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Saturday 10 May 2008


A 85-year-old woman consulted for a slowly enlarging pigmented lesion on her right cheek

Dermoscopy revealed a pseudonetwork which is characteristic of facial pigmented lesions.
Furthermore, dermoscopy showed multiple slate-grays dots or pepper-like granules realizing a typical an annular-granular pattern or peppering in favor of a lentigo maligna melanoma. A biopsy confirmed this diagnosis.


Peppering or annular-granular pattern can also be present in lichen planus-like keratosis and actinic keratosis.
Some lentigo maligna melanomas exhibit this structure.