To the Editor We praise Pampena et al1 for shedding light on the dermoscopic-pathological correlation of 10 rare variants of cutaneous melanoma (CM). Nonetheless, we would like to highlight certain significant limitations of this study.
First, the authors evaluated the dermoscopic features of balloon cell CM. Balloon cell CM cases share a peculiar cytological feature (ie, presence of “balloon cells” representing at least 50% of the total tumor cell population), but their architecture is highly protean, as demonstrated by the 5 previously published cases of balloon cell CM selected in this study.1 Dermoscopy offers a comprehensive view of the architecture of a lesion, taken from an orthogonal plane to the plane of the histological section; cytological features, however, are largely missed. It comes as no surprise that the authors failed to detect any specific patterns in balloon cell CM.
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Saggini A, Kutzner H, Cerroni L. Correlation Between Dermoscopic and Histologic Features of Uncommon Cutaneous Melanoma Variants. JAMA Dermatol. Published online July 15, 2020. doi:10.1001/jamadermatol.2020.2480
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