In a 54-year-old woman, on the face (persistence of lesion after topical TCA)
What to see at dermoscopy:
-irregular annular-granular pattern [pseudonetwork] (circle)
-strawberry appearence
Although Dermoscopy was in favor of actinic keratosis biopsy over the pigmented site was indicated. Irregular annular-pattern should raise the suspicion of lentigo maligna
In a 62-year-old woman, on the eyebrow
What to see at dermoscopy:
-pseudonetwork
-strawberry appearance
-rosette sign (circle)
Dermoscopy in favor of actinic keratosis
Comment: rosette sign is a new dermoscopic pattern where 4 white points are arranged as a 4-leaf clover inside the follicular openings.
For more information read: Cuellar F.et al “New dermoscopic pattern in actinic Keratosis and related conditions”. Arch Dermatol 2009; 145: 732
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 58-year-old woman, on the forehead
What to see at dermoscopy:
-pseudonetwork
-blue-gray ovoid nests (circle)
-erythema
Biopsy was suggested
Dermoscopy in favor of Basal cell carcinoma and histology confirmed the diagnosis
In a 76-year-old woman, on the upper eyelid
What to see at dermoscopy:
-pseudonetwork with irregular pigmentation around follicular openings
-milia-like cysts
-hypopigmented areas
-scar-like depigmentation (lower portion of lesion)
-melanosis (left side of lesion)
Biopsy at a pigmented spot was indicated
Histopathology confirmed the Lentigo solar diagnosis
Comments: frequently, slate-gray dots and asymetric follicular openings pigmentation are the earliest feature of lentigo maligna. Those findings prompt a biopsy to rule out malignancy