Melanoma histopathological biomarkers ant putative correlation with visual biomarkers

The purpose of this work is to investigate the possible correlation between histopathological and optical biomarkers in melanoma, aiming to improve diagnostic accuracy. Through this systematic review of the literature, the study highlight how dermoscopic and clinical manifestations of melanoma reflect underlying histopathological characteristics. Itcontributes to the enhancement of diagnostic and prognostic tools for melanoma, pursuing a more comprehensive and multifactorial approach to disease management. The correlations established in this study concern the following dermoscopic findings: irregular borders and color heterogeneity, the blue-white veil, and atypical vascular patterns (hairpin type). Irregular borders and color heterogeneity in the dermoscopic images of suspicious lesions are associated with histopathological findings such as tumor heterogeneity, irregular growth patterns, and involvement of both the epidermis and the dermis. The blue-white veil, an important dermoscopic finding, is related to deeper skin infiltration and a more aggressive tumor profile, as it is often linked to increased Breslow depth, which is a key prognostic indicator of melanoma. Atypical vascular patterns, such as hairpin vessels and polymorphic vessels, have been associated with increased mitotic cactivity and aggressive tumor behavior. Tumors with a high mitotic rate often exhibit moreaggressive growth and a higher likelihood of metastasis. This multi factorial approach, which combines clinical examination, dermoscopy, histopathology, and molecular analysis (such as BRAF mutation detection), can serve as a powerful tool for melanoma diagnosis, leading to timely intervention and improved therapeutic outcomes. Especially in the diagnosis of early melanoma, where optical biomarkers maybe subtle and not unequivocally indicative of malignancy, their combination with histopathological characteristics is crucial. The use of dermoscopy along side histopathological analysis allows for the early detection of tumors that may not meet typicall clinical diagnostic criteria but are malignant upon further evaluation. This study underscores the dynamic interaction between optical and histopathological biomarkers, a relation ship that has not been extensively examined in previous research. Unlike studies that focus either on dermoscopic or histopathological evaluation individually, this research highlights their interdependence to improve diagnostic caccuracy.