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Sometimes a Subtle Clue for the Recognition of Melanoma

Kenneth M. Lloyd, MD
Dermatology Services, Forum Health, Youngstown, Ohio

Arch Dermatol. 2006;142:1676.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Melanomas often have an ominous appearance. The trained eye is preferentially drawn to them. Sometimes the best clues to the diagnosis are not in the peculiarities we visually appreciate, such as variegation of color, border irregularity, and size, but in the subtleties that we may not fully appreciate.

Careful scrutiny of these lesions over the last 40 years has made me aware of an aberration that may support the clinical diagnosis of melanoma. There is often a peripheral zone of clearing surrounding the entire lesion of 1 cm or more. The pigmentation may be a shade lighter but not to the extent seen in halo nevi. The skin markings within the zone are those of normal skin; the lentigenes, ephelides, and telangiectasias that are easily found beyond the outer margin of the zone are often not found within it. The phenomenon may be likened to a . . . [Full Text of this Article]

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