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Josep Malvehy, MD; Susana Puig, MD, PhD

Arch Dermatol. 2004;140:538-544.

Background  Acral benign melanocytic lesions in white populations, particularly in subjects with atypical mole syndrome, have been poorly characterized until recently. The advent of dermoscopy has enabled more specific diagnoses of these pigmented skin lesions.

Objective  To evaluate the clinical and dermoscopic features of benign volar lesions in a group of white patients with atypical mole syndrome.

Setting  A private medical center specializing in early diagnosis of malignant melanoma and a melanoma unit in a university hospital.

Methods  Acral melanocytic lesions in 511 patients with atypical mole syndrome were studied using standard clinical assessment and dermoscopy.

Results  Two hundred ten acral melanocytic lesions were observed in 156 of the patients: 165 lesions were present on the soles of 121 patients and 45 lesions on the palms of 35 patients. No acral malignant lesions were detected. We observed the following patterns of lesions: parallel furrow in 111 lesions (52.9%), latticelike in 26 lesions (12.4%), fibrillar or filamentous in 13 lesions (6.2%), and nontypical in 29 lesions (13.8%). In 31 lesions (14.8%), we observed 3 previously undefined patterns: a globular pattern in 11 lesions (5.2%), a homogeneous pattern in 15 lesions (7.1%), and an acral reticular pattern in 5 lesions (2.4%).

Conclusions  We observed a greater number of benign melanocytic lesions in glabrous skin than expected, probably related to our cohort selection of patients with atypical mole syndrome, although the lesions generally exhibited patterns on dermoscopy similar to those seen in Japanese studies. We defined 3 new benign dermoscopic patterns, which will enable better characterization of acral lesions.

From the Center for Diagnosis of Pigmentary Lesions (CEDILP), Department of Dermatology, Hospital Clinic, Institut de Investigacions Biomèdiques August Pi i Suñé (IDIBAPS), Barcelona, Spain. The authors have no relevant financial interest in this article.

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