Clinical and Dermatoscopic Features of Amelanotic Cutaneous Melanoma: a Single-Center Experience

BACKGROUND: Malignant skin tumors occupy the second place among all oncological diseases worldwide. The most aggressive among them is skin melanoma, and of particular interest is its subspecies — pigmentless melanoma, which occurs from 2 to 8% among all skin malignancies. The atypical dermatoscopic picture, the frequent detection of pigmented melanoma in advanced stages, and its aggressive course, which worsens long-term treatment results, require a closer study of the issue and improvement of methods for early detection of the disease.

AIM: Analysis of clinical cases of pigmented skin melanoma with assessment of pathognomonic clinical and dermatoscopic picture.

METHODS: A retrospective analysis of the data of patients with pigmentless melanoma of the skin provided from the cancer registry of the Tyumen region for 2018-2023 was performed.

RESULTS: During the study, it was revealed that at the initial request for medical help, most of the patients were not bothered by the existing pigmentation-free formation, and complaints of rapid growth of the lesion and contact bleeding were less common. When assessing the localization of tumors, it was found that pigmented melanoma was most common on the skin of the trunk (in 38.4%), less often on the skin of the head and neck (26.9%) and only in isolated cases on the skin of the upper and lower extremities. The primary lesion more often had the appearance of a node or papule, less often — spots or plaques. When assessing the dermatoscopic picture, vascular polymorphism became the most common feature (43.18%), regression zones were slightly less common. In exceptional cases, it was impossible to assess the dermatoscopic picture due to tumor disintegration.

CONCLUSION: The rare occurrence of pigmented skin melanoma in clinical practice, the atypical dermatoscopic picture of the primary focus and the asymptomatic course are predictors of late diagnosis of the disease, which exacerbates the further course of the oncological process and long-term treatment results. This indicates to us the need to increase cancer awareness regarding pigmented melanoma of the skin, and the study and identification of typical clinical and dermatoscopic signs is an essential step towards early diagnosis of the malignant pathology in question and timely treatment of patients.