Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.

Presentation

Challenging Cases of Dermoscopy: An Interactive Session

Description

The session, led by dermatologists Joel Claveau and Zachary Emilio Lalas, focused on challenging dermoscopic cases, engaging participants in interactive voting to diagnose various skin lesions. Claveau presented five cases, starting with a lesion on a 50-year-old woman's neck, diagnosed as seborrheic keratosis rather than melanoma due to its characteristics like sharp demarcation and absence of a pigment network. He demonstrated the importance of recognizing benign versus malignant structures using dermoscopy, discussing key features of combined nevus, nodular melanoma, and other melanoma variants. Each case prompted audience participation through votes, revealing misconceptions and emphasizing the need for correct diagnosis based on dermatoscopic signs. The presentation highlighted the subtlety of differentiating between conditions like actinic keratosis and melanoma, particularly in chronically sun-damaged skin, and illustrated the varied dermoscopic presentations. Claveau articulated the necessity of thorough follow-up in melanoma patients to identify recurrence early, showcasing cases of metastasis and diagnostic challenges. Overall, the session underscored the critical role of dermoscopy in clinical practice and the collaborative effort in refining diagnostic criteria within the dermatologic community.

View more

Conclusions

Using dermatoscopic features can help differentiate between various types of skin lesions, including melanoma and benign conditions.
Specific patterns such as seborrheic keratosis and actinic keratosis can provide negative signs for diagnosing facial melanoma.
Combined blue nevi can exhibit unique dermatoscopic features that distinguish them from melanoma.
The presence of grey structures can indicate potential malignancy, although recognizing these features is challenging for inexperienced physicians.
Dermatologists should be vigilant in monitoring patients with a history of melanoma due to the risk of recurrence or metastasis.
Dermoscopic patterns in chronic sun-damaged skin require careful evaluation to avoid misdiagnosing melanoma as benign lesions.

Tschandl, P., Gambardella, A., Boespflug, A., Deinlein, T., De Giorgi, V., Kittler, H., Lallas, A., Malvehy, J., Moscarella, E., Puig, S., Scalvenzi, M., Thomas, L., Zalau-dek, I., Alfano, R., & Argenziano, G. (Year). Seven Non-melanoma Features to Rule Out Facial Melanoma. Acta Dermato-Venereologica.
Stojkovic-Filipovic, J., Tiodorovic, D., Lallas, A., Akay, B. N., Longo, C., Rosendahl, C., Dobrosavljevic, D., Nazzaro, G., Argenziano, G., Zalaudek, I., Tromme, I., Tschandl, P., Puig, S., Lanssens, S., & Kittler, H. (Year). Dermatoscopy of combined blue nevi: A multicenter study of the International Dermoscopy Society. Journal of The European Academy of Dermatology and Venereology.