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Alda Arevalo, MD; Davide Altamura, MD; Michelle Avramidis, BSc; Andreas Blum, MD; Scott Menzies, MBBS, PhD

Arch Dermatol. 2008;144(11):1440-1444.

Objective  To examine the significance of eccentric hyperpigmentation (EH), central hyperpigmentation (CH), multifocal hyper/hypopigmentation (MH/HP), and the multicomponent pattern (MCP) in melanocytic lesions lacking specific dermoscopic features of melanoma.

Design  A total of 3367 benign and malignant melanocytic lesions (n = 341 melanomas, excluding lentigo maligna and lentigo maligna melanoma) were examined to identify those lesions lacking specific dermoscopic features of melanoma but having any of the global patterns of EH, CH, MH/HP, and MCP.

Setting  Dermoscopic images were collected from lesions excised or undergoing sequential digital monitoring from the Sydney Melanoma Diagnostic Centre, a tertiary referral institution located in Sydney, Australia.

Main Outcome Measure  The odds ratio (OR) for melanoma of EH, CH, MH/HP, and MCP.

Results  While EH (OR, 3.3; 95% confidence interval [CI], 2.5-4.6) and MCP (OR, 15.4; 95% CI, 11.9-19.9) were significant predictors of melanoma when total melanomas vs nevi were analyzed, there was no significant difference between the frequency of any of the global patterns in melanomas vs benign nevi lacking specific dermoscopic features of melanoma.

Conclusion  Based on our study results and previous prevalence data on these global patterns in benign nevi, we do not believe that lesions with EH or MCP require closer observation than other benign nevi lacking specific dermoscopic features of melanoma.

Author Affiliations: Departments of Dermatology, Medica Uruguaya Corporacion De Asistencia Medica, Montevideo, Uruguay (Dr Arevalo), and University of L’Aquila, L’Aquila, Italy (Dr Altamura); and Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre (Ms Avramidis, and Dr Menzies), and Faculty of Medicine, University of Sydney (Dr Menzies), Sydney, Australia. Dr Blum is in private practice, Konstanz, Germany.

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