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Correspondence |

Exclusively Benign Dermoscopic Pattern in a Patient With Acral Melanoma

Ralph P. Braun, MD; Olivier Gaide, MD; Andreas M. Skaria, MD; Alfred W. Kopf, MD; Jean-Hilaire Saurat, MD; Ashfaq A. Marghoob, MD
Arch Dermatol. 2007;143(9):1209-1226. doi:10.1001/archderm.143.9.1213-b.
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The article by Saida et al1 on the significance of dermoscopic patterns in detecting malignant melanoma is of great importance to us. Based on the results of this large multicenter study conducted in Japan, the authors reported that 2 dermoscopic patterns, the parallel ridge pattern and irregular diffuse pigmentation pattern, were highly specific for the diagnosis of acral melanoma.

They found that 7 of 103 melanomas revealed a benign dermoscopic pattern consisting of either a parallel furrow pattern or a latticelike pattern.2 However, the authors1 also mention that in all melanomas displaying benign dermoscopy patterns, this benign pattern was observed only focally and that the predominant pattern was the malignant pattern.

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Figure 1.

Clinical image of an acquired pigmented lesion on the right heel of a 28-year-old woman.

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Figure 2.

Dermoscopy image of the same lesion shown in Figure 1 showing a benign dermoscopy pattern throughout the lesion. The pigmentation follows the furrows, and the ridges are relatively hypopigmented (double-line parallel furrow pattern associated with dots and globules). No malignant dermoscopy pattern can be observed.

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Figure 3.

Histologic image of the lesion showing a very atypical melanocytic pattern at the dermoepidermal junction with numerous confluent nests of atypical melanocytes (Fontana-Masson stain, original magnification ×5).

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Figure 4.

Detail of Figure 3 showing confluent nests of atypical melanocytes as well as pagetoid spread of suprabasal cells. There is some fibrosis as well as pigment incontinence in the dermis. Histopathologic diagnosis was melanoma in situ (hematoxylin-eosin, original magnification ×20).

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