In this issue of the Archives, Menzies et al1 analyze a large number of hypopigmented lesions to determine the most useful dermoscopic features for detection of amelanotic and hypomelanotic melanoma (AHM). Dermoscopy, which uses magnification with a glass plate and fluid or with cross-polarized lighting, improves diagnostic accuracy for pigmented lesions.2 For clinical observation without dermoscopy, diagnostic sensitivity and specificity of AHM have been reported as 65% and 88%, respectively3; however, dermoscopy improves sensitivity and specificity to 89% and 96%, respectively.3 For truly amelanotic melanomas, diagnosis depends critically on vascular patterns, which are visible only by dermoscopy.
Stoecker WV. Dermoscopy and the Diagnostic Challenge of Amelanotic and Hypomelanotic Melanoma. Arch Dermatol. 2008;144(9):1207-1210. doi:10.1001/archderm.144.9.1207