Compound melanocytic nevus

15-year-old girl with an enlarging pigmented lesion on her back.


Dermoscopy revealed a central part with exophytic papillary structures and a peripheral typical reticular pattern in favor of a benign compound melanocytic nevus.



Exophytic papillary structures (blue circle) and reticular pattern (square).

Stars in the sky...

A 68-year-old man with a pigmented lesion on the sternal area.


Dermoscopy revealed many a non melanocytic lesion, many milia-like cysts, some crypts and papillary structures, in favor of a seborrheic keratosis.


In the picture above exophytic papillary structures are well seen (Rectangle)


Milia-like cysts are found in seborrheic keratoses. Nevertheless, they can be present in papillomatous dermal , congenital nevi and melanomas.

Milia-like cysts are often described as "stars in the sky"

Unna nevus

Melanocytic nevus on the abdomen of a 35-year-old woman.
Dermoscopy reveals exophytic papillary structures, comedo-like openings, milia-like cysts and comma-like vessels.

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.