Clinical and Dermatoscopic Characteristics of Melanoma in situ - Institutional Experience

Authors

  • Andrej Petrov Department of Dermatology, Acibademsistina Clinic Hospital, Skopje, North Macedonia; Department of Dermatology, Faculty of Medical Sciences, UGD, Shtip, North Macedonia https://orcid.org/0000-0002-6859-7021
  • Djengis Jashar Department of Pathology, Acibademsistina Clinic Hospital, Skopje, North Macedonia; Department of Pathology, Faculty of Medical Sciences, UGD, Shtip, North Macedonia
  • Deva Petrova Department of Oncology and Radiotherapy, Acibademsistina Clinic Hospital, Skopje, North Macedonia; Department of Oncology and Radiotherapy, Faculty of Medical Sciences, UGD, Shtip, North Macedonia

DOI:

https://doi.org/10.3889/oamjms.2024.11840

Keywords:

melanoma in situ, dermoscopy, hysto-pathology

Abstract

BACKGROUND: Melanoma in situ (MIS) is the very early stage of a skin tumor called melanoma. In recent decades, the incidence rate for melanoma has increased by 2.6%/year and MIS is the main diagnosis responsible for this increase. It is important to recognize MIS since in this phase (called the intraepidermal phase), cancer cells do not have the opportunity to spread anywhere in the body. The use of dermoscopy has contributed to the early diagnosis of melanoma. The most common dermoscopic features of melanoma are multiple structures and colors (multicomponent pattern), an atypical reticular pattern (with wide, irregular meshes), and an absence of distinguishing features (nonspecific pattern) associated with the presence of vascular structures. The clinical decision about the excision of the lesion should always be in correlation with the dermoscopic picture of the pigmented lesion. If dermoscopy is unclear and there is suspicion for MIS, surgical excision with a wide margin of more than 5 mm should be performed.

AIM: In this work, we are presenting four cases of diagnosis of MIS and their clinical, dermoscopic, and histopathological findings.

METHODS: In this work, we present four cases of diagnosis of MIS, their clinical, dermoscopic and histopathological findings.

RESULTS: The invasive melanoma cohort, compared with the MIS cohort, had an elevated risk for subsequent invasive melanoma in the first 10 years. However, the MIS cohort was more likely to develop subsequent MIS during the entire follow-up period than the invasive melanoma cohort. In our work, none of the four patients that we presented had relapsed during the first 2 years of follow-up, which is consistent with these results.

CONCLUSION: With the presentation of these cases, we want to stress and help clinicians that the main focus in dermoscopy assessment of MIS is on the asymmetry of the pigmented network and a two-color sign because many other marks of melanoma are missing.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Hollestein LM, van den Akker SA, Nijsten T, Karim-Kos HE, Coebergh JW, de Vries E. Trends of cutaneous melanoma in the Netherlands: Increasing incidence rates among all breslow thickness categories and rising mortality rates since 1989. Ann Oncol. 2012;23(2):524-30. https://doi.org/10.1093/annonc/ mdr128 PMid:21543630 DOI: https://doi.org/10.1093/annonc/mdr128

Michielin O, van Akkooi AC, Ascierto PA, Dummer R, Keilholz U. Cutaneous melanoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019;30(12):1884-901. https://doi.org/10.1093/annonc/mdz411 PMid:31566661 DOI: https://doi.org/10.1093/annonc/mdz411

Pehamberger H, Binder M, Knollmayer S, Wolff K. Immediate effects of a public education campaign on prognostic features of melanoma. J Am Acad Dermatol. 1993;29(1):106-9. https://doi.org/10.1016/s0190-9622(08)81812-9 PMid:8315067 DOI: https://doi.org/10.1016/S0190-9622(08)81812-9

Skudalski L, Waldman R, Kerr PE, Grant-Kels JM. Melanoma: How and when to consider clinical diagnostic technologies. J Am Acad Dermatol. 2022;86(3):503-12. https://doi.org/10.1016/j.jaad.2021.06.901 PMid:34915058 DOI: https://doi.org/10.1016/j.jaad.2021.06.901

Thompson JF, Haydu LE, Sanki A, Uren RF. Ultrasound assessment of lymph nodes in the management of early-stage melanoma. J Surg Oncol. 2011;104(4):354-60. https://doi.org/10.1002/jso.21963 PMid:21858829 DOI: https://doi.org/10.1002/jso.21963

Gershenwald JE, Scolyer RA, Hess KR, Sondak VK, Long GV, Ross MI, et al. Melanoma staging: Evidence-based changes in the American joint committee on cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67(6):472-92 https://doi.org/10.3322/caac.21409 PMid:29028110 DOI: https://doi.org/10.3322/caac.21409

Polesie S, Jergéus E, Gillstedt M, Ceder H, Dahlén Gyllencreutz J, Fougelberg J, et al. Can dermoscopy be used to predict if a melanoma is in situ or invasive. Dermatol Pract Concept. 2021;11(3):e2021079. https://doi.org/10.5826/dpc.1103a79 PMid:34123569 DOI: https://doi.org/10.5826/dpc.1103a79

Pomerantz H, Huang D, Weinstock MA. Risk of subsequent melanoma after melanoma in situ and invasive melanoma: A population-based study from 1973 to 2011. J Am Acad Dermatol. 2015;72(5):794-800. https://doi.org/10.1016/j.jaad.2015.02.006 PMid:25769192 DOI: https://doi.org/10.1016/j.jaad.2015.02.006

Ciudad-Blanco C, Avilés-Izquierdo.JA, Lázaro-Ochaita, P, Suárez-Fernández R. Dermoscopic findings for the early detection of melanoma: An analysis of 200 cases. Actas Dermosifiliogr. 2014;105(7):683-93. https://doi.org/10.1016/j.ad.2014.01.008 PMid:24704190 DOI: https://doi.org/10.1016/j.adengl.2014.07.015

Borsari S, Pampena R, Benati E, Bombonato C, Kyrgidis A, Moscarella E, et al. In vivo dermoscopic and confocal microscopy multistep algorithm to detect in situ melanomas. Br J Dermatol. 2018;179(1):163-72. https://doi.org/10.1111/bjd.16364 PMid:29355898 DOI: https://doi.org/10.1111/bjd.16364

Salerni G, Terán T, Puig S, Malvehy J, Zalaudek I, Argenziano G, et al. Meta-analysis of digital dermoscopy follow-up of melanocytic skin lesions: A study on behalf of the international dermoscopy society. J Eur Acad Dermatol Venereol. 2013;27(7):805-14. https://doi.org/10.1111/jdv.12032 PMid:23181611 DOI: https://doi.org/10.1111/jdv.12032

Wei EX, Qureshi AA, Han J, Li TY, Cho E, Lin JY, et al. Trends in the diagnosis and clinical features of melanoma in situ (MIS) in US men and women: A prospective, observational study. J Am Acad Dermatol. 2016;75(4):698-705. https://doi.org/10.1016/j.jaad.2016.05.011 PMid:27436155 DOI: https://doi.org/10.1016/j.jaad.2016.05.011

Downloads

Published

2024-03-15

How to Cite

1.
Petrov A, Jashar D, Petrova D. Clinical and Dermatoscopic Characteristics of Melanoma in situ - Institutional Experience. Open Access Maced J Med Sci [Internet]. 2024 Mar. 15 [cited 2024 May 1];12(1):128-35. Available from: https://oamjms.eu/index.php/mjms/article/view/11840