Discussing Pediatric Dermoscopy and AI for Skin Cancer Detection, With Ashfaq Marghoob, MD

During the 2026 Maui Derm Hawaii meeting, Ashfaq Marghoob, MD, spoke with HCPLive about several key takeaways from his portion of the ‘Pediatric Dermoscopy Workshop: Dermoscopy in Infants, Children, Teens and Young Adults’ session, with a strong emphasis on pattern recognition and reassurance in pediatric populations.1

Marghoob, MD, a dermatologist who specializes in the diagnosis and treatment of skin cancer, is the director of the Memorial Sloan-Kettering regional skin cancer clinic. A central theme of his session was spotlighting common areas of clinician anxiety, particularly nevi on the scalp in children. He reviewed several characteristic benign scalp patterns, their dermoscopic features, and supporting literature demonstrating no established association with melanoma.2 Looking ahead, Marghoob also expressed optimism about artificial intelligence (AI) in melanoma screening.

The following is a transcription of this portion of his discussion of the session and its major highlights, conducted on-site with the HCPLive editorial team:

HCPLive: Would you highlight some of the key points made in your pediatric dermascopy workshop that you feel are important for clinicians to take home with them?

Marghoob: Basically, what I concentrated on is that there is a group of lesions that clinicians somehow have anxiety about. I honed in on those lesions, and one of them is a lesion on the scalp. Let’s say I'm seeing a nevus on a child’s scalp. For some reason, it causes anxiety for clinicians. It may be that having it on the scalp is a harbinger or a sign that this child may eventually develop ‘Atypical mole syndrome.’

What I drilled down on was the dermoscopic features of the nevi that occur in the scalps of kids. We have the so-called ‘eclipse’ nevus, the ‘reverse eclipse’ nevus, the ‘cockade’ nevus, and the ‘balloon cell’ nevus. Those are sort of the four types of nevi that are frequent on the scalp. And for whatever reason, they often will get sent to me for referral as to what we do for these. I think that these are all benign patterns.

This is kind of reassuring, providing the literature to show that there are, in fact, benign patterns never been associated with melanoma. We encourage individuals to just monitor them, realizing also that, since they are children, over the course of time, these will become a little bit bigger. That is normal, and that shouldn't justify their removal. It's sort of a reassurance from a dermatoscopic perspective, [telling them] from a literature perspective, these lesions on the scalp are benign.

HCPLive: Were there any other elements you highlighted in the pediatric dermoscopy session worth highlighting for clinicians viewing this interview?

Marghoob: The second thing that we covered is lesions on the palms and soles in kids. Again, there's a myth out there that if you see a lesion on the palm and sole, you always have to cut it out. I'm not sure where that myth began, but it is one that kind of permeates across not only dermatologists, but family physicians as well. As I said, I don't know what it's founded in, but dermoscopy has been proven to have distinct patterns in children that are benign. We don't have to cut them out. We don't even have to monitor them.

One of the key things to remember is that in nevi, as I mentioned before, you have parallel lines in the invagination…In adults, this line tends to be a solid, single line. But in children, it is very often a double line, or the lines are made out of dots. That sometimes confuses clinicians. I kind of highlighted what they look like and that they are benign. Then the second pattern that we see on the palms and soles of kids is something called the ‘peas in a pod’ pattern, where you'll see parallel lines in the furrows and dots on the ridge. These, when you biopsy them, tend to have a congenital feature. And again, based on dermoscopy, these are reassuring patterns. Then I highlighted what the histopathology correlates are for this specific pattern. So again, patterns of reassurance for clinicians.

Then the third thing I covered in the pediatric dermoscopy talk was melanonychia striata, so having pigmented nails in children. Kids form moles on their nail unit that will resemble melanoma in every way. They'll encompass more than half the nail, the full nail, they'll have pigment around on the cuticle, hyponychium, and everywhere. The only reassurance we have is that kids don't get melanoma of the nail unit. So we need to have a little bit of patience and monitor them.

HCPLive: Zooming out, what are you most looking forward to in the dermatology space in 2026, specifically related to these topics?

Marghoob: I think that probably the area that I'm most interested in right now is making screening for melanoma more efficient and maybe more fail-proof. What do I mean by that? If the patient comes in, the conventional method right now is we examine them, and sometimes we have images that we compare. But it is me, the human, comparing [images] and looking for change. But we have to acknowledge that the human brain is not 100%...I think that the AI technology that is out there now will make that [type of mistake] extremely unlikely. The ability for AI to compare images, for example, is something that has been used forever.

So, this idea that computers can find new and change lesions, I think, will ensure that we will not miss anything. Add to that a second layer. On the lesion level, we have AI technology that is likely to come to bear. If you have a troubling lesion about which you're not quite sure, and we're not talking about lesions that 100% are benign or 100% malignant, but in between, AI may actually be able to help us in the management of those lesions. Then it may decide on what type of follow-up, biopsy, or no biopsy. Although it's in its infancy on that side, I do think that within my lifetime that I will see that somehow permeate into our clinical practice.

The quotes used in this interview summary were edited for the purposes of clarity.

Marghoob had no disclosures of note to highlight.

References

1. Marghoob A. Dermoscopy Workshop: Special Site Dermoscopy. Presented at the 2026 Maui Derm Hawaii Conference, January 25-29.

2. Ring C, Cox N, Lee JB. Dermatoscopy. Clin Dermatol. 2021 Jul-Aug;39(4):635-642. doi: 10.1016/j.clindermatol.2021.03.009. Epub 2021 Mar 19. PMID: 34809768.