Recurrent melanocytic nevi and melanomas in dermoscopy: results of a multicenter study of the International Dermoscopy Society.
IMPORTANCE Differentiating recurrent nevi from recurrent melanoma is challenging. OBJECTIVE To determine dermoscopic features to differentiate recurrent nevi from melanomas. DESIGN, SETTING, AND PARTICIPANTS Retrospective observational study of 15 pigmented lesion clinics from 12 countries; 98 recurrent nevi (61.3%) and 62 recurrent melanomas (38.8%) were collected from January to December 2011. MAIN OUTCOMES AND MEASURES Scoring the dermoscopic features, patterns, and colors in correlation with the histopathologic findings. RESULTS In univariate analysis, radial lines, symmetry, and centrifugal growth pattern were significantly more common dermoscopically in recurrent nevi; in contrast, circles, especially if on the head and neck area, eccentric hyperpigmentation at the periphery, a chaotic and noncontinuous growth pattern, and pigmentation beyond the scar's edge were significantly more common in recurrent melanomas. Patients with recurrent melanomas were significantly older than patients with recurrent nevi (mean [SD] age, 63.1 [17.5] years vs 30.2 [12.4] years) (P<.001), and there was a significantly longer time interval between the first procedure and the second treatment (median time interval, 25 vs 8 months) (P<.001). In a multivariate analysis, pigmentation beyond the scar's edge (P=.002), age (P<.001), and anatomic site (P=.002) were significantly and independently associated with the diagnosis of recurrent melanoma in dermoscopy. CONCLUSIONS AND RELEVANCE Dermoscopically, pigmentation beyond the scar's edge is the strongest clue for melanoma. Dermoscopy is helpful in evaluating recurrent lesions, but final interpretation requires taking into account the patient age, anatomic site, time to recurrence, growth pattern, and, if available, the histopathologic findings of the first excision.
Public, Private, and Teaching Practice of Dermatology, Konstanz, Germany.
Andreas
A
Blum
Medical University of Graz, Graz, Austria.
Rainer
R
Hofmann-Wellenhof
Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York.
Ashfaq A
AA
Marghoob
Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy.
Giuseppe
G
Argenziano
Medical Research Institute "A. Lanari," University of Buenos Aires, Buenos Aires, Argentina.
Horacio
H
Cabo
Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER) Enfermedades rara, Barcelona, Spain.
Cristina
C
Carrera
Skin Cancer and Dermatology Center, Hospital AC Camargo São Paulo, Brazil.
Bianca
B
Costa Soares de Sá
Public and Private Practice of Dermatology, Lille, France.
Eric
E
Ehrsam
Departamento de Introducción a la Clínica, Facultad de Medicina, UANL, Monterrey, México.
Roger
R
González
Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER) Enfermedades rara, Barcelona, Spain.
Josep
J
Malvehy
Department of Dermatology, University of Brescia, Brescia, Italy.
Ausilia Maria
AM
Manganoni
Melanoma Unit, Department of Dermatology, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigacion Biomedica en red de enfermedades raras (CIBERER) Enfermedades rara, Barcelona, Spain.
Susana
S
Puig
First Dermatological Clinic, Carol Davila University of Medicine and Pharmacy, Colentina Hospital, Bucharest, Romania.
Olga
O
Simionescu
Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Masaru
M
Tanaka
Department of Dermatology, Lyon 1 University Centre Hospitalier Lyon Sud, Pierre Bénite, France.
Luc
L
Thomas
Department of Dermatology, Centre du Cancer, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium.
Isabelle
I
Tromme
Medical University of Graz, Graz, Austria.
Iris
I
Zalaudek
Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Harald
H
Kittler
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D046169:Dermoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012880:Skin Pigmentation; D013997:Time Factors; D055815:Young Adult