Black grapes

A 35-year-old man consulted for this blue lésion on his back.
Dermoscopy revealed a blue / black saccular pattern.

This lesion was typical of an angiokeratoma.

Black lesion

A 32-year-old man consulted for this black solitary lesion.

Dermoscopy revealed :

• absence of any criteria for a melanocytic lesion
• blue hue
• black lagoons (saccular pattern)

in favor of an angiokeratoma.

Red lacunes on the ridges

A 28-year old-woman consulted for this dark red acral lesion present since early childhood.

Dermoscopy revealed many red saccules (or lacunes) located on the ridges with a parallel pattern.

This dermoscopic feature was in favor of an hemangioma or an hemolymphangioma

Cherry hemangiomas

Case 1: 45-year-old woman with a solitary lesion on her left thigh.
Multiple, well-demarcated, red to blue-red structures typical of a saccular pattern.
Absence of pigment network, globules or streaks.
Diagnosis: cherry hemangioma



Case 2: red saccular pattern a the inferior pole of a pigmented lesion with a typical reticular pattern.
Diagnosis: cherry hemangioma associated with a melanocytic nevus or collision tumor.

Other cases of collision tumors: 1 2

Hemangioma

A 25-year-old woman consulted for a dark blue papular lesion on her left thigh present for 6 years.
Dermoscopy revealed numerous red-blue lacunes (or red-blue saccules) in favor of an hemangioma.
A scar-like depigmentation was present on this lacunar pattern (or saccular pattern).
Fibrosis is a pathological finding sometimes found in hemangiomas.

Thrombosed hemangioma

A 34-year-old man consulted for this dark blue lesion on his right lumbar area. The lesion was traumatized by his chest and became darker 2 weeks before the consult.
Dermoscopy revealed several blue dark blue smooth-bordered round to oval variously sized structures in favor of a lacunar pattern (also named saccular pattern)
The lesion was removed and pathology revealed a thrombosed hemangioma.