Whitish area

A 17-year-old girl presented a pigmented lesion with a lateral  depigmentation.

Dermoscopy  revealed a globular pattern associated with a whitish structureless area. On this whitish area some vessels were observed. There were no signs of peppering.

This lesion was excised and pathology revealed a benign dermal melanocytic nevus with a fibrous involution.

Whitish structureless area can be observed in:

• fibrous involution
• after traumatism
• in case of regression (with peppering)

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

Collision tumor

A patient presented a pigmented lesion on his back (lumbar area). He had no idea of change of colors or size and this lesion had not been traumatized.

Picture taken with a Fotofinder dermoscope

Dermoscopy revealed a peripheral reticular-globular pattern with a central hypopigmentation in favor of a benign melanocytic nevus.

Picture taken with a 3Gen Dermalite Foto System Pro

At the inferior pole of the lesion, a red structureless area was noticed in favor of a cherry angioma.

The association of these to lesions, namely melanocytic nevus and cherry angioma corresponded to a collision tumor.

Picture taken with a Fotofinder dermoscope

Picture taken with a 3Gen Dermalite Foto System Pro

A collision tumor is defined as a side-by-side occurence of two tumors (benign or malignant).

For example: confluence of a seborrheic keratosis and a basal cell carcinoma, confluence of a melanoma and a BCC, confluence of an angioma and a Clark nevus.

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)

Dysplastic nevus

A 34-year-old woman presented a Clark nevus (synonyms: atypical nevus or dysplastic nevus) on her back.


Dermoscopy revealed an asymmetric reticular-globular pattern.


Central globular pattern (circle) and reticular pattern (rectangle) are well seen on this picture.
The reticular-globular pattern is the most frequent of the different patterns observed in Clark Nevi.

Acral melanocytic nevus with a globular pattern

Acquired or congenital benign melanocytic lesions on the palms and soles (volar skin) are usually called acral nevi.
Acral melanocytic nevi typically feature the following aspects: parallel furrow pattern, lattice-like pattern and fibrillar pattern.

A 25-year-old man consulted for a congenital melanocytic nevus located on the right plantar arch.


Dermoscopy featured a globular pattern without signs of parallel pattern.

Patchy network in a congenital melanocytic nevus

A 11-year-old girl presented a congenital melanocytic nevus on her left thigh.

Dermoscopy revealed a globular pattern and the presence of a patchy network (white circle)



A regular follow-up did not show any changing.

Globular pattern

Typical globular pattern with a rim of globules.
This benign melanocytic nevus does not need an excision.

Nevus spilus

A 25-year-old woman consulted for a pigmented lesion on her right arm.
The lesion was a lentiginous patch with darker brown pigmented macules in favor of a nevus spilus.
Dermoscopy revealed darker brown areas with a reticulo-globular pattern in favor of melanocytic nevi. The background was light brown and reticular.

Nevus spilus are present at birth or childhood. On histology they correspond to a lentigo with surimposed junctional or compound nevi.
Main differential diagnosis is agminated nevus which correspond to lentiginous compound melanocytic nevi without light background pigmentation.

Reference: Bragg et al. Agminated acquired melanocytic nevi of the common and dysplastic type. J Am Acad Dermatol 2005;52:67-73

Globular pattern

27-year-old woman with an asymetrically pigmented nevus on her right arm.


Dermoscopy: asymetric globular pattern (eccentric hyperpigmentation on the left). No excision was necessary for this benign dermal nevus which was followed-up every 12 months.

Patchy multifocal hypopigmentation

Congenital melanocytic nevus: reticulo-globular pattern, and patchy multifocal hypopigmentation (peri-follicular hypopigmentation)

Congenital melanocytic nevus

This 17-month-old boy presented a typical congenital melanocytic nevus with an homogenous globular pattern.