Scapular pigmented lesion

Due to an unfortunate accident, I am on a sick leave for a couple of months.

I am pleased to welcome Dr Eric Pierard'cases. Dr Pierard, dermatologist at private practice in Dunkerque, France has an important activity in dermato-oncology and is an expert in dermoscopy.

A 16-year-old man consulted for a left scapular pigmented lesion.

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Dermoscopy revealed:

• an atypical reticular pattern
• regular streaks
• blue hint

This lesion was excised and pathology revealed a Reed nevus.

Labial lentigo

A 15-year-old girl consulted for this acquired pigmented lesion on her lower lip.
This lesion was solitary.

Dermoscopy revealed a pigmentation with a parallel pattern of light-brown to dark-brown streaks which were linear or curvilinear.

This dermoscopic presentation was quite typical of lentigos of the mucous membranes.

We must note that melanoma-specific criteria (atypical pigment network, irregular dots and globules, blue-white veil etc...) are not found in benign lentigos of the oral and genital mucous membranes.

In our case, a biopsy was performed and confirmed the diagnosis of benign labial lentigo.

Eccentric hyperpigmented nevus

A 27-year-old woman consulted for pigmented lesion on her back. The lesion had a darker area on the upper right quadrant.


Dermoscopy revealed a central globular pattern and a peripheral atypical reticular pattern with branched streaks.



Atypical reticular pattern (rectangle) and branched streaks (circle).

The lesion was excised and pathology revealed a compound nevus.

Atypical nevi with eccentric hyperpigmentation are atypical nevi of the utmost importance, the main differentiel diagnoses being melanomas in situ or early invasive melanomas.

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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Acral melanocytic nevus

A 39-year-old woman (phototype V) noticed a pigmented lesion on her 5th left toe.
Dermoscopy revealed a uniform black homogeneous pattern with whitish dots (eccrine pores) and some streaks.
The lesion was excised and pathology revealed a compound melanocytic nevus.

Other cases of acral nevi:

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Superficial spreading melanoma

A 50-year-old woman consulted for an a assymetric pigmented lesion on her back.










Typical blue white veil
and peripheral streaks
The lesion was removed and pathology revealed a superficial spreading melanoma with a Breslow index at 1.09 mm



Other cases of melanoma
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Spitz nevus

A 47-year-old woman consulted for a a slowly enlarging pigmented lesion of her right wrist for 3 months.


Dermoscopy (x20) revealed regular streaks throughout the lesion (pseudopods and radial streaming) with a symmetrical starburst pattern.

Because of the age of the patient and the rapid enlargement, the lesion was removed.

Pathology revealed a Spitz nevus

superficial spreading melanoma

This case concerned a 59-year-old patient: this pigmented lesion of his right thigh was discovered during a consultation for condylomas. The patient was not conscious of this lesion.

On dermoscopy (x 20) : Multicomponent pattern, irregular pigment network, blue white veil very irregular, irregular streaks (bottom) irregular dots and globules.

Other cases of melanoma
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