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September 15, 2008

Dermoscopy and the Diagnostic Challenge of Amelanotic and Hypomelanotic Melanoma

Arch Dermatol. 2008;144(9):1207-1210. doi:10.1001/archderm.144.9.1207

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.

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