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- Presentation
Rules Not to Miss Acral Melanoma
Description
The lecture focuses on recognizing acral melanoma and emphasizes the importance of understanding the normal appearance of skin on acrocytes. Key points include identifying patterns, such as the parallel ridge pattern for malignant melanoma and the benign parallel furrow pattern. Various benign acral nevi patterns are discussed, including variations in color and structure. The six rules, supplemented by an additional guideline to avoid over-diagnosis, are introduced for assessing potential melanoma lesions. These rules utilize a scoring system based on characteristics like symmetry and pigmentation patterns. The importance of recognizing benign features to reduce unnecessary excisions is highlighted, alongside the observation that dermoscopy may not always be necessary. Finally, the lecture stresses the critical need for ongoing monitoring of atypical lesions that may not pose an immediate risk, promoting careful assessment to prevent excessive surgical interventions.
Conclusions
- Learning to recognize normal skin patterns on acral sites is crucial for identifying melanoma.
- Benign acral nevi exhibit a consistent parallel furrow pattern.
- Suspicious signs for melanoma include a parallel ridge pattern and pigment surrounding acrosyringia.
- The biology of the skin aids in differentiating between benign lesions and melanoma.
- Only 38% of acral melanomas show a parallel ridge pattern, emphasizing the need for comprehensive assessment criteria.
- Utilizing the BRAAFF checklist improves diagnostic accuracy for acral melanoma by incorporating various criteria.
- Asymmetry of structure and color is a strong indicator of melanoma.
- Determining the risk of melanoma involves evaluating multiple characteristics, not solely relying on one aspect like the ridge pattern.
- Avoiding the overdiagnosis of melanoma is key to preventing unnecessary procedures and patient anxiety.
- Lallas, A., Kyrgidis, A., Koga, H., Moscarella, E., Tschandl, P., Apalla, Z., Di Stefani, A., loannides, D., Kittler, H., Kobayashi, K., Lazaridou, E., Longo, C., Phan, A., Saida, T., Tanaka, M., Thomas, L., Zalaudek, I., & Argenziano, G. (2015). The BRAAFF checklist: a new dermoscopic algorithm for diagnosing acral melanoma. British Journal of Dermatology, 173, 1041-9.
- Paoli, J. (2020). Diagnostic accuracy and safety of short-term teledermoscopic monitoring of atypical melanocytic lesions. JEADV, 34, 1233-9.