Dermoscopy, reflectance confocal microscopy and histopathology of an amelanotic melanoma from an individual with the heterozygous MC1R variation 160W

Amelanotic melanoma is a rare form of melanoma. Its lack of pigment makes it diffi cult to detect clinically and assess dermoscopically. Individuals with melancortin-1-receptor (MC1R) red hair colour variants, such as 160W, D84E, R151C and D294H, have been found to have an increased risk of developing melanoma1 and their early melanomas have been reported to have reduced colours and structures in dermoscopy2. New imaging modalities such as reflectance confocal microscopy (RCM) can be used to help confirm the diagnosis of amelanotic melanoma prior to surgery. In this case study we present clinical, dermoscopic, RCM and histological features of a completely amelanotic melanoma found on a 26 year old female with brown hair, fair skin complexion and hazel eyes, who has a heterozygous MC1R variation 160W.