A 60-year-old man consulted for this black-blue tumor on his back.

Patient did not know when this lesion appeared.

Dermoscopy revealed a homogenous blue pattern with whiter areas.

Two diagnosis were suspected:

- blue nevus

- melanoma

This lesion was excised and pathology revealed a blue nevus with fibrous involution

A new melanoma ?

A 30-year-old woman consulted for this black pigmented lesion on her 4th right toe. She mentioned to have tried to remove it with a blade and a needle.

Dermoscopy revealed a black homogeneous pattern.
A melanoma was suspected and lesion was surgically removed for pathology.

Pathology revealed a wart.

This is a quite unusual presentation for a wart.

Blue lesion on a leg

A 58-year-old woman consulted for a pigmented lesion on her right leg present for many years.

NB: a scar is due to a former fracture.

Dermoscopy revealed an homogeneous blue pattern in favor of a benign blue nevus.

Actinic lentigo

A 72-year-old man consulted for an enlarging pigmented lesion on his right hand. This lesion was quite typical of an actinic lentigo.

Dermoscopy confirmed easily this diagnosis showing: a homogeneous pattern and a pseudoreticular network with thin lines,  with a moth-eaten border

Atypical (dysplastic) nevi

A 19-year-old man consulted for multiple atypical (dysplastic nevi or Clark nevi) on her trunk. Three of them were clustered on her back. They featured three different dermoscopic patterns:

1-reticulo-globular pattern with eccentric hyperpigmentation

2 - multicomponent pattern (globular, reticular and homogeneous patterns)

3- reticular pattern with central hypopigmentation

Combined nevus

A 16-year-old girl consulted for a melanocytic nevus with 2 colors located on her back.
Dermoscopy revealed a globular pattern associated with a central homogenous pattern (darker area) in favor of a benign combined nevus.

A combined nevus is a nevus which contains two or more components, most often with 2 distinct colors.
In some cases combined nevus consists of a typical blue nevus associated with another kind of nevus.
A combined nevi can clinically mimick melanomas because of the markedly variegated coloration and asymmetry suggestive of a melanoma occuring on pre-existing nevus.
Dermoscopically , combined nevi present with a multicomponent pattern (homogenous, reticular and globular in combinations )
If a combined nevus is composed of a blue nevus and a common nevus, dermoscopy reveals the stereotypical findings of a blue nevus, namely ( homogenous blue-gray pigmentation without observable local features)

Blue nevus

A 43-year-old woman consulted for a dark bue lesion on her left buttock.

Dermoscopy revealed an homogeneous pattern made of bluish to white-blue structureless pigmentation, in favor of a blue nevus.

Acral melanocytic nevus

A 6-year-old boy consulted for a congenital acral melanocytic nevus on his 2nd left toe.


This lesion exhibited a combination of 3 patterns, namely a parallel furrow pattern (dots on the furrows), an homogeneous pattern and a reticular pattern.


Parallel furrow pattern (circle) and reticular pattern (rectangle) were the main patterns observed on this benign melanocytic nevus.

Other cases of acral nevi:

1  2  3  4  5  6  7  8  9  10  11  

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.

Acral melanocytic nevus

A 39-year-old woman (phototype V) noticed a pigmented lesion on her 5th left toe.
Dermoscopy revealed a uniform black homogeneous pattern with whitish dots (eccrine pores) and some streaks.
The lesion was excised and pathology revealed a compound melanocytic nevus.

Other cases of acral nevi:

1  2  3  4  5  6  7  8  9  10  11  

Atypical (dysplastic) nevus

A 68-year-old woman consulted for this pigmented lesion on her back.
Dermoscopy revealed an asymmetric lesion with an atypical reticular and homogenous pattern , a few subtle blue-white structures (circle) and brown dots (arrow)
The lesion was excised and pathology revealed an atypical (dysplastic) compound type.

Spitz nevus

A 14-year-old boy presented a dark pigmented lesion on his lumbar area. Dermoscopy revealed a homogeneous pattern with a bluish pigmentation. Rare brown globules were found at the periphery. The lesion was excised and pathology revealed a dermal Spitz nevus.

Six dermoscopic patterns of Spitz nevus have been described:
-vascular pattern with dotted vessels
-globular pattern
-reticular pattern
-starburst pattern
-homogeneous pattern
-atypical pattern

Blue nevus

A 32-year-old woman consulted for this blue lesion on her nose.
Dermoscopy revealed an homogeneous blue pattern in favor of a blue nevus.

Atypical nevus

A 40-year-old man consulted for this atypical mole of the intermammary region, without recent changing.
Dermoscopy (x20) showed a combination of two patterns:

1-on the left: an homogenous pattern with comma vessels

2- on the right: a reticular pattern with blue white veil




The lesion was removed and pathology revealed a benign irritated compound nevus with lateral junctionnal extension