The article by Pampena et al1 describes 10 rare melanoma variants. Their systematic review highlights the challenging nature of diagnosing melanomas with atypical clinical and dermoscopic features, with a wide differential diagnosis that often includes nonmelanocytic tumors and inflammatory conditions.
This systematic review also highlights the complex and evolving nature of melanoma classification, which has traditionally been based on histopathologic and clinical features but more recently also incorporates genomic alterations.2,3 Many rare variants of melanoma have been described that often defy classification among the traditional major subtypes. By definition, these variants have atypical clinical or histopathologic features, and based on the current study, many may also exhibit unique dermoscopic patterns.
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Miller DM, Wanat KA. Dermoscopy of Uncommon Melanoma Variants—Perspective From the Pathologist. JAMA Dermatol. Published online February 26, 2020. doi:10.1001/jamadermatol.2019.4889
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