Knowledge regarding the morphologic spectrum of pediatric melanoma (PM) is sparse and this may in part contribute to delay in detection and thicker tumors.
Analyze the clinical-dermoscopic characteristics of PM.
Retrospective study of 52 melanomas diagnosed before age of 20.
Based on clinical, dermoscopic and histopathological characteristics, PM can be classified as Spitzoid and Non-Spitzoid Non-Spitzoid (37, 72.3%) melanomas presented at a mean age of 16.3 (8-20) and were associated with a high-risk phenotype and a preexisting nevus (62.2%). Spitzoid melanomas (15, 27.7%) were diagnosed at a mean age of 12.5 (2-19) and were mostly de novo lesions (73.3%) located on the limbs (73.3%). While less than 25% of PM fulfilled the modified clinical ABCD criteria, 40% of spitzoid melanomas did. Non-Spitzoid tended to be multicomponent (58.3%) or nevus-like patterns (25%). Dermoscopic melanoma criteria were found in all cases. Spitzoid melanomas revealed atypical vascular patterns with shiny-white lines (46.2%) or atypical pigmented spitzoid pattern (30.8%). There was good correlation between Spitzoid subtype histopathologically and dermoscopically (kappa 0.66).
Retrospective study without re-review of pathology.
Dermoscopy in addition to conventional and modified clinical ABCD criteria helps in detecting PM. Dermoscopy assists in differentiating Spitzoid from non-Spitzoid melanomas.