Skin Cancer Blog

This month, we look at the value of dermoscopy in the diagnosis of melanoma in situ. We all know how valuable dermoscopy is in increasing our diagnostic accuracy. Dermoscopy allows us to see more details in the skin lesions of our patients, giving us more information, and hence providing more data for diagnosis.

What are the limits of this? In this article, Lallas et al explore the value of dermoscopy in diagnosis of melanoma in situ, and Nufer et al put this in context in this accompanying comment. I recommend reading both.

Be definition, diagnosis of melanoma in situ is more difficult than invasive melanoma. Lesions tend to be smaller, earlier in their evolution and thinner. Lallas et al identified five frequent dermoscopic criteria for melanoma in situ:

1. atypical network
2. regression
3. irregular hyperpigmented areas
4. prominent skin markings
5. angulated lines.

Importantly, in comparison with naevi only (which for more experienced doctors is perhaps the key decision), two criteria remain potent: irregular hyperpigmented areas and prominent skin markings.

We are now pushing the limits of diagnostic yield with dermoscopy.

Professor David Wilkinson.

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Read more from Professor David Wilkinson on recent research:

• Can a course of fluorouracil cream reduce a person’s risk of BCC and SCC?
• A New Way to Evaluate Acral Lesions
• How is artificial intelligence changing skin cancer medicine?
• Proportion of Melanomas Managed by GPs in Australia
• Mohz Micrographic Surgery vs. Wide Local Excision for Melanoma In Situ

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Learn more about skin cancer medicine in primary care at the next Skin Cancer Certificate Courses: