Melanoma with peripheral globules: Clinical and dermatoscopic features

Background: The morphology and biology of nevi with peripheral globules are well known, whereas those of melanomas with peripheral globules remain unclear.

Objective: Comparing the dermatoscopic characteristics of nevi and melanomas with peripheral globules.

Methods: A total of 401 melanocytic lesions with peripheral globules were included in this retrospective study. Dermatoscopic patterns and structures, including those of peripheral globules, were evaluated. A generalized estimating equation model with a binomial distribution dependent variable and logit link function was fitted to the dataset to identify features with the highest odds of differentiating melanoma from nevi.

Results: Of the 401 lesions, 179 (44.64%) were excised, 41 (10.22%) of which were melanomas. Melanomas were most common in the lower extremities (P < .01), with a disorganized pattern, whereas melanocytic nevi were most common on the trunk, with an organized pattern. In addition, the presence of blotches, atypical dots and globules, or atypical vessels was associated with melanomas (P < .01).

Limitations: The retrospective design of the study may have caused an inclusion bias.

Conclusion: Melanocytic lesions displaying peripheral globules are at the greatest risk of melanoma if located on the lower extremity and if lesions reveal any of the following structures: blotch, atypical dots and globules, or atypical vessels.