Acral Nevi: Dermatoscopic Features and Key Points

Introduction. Acral nevus is a benign melanocytic proliferation at the palms and soles, which occurs in approximately 4.0 % of people with white skin. Sometimes the differentiation of acral nevi and acral lentigious melanoma can be difficult, and in these cases the correct interpretation of dermatoscopic picture can be crucial. Aim. To investigate the dermoscopic features of 306 acral melanocytic nevi, to determine the most common patterns and to trace their connection with development of acral lentiginous melanoma. Materials and methods. The article presents the results of a dermatoscopy examination of 306 acral melanocytic nevi in 117 Caucasian patients with I-II skin type. For each patient was collected data of the predominant body pattern of the nevi, the number of volar lesions, the location and diameter of each volar lesion and dermoscopic patterns. Lesions located on dorsal areas were excluded. Digital dermoscopic images were captured with a Sumsung Galaxy S4 digital camera equipped with a Dermlite DL3 dermoscope. Results. In 84.0 % of cases the typical dermatoscopic pattern for acral nevi were parallel lines located in the furrows. In 14.0 % parallel lines in the furrows were connected with сrossing lines, giving the impression of reticular. As a rule, in each furrow was one pigmented line, in some cases there were two, but usually these lines were composed from dots and they were not continual. Among other elements dots, clods and structureless area were seen frequently, reticular lines less often, radial lines rarely. Among observed in 5 patients were detected 5 acral melanomas. Each nosological unit of acral lesion has its particular dermatoscopic pattern that helps to differentiate between malignant and benign proliferation. Specific dermatoscopic pattern of acral melanoma are structures of parallel line on the ridges, while for nevi typical patter are parallel lines in the furrows. Conclusions. The widespread introduction of dermoscopy into clinical practice will enable dermatologists to diagnose melanoma in its early stages and to avoid unjustified removal of benign tumors.