Australian Family Physician
Australian Family Physician


Volume 38, Issue 7, July 2009

Cutaneous melanoma Atypical variants and presentations

Alex Chamberlain Jonathan Ng
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The incidence of melanoma continues to rise in Australia. General practitioners treat the majority of skin cancers affecting Australians. In the past decade, there has been improved uptake of dermoscopy by GPs who realise its value in the assessment of pigmented and nonpigmented lesions.
This article outlines those variants or presentations of melanoma that create diagnostic difficulty for all clinicians. Practice tips regarding clinical features or useful dermoscopic clues are included.
A clinical overview of lentigo maligna, acral lentiginous and subungual melanoma, nodular melanoma, desmoplastic melanoma, verrucous melanoma and hypomelanotic melanoma is presented. Dermoscopy has become a vital diagnostic aid in the assessment of all skin lesions. Its value in the diagnosis of melanoma is highlighted where relevant. Expert dermatopathology assessment is equally as crucial in reaching a correct diagnosis, especially for some of these atypical variants.

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