Objective: To identify and analyze subtypes of globules based on size, shape, network connectedness, pigmentation, and distribution to determine which globule types and globule distributions are most frequently associated with a diagnosis of malignant melanoma. Design: Retrospective case series of dermoscopy images with globules. Setting: Private dermatology practices. Participants: Patients in dermatology practices. Intervention: Observation only. Main Outcome Measure: Association of globule types with malignant melanoma. Results: The presence of large globules (odds ratio [OR], 5.25) and globules varying in size (4.72) or shape (5.37) had the highest ORs for malignant melanoma among all globule types and combinations studied. Classical globules (dark, discrete, convex, and 0.10-0.20 mm) had a higher risk (OR, 4.20) than irregularly shaped globules (dark, discrete, and not generally convex) (2.89). Globules connected to other structures were not significant in the diagnosis of malignant melanoma. Of the different configurations studied, asymmetric clusters have the highest risk (OR, 3.02). Conclusions: The presence of globules of varying size or shape seems to be more associated with a diagnosis of malignant melanoma than any other globule type or distribution in this study. Large globules are of particular importance in the diagnosis of malignant melanoma.



Second Department

Electrical and Computer Engineering

Keywords and Phrases

Cancer Risk; Classification; Differential Diagnosis; Epiluminescence Microscopy; Globule; Human; Image Analysis; Juvenile Melanoma; Melanoma; Pigmentation; Predictor Variable; Priority Journal; Retrospective Study; Sensitivity and Specificity; Skin Structure; Cohort Studies; Dermoscopy; Diagnosis; Differential; False Negative Reactions; False Positive Reactions; Female; Humans; Male; Nevus; Pigmented; Odds Ratio; Predictive Value of Tests; Probability; Retrospective Studies; Skin Neoplasms

Document Type

Article - Journal

Document Version

Final Version

File Type





© 2009 American Medical Association, All rights reserved.

Publication Date

01 Nov 2009