Milkline nevus

A 30-year-old woman consulted for a nevus on her left breast. This lesion was stable for many years.

Milkline nevi are located on the bilateral lines extending from the axilla through the areola and peri-ombilical area to the groin and genitalia.
They can be difficult to distinguish from melanomas.



At dermoscopy, milkine nevi often display a reticular or a parallel pattern at the periphery of the lesion.


On this picture, a parallel pattern is well seen. Management decision consisted in a 3-month follow-up.
This parallel pattern is also observable in nevi of the mucous membranes and nevi on the flexural skin (poplitea /antecubital fossa)

Globular pattern

Typical globular pattern with a rim of globules.
This benign melanocytic nevus does not need an excision.

Saccular pattern

A 43-year-old woman consulted for 2 lesions on her abdomen. The right lesion was a banal skin tag.
The lesion on the left was violaceous-black. Dermoscopy revealed many roundish or oval areas with a red or red-blue coloration typical of a saccular pattern (or lacunar pattern) in favor of an hemangioma.


It is common to observe a blue-white veil or white lines between the lacunas.

Moth-eaten border

A 34-year-old patient consulted for this pigmented lesion on his face which was slowly enlarging for 2 years.


Dermoscopy was in favor of a seborrheic keratosis:

• absence of pigmented network
• moth-eaten borders (->)
• milia-like cysts
  

Milia-like cysts

This patient presented an enlarging pigmented lesion on her back for 2 years.


Dermoscopy: lack of pigmented network, sharp borders, comedo-like openings and many milia-like cysts were in favor of a a seborrheic keratosis.


Many milia-like cysts like stars in the sky are typically found in seborrheic keratoses.

White dots

Typical case of benign acral melanocytic nevus.

Parallel furrow pattern.


Eccrine pores are well recognized as white dots which are located on the ridges between the furrows

Parallel furrow pattern

Pigmented nevus on the 5th right toe. Parallel furrow pattern in favor of a benign acral melanocytic nevus. Blue-white color in some areas correspond to the dermal production of melanin by nevus cells. No excision was required for this benign nevus.

Parallel furrow pattern

A 3-year-old boy consulted for this congenital nevus on his 4th right toe. Dermoscopy revealed a parallel furrow pattern. An annual follow-up was scheduled.

Other cases of acral nevi:

1  2  3  4  5  6  7  8  9  10  11  

Basal cell carcinoma

Clinical picture
A 44-year-old woman consulted for this lesion on her back with a circinar papulous border clinically suspicious of being a basal cell carcinoma.


Dermoscopy 1
In dermoscopy the lesion lacked pigment network.
There were blue- gray globules and polymorphous vessels (glomerular vessels, linear irregular vessels, hairpin vessels)

Dermoscopy 2


Dermoscopy 3
Glomerular vessel and hairpin vessels (right part)


Dermoscopy 4
irregular linear vessels

In this case, vascular pattern was atypical for a basal cell carcinoma which features typically arborizing tree vessels. Irregular linear vessels are more often observed in melanomas.
The lesion was excised and pathology confirmed the diagnosis of basal cell carcinoma.

Other cases of basal cell carcinomas: 

1 2 3 4 5 6 7 8 9  10 11 12 13 14 15 16 17 18 19 20 21

Compound melanocytic nevus

A 14-year-old girl consulted for an enlarging melanocytic nevus on her back. One of her sister, aged 24, had been operated for a superficial spreading melanoma 2 years before, and she was very anxious. The lesion was larger than 6 mm and had an irregular border.


Dermoscopy revealed a central homogeneous pattern and a peripheral typical reticular pattern, and peripheral globules, but no signs for a SSM.
The lesion was removed and pathology was in favour of a compound melanocytic nevus.