ABSTRACT
Abstract
Background:
Melanoma thickness is a relevant prognostic marker that is crucial for staging and its calculation relies on the histopathological examination. There is a
risk of thickness underestimation with an incisional
biopsy if the latter is not performed on a
tumor area where the thickness is maximal. This occurrence may have an impact on a
therapeutic decision, particularly regarding the
excision margins and the need for
sentinel lymph node biopsy.
Objective:
To assess the
association between
melanoma thickness and dermoscopic, demographic, epidemiological and clinical variables, aiming to identify predictive factors of thickness >1 mm.
Methods:
This was an observational and
cross-sectional study, carried out on
patients diagnosed with
melanoma, from a single center over a
time span of four years. Anatomopathological (thickness), dermoscopic, demographic, epidemiological, and clinical variables were collected. The
associations between the variables with
melanoma thickness were assessed.
Results:
A total of 119
patients were included. The presence of atypical vessels on the dermoscopic examination was an independent predictive factor of thickness >1 mm. Conversely, an atypical reticular pattern predicted
melanoma thickness <1 mm. The presence of ephelides and a previous
history of
sunburn were also associated with
melanomas thinner than 1 mm in the univariate
analysis. Study
limitations:
The lack of data related to some variables and the absence of an optimal correlation between the dermoscopic and the anatomopathological examination constituted study limitations.
Conclusion:
An atypical vascular pattern on
dermoscopy is associated with thickness >1 mm, helping with the choice of the optimal site to perform an incisional
biopsy when an excisional
biopsy is not feasible.