In a 72-year-old man, on the upper back
What to see at dermoscopy:
-leaf-like areas
-spoke-wheel-like structures
-arborized telangectasia
-erythema
-multiple blue-gray globules
-scar-like depigmentation
Biopsy was indicated
Histopathological correlation: basal cell carcinoma
In a 56-year-old woman, on the perilabial area
What to see at dermoscopy:
-globular pattern
-overall architecture is symmetric
-telangectasia, comma and arborizing blood vessels
-terminal hair
Biopsy was indicated
Histopathological correlation: dermal nevus
Comments: although the dermoscopic features strongly suggest a dermal nevus, the differential diagnosis of arborizing blood vessels includes basal cell carcinoma. Collision tumours in the same biopsy specimen is not uncommon and is often reported in the literature. The most common association is basal cell carcinoma and melanocytic nevus.
For more information: Boyd AS et al: Cutaneous CollisionTumors. An analysis of 69 cases and review of the literature. Am J Dermatopatol 1994; 16: 253-257 and De Giorgi V et al. : Cutaneous collision tumor (melanocytic naevus, basal cell carcinoma, seborrhoeic keratosis): a clinica, dermoscopic and pathological case report. Br J Dermatol 2005; 152: 787-790
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.
In a 62-year-old woman, on the volar aspect of the great toe
What to see at dermoscopy:
-scaly, reddish patch with small foccus of light brown globules
-remnants of paralell pattern on the upper side portion of the lesion
Biopsy of eczemalike patch was indicated
Histopathological correlation: acral lentiginous melanoma
Comments: our case belongs to a group of clinically featureless melanoma. The presence of remnants of pigment in a eczemalike lesion should raise a red flag for melanoma.
For more information: Giacomel J et al..Dermoscopy Patterns of Eczemalike Melanoma. Arch Dermatol 143: 1081-1082
In a 32-year-old woman with atypical mole syndrome, on the thigh
What to see at dermoscopy:
-reticular pattern
-irregularly distributed dots
-irregular hypopigmentation
-structureless areas
-target-like structures
-comma blood vessels
Excision was indicated
Histopathological correlation: mild dysplastic nevus