Dermatoscopic patterns of cutaneous metastases: A multicentre cross‐sectional study of the International Dermoscopy Society
Danica Tiodorović, Jelena Stojković‐Filipović, Ashfaq A. Marghoob, Giuseppe Argenziano, Susana Puig, Josep Malvehy, Linda Tognetti, Pietro Rubegni, Bengü Nisa Akay, Iris Zalaudek, Holger A. Haenssle, Christine Müller‐Christmann, Élisa Cinotti, Jean Luc Perrot, Pedro Zaballos, Renato Marchiori Bakos, L. Thomas, Ketty Peris, Aimilios Lallas, Zoé Apalla, Juergen Kreusch, Isabelle Tromme, Alexandros Stratigos, Maria Antonietta Pizzichetta, Lidija Kandolf, Caterina Longo, Andreas Blum, Masaru Tanaka, Rainer Hofmann‐Wellenhof, Andrija Jović, John Paoli, Marija Buljan, Martina Espasandín‐Arias, Horacio Cabo, Sonia Rodrigiez Saa, Gabriel Salerni, Gianluca Nazzaro, Grażyna Kamińska‐Winciorek, Giovanni Damiani, Franciska Geszti, Harald Kittler, IDS Study group
Abstract
BACKGROUND: The detection of cutaneous metastases (CMs) from various primary tumours represents a diagnostic challenge. OBJECTIVES: Our aim was to evaluate the general characteristics and dermatoscopic features of CMs from different primary tumours. METHODS: Retrospective, multicentre, descriptive, cross-sectional study of biopsy-proven CMs. RESULTS: We included 583 patients (247 females, median age: 64 years, 25%-75% percentiles: 54-74 years) with 632 CMs, of which 52.2% (n = 330) were local, and 26.7% (n = 169) were distant. The most common primary tumours were melanomas (n = 474) and breast cancer (n = 59). Most non-melanoma CMs were non-pigmented (n = 151, 95.6%). Of 169 distant metastases, 54 (32.0%) appeared on the head and neck region. On dermatoscopy, pigmented melanoma metastases were frequently structureless blue (63.6%, n = 201), while amelanotic metastases were typified by linear serpentine vessels and a white structureless pattern. No significant difference was found between amelanotic melanoma metastases and CMs of other primary tumours. CONCLUSIONS: The head and neck area is a common site for distant CMs. Our study confirms that most pigmented melanoma metastasis are structureless blue on dermatoscopy and may mimic blue nevi. Amelanotic metastases are typified by linear serpentine vessels and a white structureless pattern, regardless of the primary tumour.