Analysis of globule types in malignant melanoma.
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.
Xu
Jin
J
Stoecker and Associates, 1702 E 10th St, Rolla, MO 65401-4600, USA.
Gupta
Kapil
K
Stoecker
William V
WV
Krishnamurthy
Yamini
Y
Rabinovitz
Harold S
HS
Bangert
Austin
A
Calcara
David
D
Oliviero
Margaret
M
Malters
Joseph M
JM
Drugge
Rhett
R
Stanley
R Joe
RJ
Moss
Randy H
RH
Celebi
M Emre
ME
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*