In a 50-year-old woman, on the leg
What to see at dermoscopy:
-sharply demarcated and moth-eaten border
-fissures and ridges (cerebriform pattern)
-milia-like cysts
Dermoscopy in favor of early seborrheic keratosis
In a 56-year-old woman, on the nose
What to see at dermoscopy:
-pseudonetwork
-irregular pigmentation around follicular opening (circle)
-erythema
-finguerprint-like structures
-moth-eaten border
Biopsy at the irregular pigmentation (circle area) was indicated to rule out a lentigo melanoma
Histology correlation: actinic keratosis
Comment: the finding of finguerprint-like structures and the moth-eaten border indicates the possibility of coexistence of a solar lentigo beside the actinic keratosis.
In a 54-year-old man, on the chest
What to see at dermoscopy:
-sharply demarcated and irregular border (moth-eaten appearance)
-within the lesion, faint and irregular network (fingerprint-like appearance)
-structureless areas
Dermoscopy signs in favor of solar lentigo
In 82-year-old woman, on the supraclavicular fossa
What to see at dermoscopy:
-sharply demarcated and irregular border (moth-eaten appearance); within the lesion, faint and irregular network
-structureless areas
-peppering at the edge of the lesion (regression areas)
-milia-like cysts and comedo-like openings
-cerebriform appearance at the upper right portion of the lesion
Dermoscopy signs in favor of lichen planus-like keratosis
Comments: lichen planus-like keratosis is believed to be either a solar lentigo or an early seborrheic keratosis undergoing regression; important to remember that it can simulate the early changes seen in lentigo maligna.
In a 62-year-old man, on the forehead
What to see at dermoscopy:
-sharp and moth-eaten border
-pseudonetwork with asymmetric pigmented follicular openings
-milia-like cysts
-light brown homogeneous areas
-jelly sign
Biopsy at pigmented site was indicated
Dermoscopy signs in favor of seborrheic keratosis
Comments: although the observed dermoscopic structures strongly suggest a seborrheic keratosis, we can not rule out a melanoma for the presence of asymmetric pigmented follicular openings.