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The Advantages of Dermoscopy in the Diagnosis of Acral Melanoma from Other Podiatric Lesions: A Literature Review
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INTRODUCTION AND OBJECTIVES: Melanoma is one of the most common primary malignant tumors arising in the lower extremity. It is crucial to diagnose melanoma as quickly and as efficiently as possible for a better prognosis. The use of dermoscopy is helpful in diagnosing such conditions. Dermoscopy is a non-invasive, in-vivo technique primarily used in the examination of pigmented skin lesions. This procedure allows the visualization of subsurface skin structures in the epidermis, dermoepidermal junction, and upper dermis - structures not visible to the naked eye. This poster presents the advantages of dermoscopy in the field of podiatry by assessing the dermoscopic criteria with positive predictive values for distinguishing acral melanoma from acral nevus. Additionally it analyzes cases of melanomas misdiagnosed as a plantar-pigmented wart and a diabetic ulcer.
METHODS: The authors used PubMed to perform an English language literature search. The exclusion criteria included articles older than 10 years. Inclusion criteria consisted of research done on humans and the terms dermoscopy and foot lesions or melanoma. After retrieving a total of 140 articles, 14 articles were found to meet both the inclusion and exclusion criteria.
RESULTS: Qualitative analysis of relevant articles demonstrates that the detection of malignant dermoscopic patterns enhances quick and correct diagnosis.
CONCLUSIONS: The use of dermoscopy is slowly evolving in podiatry. It aims to minimize the amount of biopsies taken, thereby decreasing the risk of creating an ulcer and reducing the patients exposure to anesthesia. While controversy remains over sensitivity and specificity of using a dermatoscope alone to diagnose pedal lesions, particular attention should be paid to the accuracy of diagnosing a lesion when dermoscopy is used in conjunction with a biopsy. With the continued usage of a dermatoscope along with experience and expertise in the field, the need for a biopsy could eventually be eliminated.
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