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ABSTRACT: Background
Melanoma can mimic other cutaneous lesions, but the full spectrum and prevalence of these morphologic variants remain largely unknown.Objective
To classify nonacral cutaneous melanomas into distinct morphologic clusters and characterize clusters' clinicopathologic features.Methods
All pathologic melanoma diagnoses (occurring during 2011-2016) were reviewed for routine prebiopsy digital photographs (n = 400). Six dermatologists independently assigned lesions into 1 of 14 diagnostic classes on the basis of morphology. Image consensus clusters were generated by K-means; clinicopathologic features were compared with analysis of variance and χ2.Results
Five morphologic clusters were identified: typical (n = 136), nevus-like (n = 81), amelanotic/nonmelanoma skin cancer (NMSC)-like (n = 70), seborrheic keratosis (SK)-like (n = 68), and lentigo/lentigo maligna (LM)-like (n = 45) melanomas. Nevus-like melanomas were found in younger patients. Nevus-like and lentigo/LM-like melanomas tended to be thinner and more likely identified on routine dermatologic examinations. NMSC-like melanomas were tender, thicker, more mitotically active, and associated with prior NMSC. Typical and SK-like melanomas had similar clinicopathologic features.Limitations
Cluster subdivision yielded diminished sample sizes. Visual assignment was performed without clinical context.Conclusion
When primary cutaneous melanomas were assigned into diagnostic groups and subjected to novel consensus clustering, recurrent morphologic patterns emerged. The spectrum of these morphologies was unexpectedly diverse, which might have implications for visual training and possibly clinical diagnosis.
SUBMITTER: Klebanov N
PROVIDER: S-EPMC6492030 | biostudies-literature | 2019 Jan
REPOSITORIES: biostudies-literature
Klebanov Nikolai N Gunasekera Nicole S NS Lin William M WM Hawryluk Elena B EB Miller David M DM Reddy Bobby Y BY Christman Mitalee P MP Beaulieu Derek D Rajadurai Suvithan S Duncan Lyn M LM Sober Arthur J AJ Tsao Hensin H
Journal of the American Academy of Dermatology 20180828 1
<h4>Background</h4>Melanoma can mimic other cutaneous lesions, but the full spectrum and prevalence of these morphologic variants remain largely unknown.<h4>Objective</h4>To classify nonacral cutaneous melanomas into distinct morphologic clusters and characterize clusters' clinicopathologic features.<h4>Methods</h4>All pathologic melanoma diagnoses (occurring during 2011-2016) were reviewed for routine prebiopsy digital photographs (n = 400). Six dermatologists independently assigned lesions int ...[more]