%0 Journal Article
%T Micromelanomas: A Review of Melanomas ¡Ü2£¿mm and a Case Report
%A Sharad P. Paul
%J Case Reports in Oncological Medicine
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/206260
%X The ABCD acronym used to screen pigmented lesions for melanoma obviously was not designed to contend with melanomas that are under 2£¿mm in diameter. Previously, views ranged that such small lesions could not be melanomas until a few reports of such ¡°micromelanomas¡± emerged. The author presents a 2£¿mm melanoma in situ presenting as an insignificant pigmented lesion in a 60-year-old patient with no previous history of melanoma or multiple nevi¡ªwhich is usually the norm in cases of small melanoma. This paper reiterates the fact that when it comes to a melanoma, size does not matter. In this paper, the term ¡°micromelanoma¡± is used by the author to represent melanomas under 2£¿mm. Dermatoscopy and histopathology findings are discussed in this case, along with a review of small melanomas. 1. Background In 1985, the oft-quoted ABCD acronym was developed for melanoma screening as a public health tool to aid the diagnosis of melanomas [1]. Asymmetry, border, color, and diameter of the pigmented lesion were parameters discussed in this context. In 1987, Schmoeckel and Braun-Falco even suggested that pigmented lesions under 5£¿mm cannot be considered melanomas as clinical and histological features only became apparent when lesions enlarged beyond 5£¿mm size [2]. Then a study from the Sydney Melanoma Unit undertook a large retrospective study and concluded that 31.1% of lesions were 6£¿mm or less in diameter [3]. After adjusting for tissue shrinkage among specimens from this Australian cohort, it was reported that only 10% of invasive melanomas were small-diameter tumors [4]. A few years later, a paper presented a series of invasive small-diameter melanomas, debating if the ¡°D¡± should be removed from the ABCD acronym [4]. Recently, a case report reviewed the dermatoscopy and dermatopathology findings of a tiny invasive melanoma in a 38-year-old patient who had >100 nevi¡ªwith the smallest diameter ever of a reported melanoma of 1.6£¿mm [5]. Some groups reported that small-diameter melanoma tumor thicknesses ranged from 0.11 to 1.5£¿mm, with a median thickness of approximately 0.7£¿mm [6]. The author presents a 2£¿mm melanoma in situ presenting as a solitary de novo lesion in a 60-year-old patient with no previous history of melanoma or multiple nevi¡ªillustrating the fact that when it comes to a melanoma, established clinical patterns or size do not seem to matter. As many authors have already stated, the ABCD criteria often does not seem to matter [7, 8]. In this paper, the term ¡°micromelanoma¡± is coined to represent melanomas under 2£¿mm. The presentation is also unusual
%U http://www.hindawi.com/journals/crionm/2014/206260/