Dermaimaging

In a 48-year-old woman, on the breast

What to see at dermoscopy:

-central homogeneous area with a small scar-like depigmentation
-polymorphous atypical vessels (linear-irregular vessels, telangectasias, arborizing and dotted vessels)
-erythema
Excision was indicated
Histopathological correlation: dermatofibroma

Comments: this case represents an uncommon presentation of dermatofibroma where atypical vessels are the main dermoscopic feature observed. In doubtful cases, excision is mandatory to rule out a melanoma.
For more information: Zaballos et al.. Dermoscopy of Dermatofibromas-a prospective morphological study of 412 cases. 2008. Arch Dermatol 144: 75-83

In a 36-year-old woman, on the back

What to see at dermoscopy:

-slight asymmetric pigmented network
-dots and blotches
-hypopigmented areas
-streaks in the down right portion of the lesion
Excision was indicated
Histopathological correlation: junctional nevus

Comments: the differential diagnosis of this lesion includes a dysplastic nevus (> 5mm, irregular border and colors)

In a 56-year-old woman, on the thigh

What to see at dermoscopy:

-comedo-like openings
-milia-like cysts
-corno cutaneum
Biopsy of skin underllying corno cutaneum was indicated.
Histopathological correlation: seborrheic keratosis

Comments: corno cutaneum may complicate several skin pathologies (solar keratosis, viral wart, seborrheic keratosis, squamous cell carcinoma, keratoacanthoma, lichenoid keratosis and basal cell carcinoma). The base of the keratin horn must be sampled to determine the nature of the underlying lesion.

 In a 36-year-old woman, on the thigh

What to see at dermoscopy:

a multicomponent pattern is observed:
-asymmetrical pigmentation pattern: eccentric hyperpigmentation (blotch)
-broadened pigment network
-globules
-irregular hypopigmentation
-target-like structures
Excision was indicated
Dermoscopy signs in favor of melanoma

Comments: Arevalo A et al observed that eccentric hyperpigmentation and multicomponent pattern are significant predictors of melanoma when other melanoma features are present.
For more information: Arevalo A et al. The significance of eccentric and central hyperpigmentation, multifocal hyper/hypopigmentation, and the multicomponent pattern in melanocytic lesions lacking specific dermoscopic features of melanoma. 2008. Arch Dermatol 144: 1440-1444

In a 34-year-old woman, on the abdominal wall; patient under immunosuppression treatment (kidney transplant recipient)