Difficult early melanomas

Early detection and treatment of early melanoma can result in cure; however, detection of these early tumors can be quite difficult. Dermatoscopy allows for a more detailed visual examination allowing for the identification of structural details that may favor a malignant or benign diagnosis. There are, however, lesions that remain difficult even with dermatoscopy. These difficult lesions are illustrated in the article. For difficult early lesions it is important to use all the clinical information available when making management decisions.