Melanoma with peripheral globules: clinical and dermoscopic features

Morphology and biology of nevi with peripheral globules are well known, while that of melanomas with peripheral globules remain unclear. We analyzed lesions with peripheral globules from 10-90-years old and identified features beyond the peripheral globules to distinguish benign from malignance. These observations can reduce unnecessary biopsies. A total of 401 melanocytic lesions with peripheral globules were included in this retrospective study. Dermoscopic patterns and structures, including those of the peripheral globules, were evaluated. Of the 401 lesions, 179 (44.64%) were excised, 41 (10.22%) of which were melanoma. Melanomas were most common in the lower extremities (P <0.01), with a disorganized pattern, whereas melanocytic nevi were most common on the trunk, with an organized pattern. The presence of blotches, atypical dots and globules, or atypical vessels was associated with melanomas (P <0.01). We concluded melanocytic lesions displaying peripheral globules are at the greatest risk for melanoma if located on the lower extremity and lesions reveal any of the following structures:blotch or atypical dots and globules or atypical vessels. In this Mendeley data we show examples of melanocytic nevi and melanomas with peripheral globules, the flow chart, the management algorithm proposed, supplementarey tables and the graphical abstract.