Dermoscopy and Confocal Microscopy of Nested Melanoma of the Elderly

Longo C, Zalaudek I, Piana S, Pellacani G, Lallas A, Reggiani C, Argenziano G, JAMA Dermatol. 2013;():1-5. doi:10.1001/jamadermatol.2013.321.


Importance: Nested melanoma of the elderly is a newly identified histopathologic variant of superficial spreading melanoma, characterized by intraepidermal large nests. However, the clinical, dermoscopic, and confocal aspects have been depicted only partially.


Observations: In our cases series, nested melanoma was a flat, irregularly shaped lesion with variably pigmented and irregularly distributed globules on dermoscopic examination. Confocal microscopy revealed the presence of a "clod" pattern made of large compact nests with variable atypia. These findings correlated well with histopathologic features.

Conclusions and Relevance: Nested melanoma of the elderly should be included in the differential diagnosis when a flat pigmented lesion, showing dermoscopically an irregular globular pattern, is seen in a patient older than 60 years.