title: Analysis of globule types in malignant melanoma.
abstract: OBJECTIVE
  To identify and analyze subtypes of globules based on size, shape, network connectedness, pigmentation, and distribution to determine which globule types and globule distributions are most frequently associated with a diagnosis of malignant melanoma.
  
  
  METHODS
  Retrospective case series of dermoscopy images with globules.
  
  
  METHODS
  Private dermatology practices.
  
  
  METHODS
  Patients in dermatology practices. Intervention Observation only. Main Outcome Measure Association of globule types with malignant melanoma.
  
  
  RESULTS
  The presence of large globules (odds ratio [OR], 5.25) and globules varying in size (4.72) or shape (5.37) had the highest ORs for malignant melanoma among all globule types and combinations studied. Classical globules (dark, discrete, convex, and 0.10-0.20 mm) had a higher risk (OR, 4.20) than irregularly shaped globules (dark, discrete, and not generally convex) (2.89). Globules connected to other structures were not significant in the diagnosis of malignant melanoma. Of the different configurations studied, asymmetric clusters have the highest risk (OR, 3.02).
  
  
  CONCLUSIONS
  The presence of globules of varying size or shape seems to be more associated with a diagnosis of malignant melanoma than any other globule type or distribution in this study. Large globules are of particular importance in the diagnosis of malignant melanoma.
authors.affiliation: Stoecker and Associates, 1702 E 10th St, Rolla, MO 65401-4600, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Xu
authors.forename: Kapil
authors.initials: K
authors.lastname: Gupta
authors.forename: William V
authors.initials: WV
authors.lastname: Stoecker
authors.forename: Yamini
authors.initials: Y
authors.lastname: Krishnamurthy
authors.forename: Harold S
authors.initials: HS
authors.lastname: Rabinovitz
authors.forename: Austin
authors.initials: A
authors.lastname: Bangert
authors.forename: David
authors.initials: D
authors.lastname: Calcara
authors.forename: Margaret
authors.initials: M
authors.lastname: Oliviero
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Malters
authors.forename: Rhett
authors.initials: R
authors.lastname: Drugge
authors.forename: R Joe
authors.initials: RJ
authors.lastname: Stanley
authors.forename: Randy H
authors.initials: RH
authors.lastname: Moss
authors.forename: M Emre
authors.initials: ME
authors.lastname: Celebi
mesh_terms: D015331:Cohort Studies; D046169:Dermoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000145:classification / Q000473:pathology*; D009508:Nevus, Pigmented / Q000145:classification / Q000473:pathology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000145:classification / Q000473:pathology*