma by allowing for a more accurate examination of skin lesions. Additionally, the authors emphasize the importance of dermatopathology in confirming the diagnosis and determining the best course of treatment. Overall, the paper highlights the value of using multiple diagnostic tools in diagnosing nodular melanoma and underscores the importance of regular skin checks and screenings for early skin cancer detection.
The incidence of nodular melanoma (NM) has been consistently described as at least 10–15% of total melanomas for over 15 years despite advances in diagnostic algorithms and medical technology. NMs are strongly correlated with faster growth rates and poorer prognosis, thus providing clinicians with a challenge for early recognition.
To evaluate diagnostic clues of consecutive histopathologically proven NMs in one general practice with particular emphasis on dermatoscopic characteristics and compare this to the published literature.
A retrospective observational study of five consecutive histologically proven NM was performed, from 212 consecutive melanomas from general practice in Brisbane, Queensland, Australia. Dermatoscopic images, both polarized and non-polarized, appear to be a unique resource, and dermatopathologic slides were available for all lesions.
All of the NMs in this series were pigmented, although one was hypomelanotic. Two of them were symmetrical. The most highly sensitive clues to NM were grey or blue structures and polarizing-specific white lines.
Due to the small number of NMs in this report, no statistical significance can be attributed to the observational findings.
This small series supports what is already known: that a significant proportion of NMs may be dermatoscopically symmetrical but known clues to melanoma are frequently present. Nodular lesions, pigmented or non-pigmented, should be excised to exclude NM if there is any clue to malignancy, regardless of symmetry, unless a confident specific benign diagnosis can be made.
Rosendahl C, Hishon M, Cameron A, Barksdale S, Weedon D, Kittler H. Nodular melanoma: five consecutive cases in a general practice with polarized and non-polarized dermatoscopy and dermatopathology. Dermatol Pract Concept. 2014 Apr 30;4(2):69-75. doi: 10.5826/dpc.0402a15. PMID: 24855580; PMCID: PMC4029260.