Exophytic papillary structures

This 50-year-old patient has a soft polypoïd tumor on her left breast in favor of a Unna nevus
Dermoscopy revealed typical exophytic papillary structures,
comma-like vessels and a positive wobble sign.

The wobble sign

This melanocytic nevus has a papillomatous central part with exophytic papillary structures.
When the dermoscope is pushed from site to site, we can see that the papillomatous nevus is moving: this is the wobble sign.
It is an extra sign to distinguish papillomatous dermal nevus from seborrheic keratosis which do not wobble.

Unna nevus

A 39-year-old woman consulted for an abdominal pigmented lesion.
Dermoscopy revealed exophytic papillary structures (*), clustered milia-like cysts (black circle), comedo-like openings (blue circle).
The wobble sign was present in favor of a Unna nevus.
The wobble sign is a useful sign when it is difficult to share between a Unna nevus and a seborrheic keratosis: the dermoscope put on the lesion is moved; if the lesion wobbles, it is a Unna nevus at the difference of a seborreic keratosis which does not wobble.