Dermoscopic characteristics of extensive acral melanomas: associations with tumor thickness

Introduction. Acral melanoma (AM) presents a diagnostic challenge. Despite the prevalence of the BRAAFF algorithm in the field of dermoscopic assessment of acral lesions, concerns remain regarding its efficacy in advanced AM. Given concerns that BRAAFF-based assessment may under-detect advanced AM, the study specifically evaluated whether extensive or nodular lesions exhibit altered dermoscopic patterns that no longer align with the meet established diagnostic features. Material and methods. This retrospective case series encompassed a clinical, dermoscopic and histopathological evaluation of seven cases. Eligible participants were patients with histopathologically confirmed AM, measuring at least one centimetre in diameter. Results. Dermoscopic features of AM change in the context of aggressive nodular growth, and may lack the classical criteria defined by the BRAAFF algorithm. Conclusions. Future research should focus on validating algorithms across various populations and melanoma subtypes, improving diagnostic accuracy in subtle cases, and optimising strategies for early diagnosis rather than developing new criteria for late-stage tumors.