Features of Regression in Dermoscopic Diagnosis: A Confounding Factor? Two Clinical, Dermoscopic-Pathologic Case Studies


Address correspondence and reprints requests to: Vincenzo de Giorgi, MD, Department of Dermatology, University of Florence, Via degli Alfani, 37-50121 Firenze, Italy or e-mail: dermoncologia@unifi.it.


BACKGROUND In dermoscopy, the presence of regression areas is generally associated with melanocytic lesions and is often considered as a clue of malignancy. However, some lesions included in the differential diagnosis of melanoma may show dermoscopic regression parameters. Regression may indeed be one of the most confounding dermoscopic parameters, as it tends to cover, or rather to destroy, other parameters, thus often hindering a correct diagnosis.

OBJECTIVE We propose to raise the issue of the actual diagnostic role of this parameter.

METHODS We discuss 2 clinical cases (melanoma and basal cell carcinoma) with major dermoscopic regression features.

CONCLUSION Dermoscopic regression parameters should not be regarded as almost pathognomonic signs of melanocytic lesions. Rather, they should be taken into account only after having considered other dermoscopic parameters of greater diagnostic significance, and just as signs, which may better typify the lesion.