Microblotches on Dermoscopy of Melanocytic Lesions are Associated with Melanoma: A Cross-sectional Study

Abstract

Numerous dermoscopic structures for the early detection of melanoma have been described. The aim of this study was to illustrate the characteristics of dermoscopic structures that are similar to blotches, but smaller (termed microblotches), and to evaluate their association with other well-known dermoscopic structures. A cross-sectional study design, including 165 dermoscopic images of melanoma was used to define microblotches, and 241 consecutive images of naevi from the HAM10000 database, were studied to evaluate the prevalence of this criterion in both groups. Microblotches were defined as sharply demarcated structures ≤1 mm, with geographical borders visible only with dermoscopy. Microblotches were present in 38.7% of the melanomas and 6.7% of the naevi. Moreover, microblotches were associated with an odds ratio (OR) of malignancy of 5.79, and were more frequent in invasive melanoma than in the in-situ subtype (OR 2.92). Histologically, they correspond to hyperpigmented parakeratosis or epidermal consumption. In conclusion, microblotches are related to melanomas. This finding could help dermatologists to differentiate between naevi and melanomas.

Keywords: dermatoscopy; melanoma; microblotches; prognosis; dermoscopy.

Fig. 1

(a, b, d, e) Dermoscopic examples and (c, f) diagrams of microblotches. Note the well-defined geographical aspect of their morphology and borders.

Fig. 2

Microblotches. Examples of (a, b) microblotches and histopathological correlation with areas of: (c) consumption of superficial layers of the epidermis or (d) hyperpigmented/haemorrhagic parakeratosis (c, d: magnification ×200).

Fig. 3

Possible errors in interpretation of microblotches. (a) Globules and (b) follicular plugs are round or oval with diffused regular edges; (c) blotches are larger than microblotches, usually with ill-defined borders.