Dermoscopy of atypical non-melanocytic lesions in children

Red nodules in children can be deceptively challenging. While many malignant tumours common in adults are rare in childhood, atypical presentations in paediatric patients can blur the diagnostic picture, particularly when the lesion is amelanotic, rapidly growing, or bleeding.

In his latest video update, Dr Vincenzo Piccolo explores how dermoscopy can support your assessment of atypical non-melanocytic lesions in children, with a pattern-based approach grounded in real cases.

Why this topic matters

• The classic adult ABCDE criteria are often not reliable in children.
• Red, amelanotic nodules are a common presentation.
• The differential diagnosis is broad — spanning benign tumours, inflammatory and infectious conditions, and rare malignancies.
• Typical dermoscopic patterns may not apply in paediatric patients.

Recognising when a lesion is simply “unusual for a child” versus genuinely concerning requires both pattern recognition and clinical judgement.

Dr Piccolo walks through:

• How the modified paediatric ABCDE criteria differ from adult algorithms
• Dermoscopic clues seen in common benign tumours that may present atypically
  
• Overlapping features between benign and malignant lesions
• When excision or biopsy is warranted
• Key “red flags” that should heighten suspicion

Rather than offering a checklist, this presentation builds diagnostic reasoning — helping you interpret vascular structures, colour patterns, ulceration, and amorphous areas in context.

Watch the presentation

Watch the previous episode with Dr Piccolo >

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About Dr Vincenzo Piccolo

Dr Vincenzo Piccolo is a dermatologist in private practice as well as responsible for the Paediatric Dermatology Service, Dermatology Unit, University of Campania, Naples, Italy. At the university, Dr Piccolo teaches the advanced course Management and Treatment of Skin Cancer and is also in the Paediatrics Residency School. He is the author of 92 scientific publications in international journals. 

 

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