Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
J Eur Acad Dermatol Venereol. 2012 May;26(5):591-6. doi: 10.1111/j.1468-3083.2011.04122.x. Epub 2011 May 18.
Amelanotic melanomas remain challenging to diagnose.
To analyze and describe the clinical and dermoscopic characteristics of amelanotic melanomas that are not of the nodular subtype.
PATIENTS/METHODS: We conducted a retrospective review of 20 consecutively diagnosed amelanotic melanomas. The clinical and dermoscopic images of pathologically confirmed amelanotic melanomas that were not of the nodular subtype were analyzed. In addition, the clinical diagnosis and the reasons why these lesions were biopsied were examined.
All 20 amelanotic melanomas were erythematous and lacked any of the clinical ABCD features commonly attributed to melanoma. The lesions appeared clinically to be relatively symmetric with regular borders and manifesting a circular to oval morphology. Dermoscopically, all lesions manifested polymorphous vascular pattern.
Amelanotic melanomas that are not of the nodular subtype often present as clinically symmetric erythematous lesions. Therefore, it is important to consider AMs in the differential diagnosis of isolated and persistent erythematous outlier lesions, even if they are symmetric in appearance. Additionally, the presence of a polymorphous vascular pattern seen with dermoscopy can facilitate in correctly identifying these melanomas.
无色素性黑素瘤的诊断仍然具有挑战性。
分析和描述非结节型无色素性黑素瘤的临床和皮肤镜特征。
患者/方法：我们对 20 例连续诊断的无色素性黑素瘤进行了回顾性研究。对经病理证实的非结节型无色素性黑素瘤的临床和皮肤镜图像进行了分析。此外，还检查了临床诊断和活检这些病变的原因。
所有 20 例无色素性黑素瘤均为红斑性，缺乏通常归因于黑素瘤的 ABCD 特征。这些病变在临床上看起来相对对称，边界规则，表现为圆形至椭圆形形态。皮肤镜下，所有病变均表现为多形性血管模式。
非结节型无色素性黑素瘤常表现为临床对称的红斑性病变。因此，在鉴别诊断孤立性和持续性红斑性外生性病变时，即使病变外观对称，也应考虑 AM。此外，皮肤镜下所见的多形性血管模式有助于正确识别这些黑素瘤。
