Abstract
Current trends in the melanoma epidemic reveal a dramatic increase of local and in situ melanoma, whereas advanced disease and mortality rates remain relatively stable. Owing to these epidemiological data, the question arose of whether or not a new spectrum of melanomas characterized by a less aggressive biological behavior does exist. Proving the existence of biologically benign melanoma is difficult or even impossible, as once melanoma is removed, its natural history will remain unclear, at least until metastasis eventually occurs. Today, digital dermoscopic imaging techniques permit a detailed documentation of lesions over time and, therefore, represent an optimal tool to disclose the natural evolution of a given lesion. To date, two cases of melanoma, followed up over 10 years, have been reported in the literature that might belong to the spectrum of biologically benign melanomas. In this review, we discuss the current literature on this topic and the impact of dermoscopy in the diagnosis and documentation of this unusual type of melanoma by providing four new cases.