Melanomas that lack significant pigment are a diagnostic challenge. Dermoscopy, although less accurate for diagnosing these lesions than for pigmented lesions, is still superior to clinical examination.
A 34-year-old woman was referred by her GP for review of an asymptomatic pink lesion on her thigh. The main concern was that the lesion had grown slightly. She had no history of significant sun exposure. Clinical examination revealed a slightly elevated pink plaque (7 x 4 mm), which appeared relatively symmetrical (Figure 1a).
On dermoscopy, the lesion was a homogeneous pink colour with a central white area, most probably caused by the pressure of the non-polarised contact dermatoscope. Numerous dotted and linear irregular vessels were visible throughout the lesion (Figure 1b).
The lesion was excised with a 2 mm margin. Histopathological examination showed a 0.3 mm level II melanoma.