Saturday, 16 January 2016

Small, beware !


A 42-year-old man consulted for this small (4mm) pigmented lesion on his left calf.




Dermoscoy revealed:

  • asymmetry of colors and structures
  • some irregular blotches
  • an atypical pigment network
  • a radial streaming


Lesion was excised and pathology was in favor or a melanoma in situ.

Tuesday, 12 January 2016

A pigmented lesion

A 32-year-old man had his moles checked up.




Dermoscopy revealed:
  • whitish globules  / white cobblestone pattern
  • Light-brown peripheral network

 In favor of an accessory nipple


Central white cobblestone pattern





 Reference:

Dermoscopy of accessory nipples in authors’ own study 
G. Kamińska-Winciorek, J. Szymszal, W. Silny
Postep Derm Alergol 2014; XXXI, 3: 127–133



Sunday, 10 January 2016

A pigmented labial lesion

A 24-year-old woman consulted for a pigmented labial lesion.







Dermoscopy revealed multiple curves of semicircle, U or V mimicking the scales of a fish.
This fish scale-like pattern was in favor of a mucosal melanotic macule.


Fish scale-like pattern


Fish scale-like pattern is a new pattern described in mucosal melanotic macules.

Reference: 
Dermoscopy of pigmented lesion on mucocutaneous junction and mucous membrane.
Lin J, Koga H, Takata M, Saida T. 
BJD 161 (6); 1255-61

A yellowish lesion


A 70-year-old woman consulted for this small lesion on her right upper lid.




Dermoscopy revealed:

  • a yellow clod pattern
  • vessels arranged in a radial arrangement 
typical of a sebaceous hyperplasia

Saturday, 9 January 2016

Red lesions



A 62-year-old woman consulted for an acquired red tumor on her left ankle.



Dermoscopy revealed:

  • regular red dots
  • in a stringlike  distribution
in favor of a clear cell acanthoma

Saturday, 28 November 2015

Black lesion.


A 25-year-old woman consulted for a dark pigmented lesion on her abdomen


Dermoscopy revealed:

  • asymmetry of form
  • a central blotch
  • regular pseudopods
Pathology was in favor of melanocytic Spitz nevus

Cheek lesion.




A 55-year-old man consulted for a pigmented lesion on his left cheek

Dermoscopy revealed:

  • an irregular broadened network
  • rhomboidal structures
Pathology was in favor of a lentigo maligna melanoma in situ.

A small pigmented lesion on a leg





A 29-year-old woman consulted for  a small pigmented lesion on her right leg.


Dermoscopy revealed

  • spoke wheel areas
Pathology revealed a superficial basal cell carcinoma 


Regression.


A 21-year-man consulted for this lesion on his arm


Dermoscopy revealed:

  • a whitish - pinkish structureless area
  • with gray dots
in favor of a regressive lesion.

Pathology was in favor of a fully regressive melanocytic lesion. A fully regressive melanoma cannot be ruled out. 

Pigmented lesion on neck.


A 57 year-old-woman consulted for a pigmented lesion on her neck.


Dermoscopy revealed:
  • no melanocytic structures
  • a structureless pattern
  • irregular blue gray dots/globules 



Pathology was in favor of a Bowen's disease.

Friday, 27 November 2015

Another back lesion.


A 34-year-old man consulted for a changing pigmented lesion on his back.


Dermoscopy revealed:

  • asymmetry
  • an atypical reticular pattern
  • a regression area
Pathology revealed a melanoma in situ.


Back lesion



A 65-year-old man with many pigmented lesions on his back. One of this lesion was atypical.


Dermoscopy revealed:
  • multiple colors
  • an atypical reticular network
  • regression
  • a reticular depigmentation  (rectangle)


Pathology revealed a melanoma in situ.

Nodular lesion


A 57-year-old woman consulted for this nodular lesion on her right chest.


Dermoscopy revealed:

  • a non pigmented lesion
  • remnant of pigmentation (red circles)
  • a pink veil
  • atypical and polymorphous vessels

Pathology revealed a nodular melanoma (Breslow index 1.6mm)

Thoracic pigmented lesion


Man 52 years old; Acquired pigmented lesion on chest.



Dermoscopy revealed:

  • multiple colors
  • asymmetry of form and structures
  • an atypical network
  • a blue white veil
  • irregular dots and globules
Pathology revealed a melanoma in situ.

Saturday, 8 November 2014

Starburst pattern



A 43-year-old man consulted for this acquired pigmented lesion on his left leg.




Dermoscopy revealed:
  • a central blotch
  • a regular starburst pattern



 Two diagnoses were evoked: Reed nevus or melanoma. Regular blotch and symmetrical starburst pattern favored Reed nevus.

Lesion was excised and pathology revealed a superficial spreading melanoma with a Breslow index at 0.28mm.

Saturday, 4 October 2014

An ugly duckling


A 26-year-old woman consulted for many moles. One of them was considered "an ugly duckling".


Dermoscopy revealed:
  • an irregular blotch
  • asymmetry of form
  • chrysalis-like structures
Pathology revealed a superficial spreading melanoma (SSM) with a Breslow index at 0,6mm

Tuesday, 16 September 2014

Macular lesion on a leg.




A 42-year-old woman consulted for this lesion localized on her left leg.





Dermoscopic evaluation revealed sharply focused elongated and serpentine telangiectasias on an whitish-yellowish structureless area in favor of a necrobiosis lipoidica.

A biopsy confirmed diagnosis.

Reference: Dermoscopy of necrobiosis lipodoidica and granuloma annulare. R. Pellican and al. Dermatology 2013; 226: 319-23
ground

Sunday, 7 September 2014





A 32-year-old man consulted for this enlarging pigmented lesion.



Clinical presentation: multiple couleurs, asymmetry

Dermoscopy revealed:

  • multiple colors
  • irregular dots
  • pink structureless area
  • irregular blotch
  • regression
This lesion was easily diagnosed superficial spreading melanoma.

Pathology revealed a superficial spreading melanoma with a Breslow index at 0.5mm

Saturday, 28 June 2014





A 28-year-old patient consulted for this pigmented lesion on his right forearm.



Dermoscopy revealed:

  • multiple patches of pigmentation
  • without background pigmentation



Clinical and dermoscopic examination were in favor of an agminated nevus.

Differential diagnosis is nevus spilus: this one includes a tan background patch which is not present in agminated nevus.

Saturday, 21 June 2014





A 28-year-old woman consulted for this lesion on her right arm.


 Clinical picture


Dermoscopic picture



Dermoscopy revealed a targetoid lesion:

  • a central globular pattern (black arrow) in favor of a melanocytic nevus
  • a peripheral ecchymotic halo (red arrow)
  • a central hemorrhagic crust (yellow arrow)

This lesion was a hemosiderotic targetoid nevus.


Wednesday, 4 June 2014

Regression




A 48-year-old woman presented this pigmented lesion on her back. 



 1: clinical picture

 2: dermoscopic picture

3: dermoscopic picture

  4:  dermoscopic picture



Dermoscopy revealed:
  • regression areas with some depigmentation (green arrows and ovoid area)
  • blue gray structures (blue arrows) and blue gray dots (peppering)
  • linear irregular vessels (black arrows)



Lesion was excised and pathology revealed a regressive superficial spreading melanoma with Breslow index at  0,39 mm