• I Zalaudek, G Argenziano, H Kerl, H P Soyer, and R Hofmann-Wellenhof.
• Department of Dermatology, University of Graz, Austria. rainer.holfmann@uni-graz.at
• J Dtsch Dermatol Ges. 2003 May 1; 1 (5): 369-73.

BackgroundAmelanotic/hypomelanotic melanoma often leads to delayed clinical diagnosis because its clinical appearance can mimic other hypopigmented skin conditions. Dermatoscopy (dermoscopy, epiluminescence microscopy) is thought to be a helpful diagnostic tool in pigmented skin lesions, but it can be used also in non-pigmented skin tumors due to the recognition of vascular structures not visible to the naked eye.Objective7 amelanotic/hypomelanotic melanomas in 6 patients were analyzed in order to define their dermatoscopic findings using standard pattern analysis.MethodsClinical and dermoscopic images of each lesion were obtained using Dermaphot (Heine Optotechnik, Herrsching, Germany), with 10-fold magnification of the lesion and the color slides were converted to digital format using a Kodak Photo CD system.ResultsAll 7 amelanotic/hypomelanotic melanomas revealed peculiar dermatoscopic findings, namely, atypical vessels, dotted vessels, and a central pink to white veil. In addition, in 2 patients a slight brownish homogenous pigmentation at the periphery of the lesion was observed. In one case the correct diagnosis was done by an experienced dermatologist using dermatoscopy, whereas in the remaining 6 cases the clinical diagnoses included squamous cell carcinoma, Bowen disease, pyogenic granuloma and basal cell carcinoma. In 2 of 6 patients amelanotic/hypomelanotic melanoma was associated with a previous history of melanoma.ConclusionAmelanotic/hypomelanotic melanoma exhibits as a common dermatoscopic denominator atypical vessels, varying in size and shape, usually associated with a central pink to white veil.

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