Giant congenial melanocytic nevi are uncommon lesions that have a higher risk of developing into cutaneous melanomas. When located on the face, they can cause neurological problems, including leptomeningeal melanocytosis and epilepsy. They can also be unattractive. A case of a 17-year-old female patient with congenial melanocytic nevus affect- ing one-third of the right side of her face is reported. The patient underwent the lesion’s resection and reconstruction with a partial skin graft in a single surgery. The objective of this study was to demonstrate a therapeutic proposal for congenial melanocytic nevi located in the periorbicular region.

Keywords: NEVUS, PIGMENTED, NEVI AND MELANOMAS, SKIN, TRANSPLANTATION, AUTOLOGOUS

Introduction: One of the most challenging dermoscopic situations is to distinguish between early melanomas and doubtful benign nevi. At times, suspicious melanocytic lesions have dermoscopic features similar to melanomas, thus leading to excessive excisions of lesions.
Objective: To develop a dermoscopic model that helps to differentiate the doubtful nevus from the early melanoma.
Material and methods: A total of 219 histopathologically confirmed dermoscopic images were analyzed and a comparison between doubtful nevi and early melanomas was then performed.
Results: The final model was based on three dermoscopic features: radial streaming, blue hue and vascular structures. If all three features were absent, it was most likely a nevus; if one dermoscopic feature was present, it could be a nevus or melanoma; if two features were present, there was a greater probability of melanoma diagnosis; if three features were present, it was melanoma.

Keywords: DERMOSCOPY, MELANOMA, NEVUS, PIGMENTED

The prognosis of cutaneous melanomas depends mainly on the lesions' thickness; early detection is of paramount importance for patient longer survival rates. An accuracy of approximately 90% can be achieved using dermoscopic assessment. Since early melanomas might not present specific dermoscopic features, they can only be diagnosed by observing alterations over time through total body mapping and serial digital dermoscopy. Patients with atypical nevus syndrome and multiple familial melanoma presented a higher sensitivity for the detection of melanoma using that technique.

Keywords: MELANOMA; DERMOSCOPY; DYSPLASTIC NEVUS SYNDROME.

Talon noir was first described in 1961 by Peachey as atraumatic petechial eruption characteristic of basketball players' heels, and were originally called calcaneal petechiae. It is a dermatosis linked to trauma, with asymptomatic lesions, marked by the presence of blood within the stratum corneum. It presents varied clinical manifestations, with the location depending on the involved provocative fac-tor. The present study describes a case of talon noir in a patient with psoriasis vulgaris and demonstrates the importance of the correlation of clinical, dermoscopic, and histopathological characteristics.

Keywords: BLOOD STAINS, NEVI AND MELANOMAS, FOOT

Introduction: In vivo confocal microscopy is an auxiliary non-invasive diagnostic method used in the diagnosis of hyperpigmented lesions in scars. Objectives: To evaluate hyperpigmentation in the scars of benign and malignant melanocytic lesions through confocal microscopy examination. Methods: Clinical, dermoscopic, and confocal microscopy images of fourteen patients with hyperpigmentation in adequately treated melanoma scars and in excised melanocytic nevi, were evaluated. Results: Among the eight patients with hyperpigmentation in melanoma scars, four showed no suspicious structures after confocal microscopy examination and four showed suspicious structures. Among the six patients with hyperpigmentation in areas where melanocytic nevi had been excised, three had atypical structures, such as dendritic cells and non demarcated papillae. Patients with suspicious structures underwent histological examination, with one case of hyperpigmentation in a lentigo maligna scar evidencing recurrence. Conclusions: The examination method allowed for the avoiding of biopsy in confirming the diagnosis in six of the fourteen patients. The finding of cells with dendritic or pagetoid pattern in the confocal microscopy examination means a diagnostic challenge, for it can indicate melanocytes or Langerhans cells in the spinous layer. Therefore, lesions that have such structures must be removed for histology and differential diagnosis.

Keywords: MELANOMA, NEVUS, DERMOSCOPY, CONFOCAL MICROSCOPY.

Eccrine poroma is a benign tumor that occurs in eccrine or apocrine sweat glands. It is a solitary lesion, usually the same color as the skin and located on the palms and soles. The authors report a clinical case of pigmented eccrine poroma, in light of its rare and atypical clinical presentation of the tumor, which in this case simulates a malignant melanoma.

Keywords: POROMA; SWEAT GLAND NEOPLASMS; MELANOMA.

