A whitish lesion

A 48-year-old woman consulted for a whitish scar-like lesion on her back.  

Clinical picture: whitish scar-like lesion with a pigmented border. Patient has a background of former heavy sun exposure.

At dermoscopy:

• no signs in favor of a melanocytic lesion
• a structureless  scar-like white pattern
• pinkish areas without any vascular structures
• a peripheral pigmentation (red square) in favor of leaf-like 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. 

A third nipple.

A 28-year-old man consulted for this pigmented lesion located under his nipple. He was thinking this lesion was present since birth.

Dermoscopy revealed a central hypo-pigmented area with a peripheral pigmented reticulation.
This feature looks like a dermatofibroma

This lesion was a surnumerary nipple (accessory nipple)


References:
1 - Blum A., Roehm S. Accessory nipple looks like dermatofibroma in dermoscopy. 
Arch Dermatol 2003 Jul; 139 (7): 948-9


2- Oztas MO, Gurer MA. Dermoscopic features of accessory nipples. Int J Dermatol 2007; 46(10):1067-8

Melanoma

Asymmetric lesion with pink homogeneous area

A 68-year old man consulted for an atypical pigmented lesion on his left lumbar area.

Dermoscopy revealed a melanocytic lesion characterized by:

• asymmetry
• an atypical pigment network
• a pink homogeneous area
• a white area of regression
• linear-irregular vessels
• polymorphous vessels

Polymorphous and linear-irregular vessels

Atypical pigment network (circle)

White area of regression (circle)

This lesion was highly suspicious of melanoma and excised.

Pathology revealed a superficial spreading melanoma (SSM) in situ developed on a melanocytic nevus developed on a melanocytic nevus

Melanoma with regression

A 62-year-old patient with a superficial spreading melanoma on his right shoulder.

Dermoscopy (x20) revealed white areas (scar-like depigmentation) and delicate peppering.

Other cases of melanoma
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