Clinically and dermoscopically featureless melanoma: When prevention fails

We report a case of amelanotic melanoma that was clinically and dermoscopically featureless; it was repeatedly missed during examination at a pigmented lesion clinic. Dermoscopy evidenced a peculiar vascular pattern, and only the adoption of a specific diagnostic algorithm including the atypical vascular pattern among the major diagnostic criteria would have helped the observer make the correct diagnosis. The risk of false-negative diagnosis by both clinical examination and dermoscopy during melanoma screening as well as the possible role of dermoscopy in the diagnosis of amelanotic melanoma are discussed.