title: The pink rim sign: location of pink as an indicator of melanoma in dermoscopic images.
abstract: Background. In dermoscopic images, multiple shades of pink have been described in melanoma without specifying location of these areas within the lesion. Objective. The purpose of this study was to determine the statistics for the presence of centrally and peripherally located pink melanoma and benign melanocytic lesions. Methods. Three observers, untrained in dermoscopy, each retrospectively analyzed 1290 dermoscopic images (296 melanomas (170 in situ and 126 invasive), 994 benign melanocytic nevi) and assessed the presence of any shade of pink in the center and periphery of the lesion. Results. Pink was located in the peripheral region in 14.5% of melanomas and 6.3% of benign melanocytic lesions, yielding an odds ratio of 2.51 (95% CI: 1.7-3.8, P < 0.0001). Central pink was located in 12.8% of melanomas and 21.8% of benign lesions, yielding an odds ratio of 0.462 (95% CI: 0.67, P = 0.204). Pink in melanoma in situ tended to be present throughout the lesion (68% of pink lesions). Pink in invasive melanoma was present in 17% of cases, often presenting as a pink rim. Conclusions. The presence of pink in the periphery or rim of a dermoscopic melanocytic lesion image provides an indication of malignancy. We offer the "pink rim sign" as a clue to the dermoscopic diagnosis of invasive melanoma.
authors.affiliation: Stoecker & Associates, LLC, 10101 Stoltz Drive, Rolla, MO 65401-7714, USA.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Rader
authors.affiliation: Stoecker & Associates, LLC, 10101 Stoltz Drive, Rolla, MO 65401-7714, USA.
authors.forename: Katie S
authors.initials: KS
authors.lastname: Payne
authors.affiliation: Missouri University of Science & Technology, G20 Emerson Electric Co. Hall, Rolla, MO 65409-0040, USA.
authors.forename: Uday
authors.identifier: 0000-0001-9152-5168
authors.initials: U
authors.lastname: Guntupalli
authors.affiliation: Skin and Cancer Associates, 201 NW 82nd Avenue, Bennett Medical Plaza, Suite 501, Plantation, FL 33324, USA.
authors.forename: Harold S
authors.initials: HS
authors.lastname: Rabinovitz
authors.affiliation: Skin and Cancer Associates, 201 NW 82nd Avenue, Bennett Medical Plaza, Suite 501, Plantation, FL 33324, USA.
authors.forename: Maggie C
authors.initials: MC
authors.lastname: Oliviero
authors.affiliation: Sheard & Drugge PC, 50 Glenbrook Road, Unit 1C, Stamford, CT 06902, USA.
authors.forename: Rhett J
authors.initials: RJ
authors.lastname: Drugge
authors.affiliation: The Dermatology Center, LLC, 10101 Stoltz Drive, Rolla, MO 65401, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Malters
authors.affiliation: Stoecker & Associates, LLC, 10101 Stoltz Drive, Rolla, MO 65401-7714, USA.
authors.forename: William V
authors.initials: WV
authors.lastname: Stoecker