Small melanomas: A clinical and dermoscopic survey

Melanomas less than 6 mm of diameter in vivo do not represent a frequent occurrence. Their clinical, prognostic and epiluminescence features are still discussed. Aim of the study was to explore the prevalence and to delineate the clinical and epiluminescence features of small melanomas occurred in our experience. 234 histologically confirmed melanomas were investigated. Classical ABCDE,age, sex, site of presentation, histotype, thickness of Breslow, epiluminescence microscopy were recorded. Thirty patients (13%) had small melanomas, Differently from patients with large melanomas, they were more frequently observed in younger, at the extremities, with no gender difference.The medial thickness was 0.24mm and a positive correlation between diameter and thickness were observed. Dermoscopic correct diagnosis was performed in 78% of cases. The agree with the classical ABC rule less than large melanomas (55% vs 72%), absence of criteria was found in 36% of these. The addition of evolution criterion has been proved to clearly improve the clinical diagnosis. Small melanomas are a relatively frequent occurrence and tended to be thin melanoma. In a high percentage of cases clinical ABCD rule is a useful tool for diagnosis. E criterion for evolution is very important to improve their diagnosis. Dermoscopic criteria , in particular irregular pigment network and gray-blue veil, already present and further improve the diagnosis.