DermatologyClinical and Dermatoscopic Characteristics of Melanoma in situ - Institutional Experience

BACKGROUND: Melanoma in situ (MIS) is the very early stage of a skin tumor called melanoma. In recent decades, the incidence rate for melanoma has increased by 2.6%/year and MIS is the main diagnosis responsible for this increase. It is important to recognize MIS since in this phase (called the intraepidermal phase), cancer cells do not have the opportunity to spread anywhere in the body. The use of dermoscopy has contributed to the early diagnosis of melanoma. The most common dermoscopic features of melanoma are multiple structures and colors (multicomponent pattern), an atypical reticular pattern (with wide, irregular meshes), and an absence of distinguishing features (nonspecific pattern) associated with the presence of vascular structures. The clinical decision about the excision of the lesion should always be in correlation with the dermoscopic picture of the pigmented lesion. If dermoscopy is unclear and there is suspicion for MIS, surgical excision with a wide margin of more than 5 mm should be performed. AIM: In this work, we are presenting four cases of diagnosis of MIS and their clinical, dermoscopic, and histopathological findings. METHODS: In this work, we present four cases of diagnosis of MIS, their clinical, dermoscopic and histopathological findings. RESULTS: The invasive melanoma cohort, compared with the MIS cohort, had an elevated risk for subsequent invasive melanoma in the first 10 years. However, the MIS cohort was more likely to develop subsequent MIS during the entire follow-up period than the invasive melanoma cohort. In our work, none of the four patients that we presented had relapsed during the first 2 years of follow-up, which is consistent with these results. CONCLUSION: With the presentation of these cases, we want to stress and help clinicians that the main focus in dermoscopy assessment of MIS is on the asymmetry of the pigmented network and a two-color sign because many other marks of melanoma are missing.