Modern non-invasive diagnostic techniques in the detection of early cutaneous melanoma

Abstract

Over the past few years melanoma has grown into a disease of socio-economic importance due to the increasing incidence and persistently high mortality rates. Melanoma is a malignant tumor with a high tendency to metastasize. Therefore, an extremely important part of the therapeutic process is to identify the disease at an early stage: in situ or stage I. Many tools for early diagnosis of melanoma are available today, including dermoscopy, videodermoscopy and in vivo reflectance confocal microscopy. Other methods such as high frequency ultrasound, optical coherence tomography and electrical impedance spectroscopy may serve as additional diagnostic aids. Modern imaging techniques also allow the monitoring of melanocytic skin lesions over months or years to detect the moment of malignant transformation. This review summarizes the current knowledge about modern diagnostic techniques, which may aid early diagnosis of melanoma.

Keywords: HFU; OCT; RCM; computer; dermatoscopy; dermoscopy; diagnosis; digital; moles; nevi; skin.

Figure 1

Videodermoscopy of thin melanomas (Breslow < 1 mm). A – melanoma in situ with asymmetric pigment network; B – melanoma 0,5 mm Breslow thickness with atypical dots and small regression area; C – melanoma in situ with blue-gray area, atypical peripheral dots and erythematous halo; D – melanoma in situ with numerous point blood vessels and hairpin vessels.

Figure 2

Videodermoscopy of thick melanomas (Breslow > 1 mm). A – melanoma 1,9 mm Breslow thickness with blue-whitish veil and atypical globules; B – melanoma 1,5 mm Breslow thickness with atypical network, asymmetry in both axes and regression area; C – hypomelanotic melanoma 5 mm Breslow thickness with irregular linear blood vessels; D – melanoma 8 mm Breslow thickness with atypical network and regression area.

Figure 3

Reflectance confocal microscopy of melanoma. A – melanoma in situ with the presence of a few dendritic cells in superficial layers of the epidermis; B – melanoma in situ with the presence of numerous atypical pigmented cells and disarray of the epidermis; C, D – melanoma 3 mm Breslow thickness (C) and 1,3 mm Breslow thickness (D) with the total disorganization of the epidermis structure and the presence of polymorphonuclear bright cells.