Rules and clues for recognizing difficult melanomas


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Dermoscopists main goal is to detect melanomas as early as possible. In our everyday practice, we encounter different clinical scenarios. Advanced melanomas are easiest to diagnose, even without dermatoscopy, they are clinically obvious. The majority of cases are clinically suspicious, fulfilling ABCD criteria and diagnosis is made upon clinical presentation and confirmed bydermoscopy. About 12% of melanomas are clinically completely bland, they dont show any of the ABCD features, often imitating a wide range of benign tumors. They are the most difficult to diagnose, sometimes even with dermatoscopy, and when that happens, when morphology is not enough we must apply some rules in order to achieve the diagnosis. I will present you with 5 challenging cases and 10 basic rules that would help you recognize these melanomas in disguise.