Introduction: Cutaneous melanoma has significant relevance among malignant skin tumors, for despite its low incidence (3-4%) it is associated with the highest mortality. In Brazil, estimates for the year 2014 correspond to 10% of all cancers, establishing this as an important public health issue. Objectives: To present epidemiological data related to melanoma skin cancer in the midlands of the Brazilian State of São Paulo. Methods: Descriptive retrospective cross-sectional analysis of data from a tertiary hospital's medical records. The analysis was subject to measurement and information bias. A descriptive analysis with frequency and percentage was carried out. Results: There was a prevalence of cutaneous melanoma in women (71%), patients between 50 and 70 years of age (56%), Caucasians (78%), and individuals who identified their lesions through self-examination (42%), with predominant involvement of the trunk (35%). The most prevalent histological subtype was the superficial spreading (58%). Conclusions: Understanding the epidemiology of cutaneous melanoma in a given geographic region enables and facilitates medical actions, allowing for the better establishment of strategies for primary and secondary prevention.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

The present article discusses the importance of differential diagnosis with lesions located in the umbilicus. A case of verrucous nevus is described in this location, emphasizing the role of dermoscopy in the diagnosis.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

Tumoral melanosis is a histological term used to refer to a nodular accumulation of melanophages in the dermis, which clinically arises as a pigmented lesion. It is usually associated with the regression of melanomas or of other melanocytic lesions. The authors present the case of a 45-year old man/woman with a pigmented macule on his/her left leg. The lesion was completely excised and diagnosed as a tumoral melanosis.

Keywords: MELANOMA; SKIN NEOPLASMS; DERMATOSCOPY

INTRODUCTION: The gold standard diagnosis of cutaneous melanoma is essentially histological. Dermoscopy adds to clinical examination improved sensitivity and specificity.
OBJECTIVE: To evaluate the histological profile of risk melanocytic lesions excised in a dermatology service.
METHODS: Case review through Excel spreadsheet and survey of dermoscopic, histological and topographic data (January 2017 to December 2018).
RESULTS: Data from 62 suspected melanoma lesions were evaluated in this period. The main histological results were: melanocytic nevi (37.1%), melanoma (19.35%), and dysplastic nevi (17.7%).
CONCLUSIONS: The positive predictive value for melanoma was 19.35%, considering the search for an early diagnosis in patients at risk.

Keywords: Neoplasms; Melanoma; Dermatology

Malignant melanoma is a melanocyte tumor responsible for more than 75% of skin cancer deaths. The rare variants of this pathology are responsible for 5% of the cases and may mimic other pathologies. We report the case of a patient with spitzoid melanoma and we discuss the dermoscopic, histopathological, and immunohistochemical findings, as well as the follow-up of this rare variant of melanoma.

Keywords: Melanoma; Nevus, epithelioid and spindle cell; Melanoma-specific antigens; Skin neoplasms; Dermoscopy

The nevus spilus (NS), also known as speckled lentiginous nevus or nevus on nevus, is represented by a brownish macule on which small macules of darker shades appear. It is more common on the trunk and lower limbs. The general population's prevalence is 0.2% to 2.3%, and they have a benign character. The exact risk for malignant transformation is still unknown; thus, it demands a routine clinical-dermoscopic follow-up. We present a case of malignant melanoma on acquired nevus spilus, in which early an excision was performed, with no recurrence, highlighting the importance of follow-up of these patients.

Keywords: Melanoma; Nevi and melanomas; Nevus

Patients with giant congenital melanocytic nevus are at higher risk of developing melanoma. After the first diagnosis of melanoma, there is also a higher incidence of subsequent melanomas in the same patient. However, the ideal therapy for this type of nevus is still controversial. We report the case of a patient with giant congenital nevus associated with multiple synchronous melanomas and the proposed treatment.

Keywords: Melanoma; Nevi and melanomas; Neoplasms

INTRODUCTION: With the advancement of digital image analysis, predictive analysis, and machine learning methods, studies have emerged regarding the use of artificial intelligence in imaging tests such as dermoscopy.
OBJECTIVE: Construction, testing, and implementation of an artificial neural network based on characteristics of dermoscopic images.
METHODS: 1949 images of melanocytic nevi and melanomas were included, both from the authors’ files and from dermoscopic image banks available on the internet, and routines and plugins were developed to extract 58 features applied to a multilayered neural network construction algorithm. Also, 52 dermatologists assessed 40 random images and compared the results compared.
RESULTS: The training and testing of the neural network obtained a correct percentage of classification of 78.5% and 79.1%, respectively, with a ROC curve covering 86.5% of the area. The sensitivity and specificity of dermatologists were 71.8% and 52%. For the same images and a cutoff point of 0.4 (40%) of the output value, the application obtained 62% and 56% values, respectively.
CONCLUSIONS: Multilayer neural network models can assist in the dermoscopic evaluation of melanocytic nevi and melanomas regarding the differential diagnosis between them.

Keywords: Artificial intelligence; Diagnosis; Melanoma; Nevus

Melanoma is a rare neoplasm in the pediatric population, and it is even rarer in children under 10 years of age. Total body mapping constitutes a low-cost and non-invasive method that increases diagnostic accuracy in evaluating pigmented lesions, especially in high-risk patients. We reported the case of a 9-year boy with dysplastic nevus syndrome, in which one lesion presented a subtle change (asymmetry of structures) within a 6-months follow-up. Its excision resulted in melanoma with a Breslow thickness of 1 mm and a negative sentinel lymph node. Total body mapping reduces the number of unnecessary excisions. It allows diagnosis of melanomas in early and potentially curable stages, especially in children and patients with risk factors such as dysplastic nevus syndrome. We report this case due to the rarity of the neoplasia in this age group and also to demonstrate the importance of sequential digital dermoscopy in early diagnosis of melanoma in this population.

Keywords: Dermoscopy; Melanoma; Dysplastic nevus syndrome