Clinical and dermoscopic predictors of invasiveness in small-diameter melanomas (≤ 6 mm): A multicenter study of 160 cases.

Authors

Alejandro Martín-Gorgojo, Tania-Maria Capusan, Francisco-Javier Bru-Gorraiz, Ana-Patricia Miguélez, Alicia Comunión, Marta Feito, Cristina Gómez, Ignacio Sánchez-Carpintero, Matías Mayor, María José Beato, Ana-Belén Enguita, Yolanda Delgado, Esteban Daudén, Ricardo Ruiz-Rodríguez, Ángel Pizarro

Published in

Actas dermo-sifiliograficas. Pages 104759. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

Small-diameter melanomas (≤ 6 mm) are increasingly diagnosed, but their recognition remains challenging because conventional clinical and dermoscopic criteria may be absent or subtle. We investigated their clinical and dermoscopic characteristics and associations with invasiveness.
This retrospective, multicenter observational study included 160 histologically confirmed primary cutaneous melanomas measuring ≤ 6 mm, excised between 1998 and 2018. Clinical features were assessed using the ABCDE rule adapted for small melanomas, and global and local dermoscopic characteristics were evaluated for associations with invasiveness.
Of 160 melanomas, 92 (57.5%) were in situ and 68 (42.5%) were invasive. Only 48 lesions (30%) exhibited at least three ABCDE characteristics, and the overall ABCDE score was not associated with invasiveness. In contrast, invasiveness was significantly associated with multiple suspicious global or local dermoscopic features, more than two colors, peripheral globules, blue-white veil, regression, and polymorphous vessels. Digital dermoscopic surveillance was associated with a higher proportion of in situ melanomas.
A substantial proportion of small-diameter melanomas are already invasive despite limited clinical atypia. Although conventional ABCDE criteria and dermoscopy have diagnostic limitations, specific dermoscopic features and their accumulation may help identify potentially invasive lesions. Digital dermoscopic surveillance may facilitate detection at the in situ stage.

PMID:
42887854
Bibliographic data and abstract were imported from PubMed on 17 Oct 2026.

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