{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T17:52:50Z","timestamp":1767203570128,"version":"build-2238731810"},"reference-count":65,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Life"],"abstract":"<jats:p>Background: The differential diagnosis of atypical melanocytic skin lesions localized on palms and soles represents a diagnostic challenge: indeed, this spectrum encompasses atypical nevi (AN) and early-stage melanomas (EN) displaying overlapping clinical and dermoscopic features. This often generates unnecessary excisions or delayed diagnosis. Investigations to date were mostly carried out in specific populations, focusing either on acrolentiginous melanomas or morphologically typical acquired nevi. Aims: To investigate the dermoscopic features of atypical melanocytic palmoplantar skin lesions (aMPPLs) as evaluated by variously skilled dermatologists and assess their concordance; to investigate the variations in dermoscopic appearance according to precise location on palms and soles; to detect the features with the strongest association with malignancy\/benignity in each specific site. Methods: A dataset of 471 aMPPLs\u2014excised in the suspect of malignancy\u2014was collected from 10 European Centers, including a standardized dermoscopic picture (17\u00d7) and lesion\/patient metadata. An anatomical classification into 17 subareas was considered, along with an anatomo-functional classification considering pressure\/friction, (4 macroareas). A total of 156 participants (95 with less than 5 years of experience in dermoscopy and 61 with \u2265than 5 years) from 17 countries performed a blinded tele-dermoscopic pattern analysis over 20 cases through a specifically realized web platform. Results: A total of 37,440 dermoscopic evaluations were obtained over 94 (20%) EM and 377 (80%) AN. The areas with the highest density of EM compared to AN were the heel (40.3% EM\/aMPPLs) of the sole and the \u201cfingers area\u201d (33%EM\/aMPPLs) of the palm, both characterized by intense\/chronic traumatism\/friction. Globally, the recognition rates of 12 dermoscopic patterns were non statistically different between 95 dermatology residents and 61 specialists: aMPPLs in the plantar arch appeared to be the most \u201cdifficult\u201d to diagnose, the parallel ridge pattern was poorly recognized and irregular\/regular fibrillar patterns often misinterpreted. Regarding the aMPPL of the \u201cheel area\u201d, the parallel furrow pattern (p = 0.014) and lattice-like pattern (p = 0.001) significantly discriminated benign cases, while asymmetry of colors (p = 0.002) and regression structures (p = 0.025) malignant ones. In aMPPLs of the \u201cplantar arch\u201d, the lattice-like pattern (p = 0.012) was significant for benignity and asymmetry of structures, asymmetry of colors, regression structures, or blue-white veil for malignancy. In palmar lesions, no data were significant in the discrimination between malignant and benign aMPPLs. Conclusions: This study highlights that (i) the pattern analysis of aMPPLs is challenging for both experienced and novice dermoscopists; (ii) the histological distribution varies according to the anatomo-functional classification; and (iii) different dermoscopic patterns are able to discriminate malignant from benign aMPPLs within specific plantar and palmar areas.<\/jats:p>","DOI":"10.3390\/life14060659","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T10:00:11Z","timestamp":1716372011000},"page":"659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pattern Analysis of Benign and Malignant Atypical Melanocytic Skin Lesions of Palms and Soles: Variations of Dermoscopic Features According to Anatomic Site and Personal Experience"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-4310","authenticated-orcid":false,"given":"Linda","family":"Tognetti","sequence":"first","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1818-6275","authenticated-orcid":false,"given":"Alessandra","family":"Cartocci","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, 53100 Siena, Italy"},{"name":"Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5160-8997","authenticated-orcid":false,"given":"Elvira","family":"Moscarella","sequence":"additional","affiliation":[{"name":"Dermatology Unit, University of Campania Luigi Vanvitelli, 81100 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-0964","authenticated-orcid":false,"given":"Aimilios","family":"Lallas","sequence":"additional","affiliation":[{"name":"First Department of Dermatology, Aristotle University, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3186-2861","authenticated-orcid":false,"given":"Emi","family":"Dika","sequence":"additional","affiliation":[{"name":"Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7249-2556","authenticated-orcid":false,"given":"Maria","family":"Fargnoli","sequence":"additional","affiliation":[{"name":"Dermatology Unit, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Modena and Reggio Emilia, 41125 Modena, Italy"},{"name":"Skin Cancer Center, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-6497","authenticated-orcid":false,"given":"Gianluca","family":"Nazzaro","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1326-8535","authenticated-orcid":false,"given":"John","family":"Paoli","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 41390 Gothenburg, Sweden"},{"name":"Department of Dermatology and Venereology, Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignazio","family":"Stanganelli","sequence":"additional","affiliation":[{"name":"Skin Cancer Unit, Scientific Institute of Romagna for the Study of Cancer, IRCCS, IRST, 47014 Meldola, Italy"},{"name":"Department of Dermatology, University of Parma, 43121 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8082-336X","authenticated-orcid":false,"given":"Serena","family":"Magi","sequence":"additional","affiliation":[{"name":"Skin Cancer Unit, Scientific Institute of Romagna for the Study of Cancer, IRCCS, IRST, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Lacarrubba","sequence":"additional","affiliation":[{"name":"Dermatology Clinic, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Broganelli","sequence":"additional","affiliation":[{"name":"Dermatology Unit, University Hospital of Torino, 10126 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4479-9961","authenticated-orcid":false,"given":"Jean-Luc","family":"Perrot","sequence":"additional","affiliation":[{"name":"Dermatology Unit, University Hospital of St-Etienne, 42270 Saint Etienne, France"},{"name":"Department of Dermatology, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariano","family":"Suppa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"},{"name":"Department of Dermatology, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"},{"name":"Groupe d\u2019Imagerie Cutan\u00e9e Non Invasive (GICNI) of the Soci\u00e9t\u00e9 Fran\u00e7aise de Dermatologie (SFD), 75008 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0051-8016","authenticated-orcid":false,"given":"Harald","family":"Kittler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5492-3033","authenticated-orcid":false,"given":"Roberta","family":"Giuffrida","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98122 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4009-0659","authenticated-orcid":false,"given":"Elisa","family":"Cinotti","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, 53100 Siena, Italy"},{"name":"Groupe d\u2019Imagerie Cutan\u00e9e Non Invasive (GICNI) of the Soci\u00e9t\u00e9 Fran\u00e7aise de Dermatologie (SFD), 75008 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5807-0664","authenticated-orcid":false,"given":"Lo","family":"Sofia","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennaro","family":"Cataldo","sequence":"additional","affiliation":[{"name":"Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Cevenini","sequence":"additional","affiliation":[{"name":"Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Rubegni","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"ref_1","first-page":"135","article-title":"The American Cancer Society\u2019s Facts & Figures: 2020 Edition","volume":"11","author":"Viale","year":"2020","journal-title":"J. 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