Dermatoscopic patterns of cutaneous metastases: A multicentre cross-sectional study of the International Dermoscopy Society

J Eur Acad Dermatol Venereol. 2024 Jul;38(7):1432-1438. doi: 10.1111/jdv.19962. Epub 2024 Mar 14.

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Cross-Sectional Studies
  • Dermoscopy*
  • Female
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / secondary
  • Humans
  • Male
  • Melanoma* / diagnostic imaging
  • Melanoma* / pathology
  • Melanoma* / secondary
  • Middle Aged
  • Retrospective Studies
  • Skin Neoplasms* / diagnostic imaging
  • Skin Neoplasms* / pathology