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 32-year-old man consulted for this enlarging pigmented lesion.

Clinical presentation: multiple couleurs, asymmetry

Dermoscopy revealed:

• multiple colors
• irregular dots
• pink structureless area
• irregular blotch
• regression

This lesion was easily diagnosed superficial spreading melanoma.

Pathology revealed a superficial spreading melanoma with a Breslow index at 0.5mm

Melanoma ?

A 52-year-old woman consulted for an atypical pigmented lesion on her right thigh.

Dermoscopy revealed:

• asymmetry
• eccentric pigmentation
• atypical reticular network
• depigmentation
• pink/red area

Clinical and dermoscopic images were in favor of a melanoma.

Lesion was excised and pathology revealed a dermatofibroma.

This case is interesting to show how a dermatofibroma may be atypical:

• clinical examination: no induration at palpation and asymmetry of colours
• dermoscopic features

Regression

A 61-year-old man consulted for a pigmented lesion on his back.

Clinically this lesion was asymmetrical with 2 colours: pink and black.

Dermoscopy revealed: regression signs with a pink area, blue gray dots with a peppering aspect.

Pathology report: fibrosis and inflammation, hypermelanosis. Melanophages developed on a 1 mm depth. Immunochemistry: anti-human A negative.

In conclusion, this lesion was a fully regressive melanoma.

We recommend to read this article:

Dermoscopy of fully regressive melanoma. L. Thomas and al.

The British Journal of Dermatology. 2008;158(6):1224-1229

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

Early superficial spreading melanoma

A 37-year-old man consulted for an enlarging pigmented lesion on his abdomen.


Dermoscopy revealed an atypical pattern with an asymmetry, homogeneous area, irregular dots and globules, and irregular branched streaks.


The lesion was excised and pathology revealed a superficial spreading melanoma with a Breslow index non measurable.

Other cases of melanoma
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