Dermoscopic patterns of acral melanocytic nevi and melanomas in a white population in central Italy

Objective: To investigate the dermoscopic features of acral melanocytic lesions in a white population in central Italy. Design: Retrospective review. Setting: University dermatology department. Patients: Six hundred fifty-one Italian subjects, ranging in age from 6 months to 78 years. Main Outcome Measures: We retrospectively investigated all digital dermoscopic images of acral melanocytic lesions included in our database from January 1996 to May 2005. Results: We retrieved digital images of 723 benign acral melanocytic lesions in 641 patients ( 235 males and 406 females; mean age, 26.5 years) and of 10 acral melanomas in 10 patients ( 7 males and 3 females; mean age, 65 years). Individual lesions were located on the soles (n= 520), fingers (n = 146), and palms (n = 67). Among acral nevi, the parallel furrow (42.1%) was the most common pattern, followed by the latticelike (14.9%), nontypical (13.7%), fibrillar (10.8%), homogeneous (9.3%), globular (5.4%), and reticular (2.1%) patterns. The frequency of distribution of the latticelike, nontypical, fibrillar, and homogeneous patterns significantly differed ( P <. 001, P=. 03, P <. 001, and P=. 03, respectively) between anatomical sites. Also, 13 acral nevi (1.8%), mainly located on the fingers, showed a new combined pattern ( transition pattern) consisting of a brownish black network associated with a parallel furrow or latticelike pattern. All 10 acral melanomas showed a multicomponent dermoscopic pattern. Conclusions: In our series of acral nevi, we observed 8 dermoscopic patterns, with varying distribution by anatomical site. Identification of a specific pattern is highly suggestive of the benign or the malignant nature of any given acral melanocytic lesion.