Dermoscopic features of acral pigmented lesions in Egyptian patients: a descriptive study

Abstract

Background: Dermoscopy is a non-invasive technique allowing rapid and magnified in vivo observation of the skin. The anatomical structure of acral volar skin results in unique dermoscopic features in this location.

Objective: To describe and analyze the characteristic dermoscopic features of various kinds of acral pigmented lesions and emphasize the diagnostic value of the dermoscope in early melanoma at this anatomic site in a sample of Egyptians.

Patients and methods: This study included 200 patients with 224 acral pigmented lesions. Dermoscopic examination was done to evaluate different dermoscopic patterns of these lesions. Clinically and dermoscopically suspicious lesions for malignancy were selected for more evaluation by histopathological examination by hematoxylin-eosin staining.

Results: The most frequent dermoscopic pattern was the parallel furrow pattern, (66.1%), followed by the lattice-like (8.9%), homogeneous (7.6%), fibrillar (6.3%), non-typical (5.4%), and then parallel ridge (2.2%). The least commonly reported patterns in our cases were the reticular and globular patterns (1.8% each). There was one case of acral lentiginous melanoma of the palm with a multicomponent dermoscopic pattern.

Conclusion: The recognition of different dermoscopic patterns is essential for diagnosis of various types of acral pigmented lesions. In addition, dermoscopy is useful in discriminating between acral nevi and early acral melanoma and narrows down the number of biopsies needed.