Title : Dermoscopic image of amelanotic nodular melanoma
Abstract:
Amelanotic /Hypomelanotic melanoma is a form of melanoma in which the malignant cells have little to no pigment. The term ‘amelanotic’ is often used to indicate lesions that are only partially devoid of pigment while truly amelanotic melanoma where lesions lack all pigment is rare. Most Amelanotic/Hypomelanotic melanomas are Nodular. Thus combining the clinical features with the dermatoscopic image features the diagnosis is Nodular Melanoma.
Case Presentation: A 54-year-old man presents to clinic with a nodule on his skin. It has been present for over 12 months and has been asymptomatic. It has grown a little over that time. Macroscopically, solitary 1X1 cm red nodule with well-defined borders and surface seems smooth, vessel network prominent surrounding skin normal-looking no excoriation, ulceration or bleeding seen. After dermoscopy, dotted and comma vessels on the upper left corner are visible, hairpin vessels on the right side of the lesion and linear vessels all through pointing towards polymorphic vessel morphology in an irregular distribution and mostly central. Lesion is a partially pigmented melanoma due to the presence of some pigment in the periphery of the lesion. There is also blue-white veil at the top right part of the lesion. The vessels most likely disappeared in the top right image due to compression via dermatoscope and the fluid medium. There are also milky-red areas with multiple shades of pink.
