In a 49-year-old man, with atypical mole syndrome, on the abdominal wall; personal history of melanoma in situ excision on the upper back
What to see at dermoscopy:
-irregular pigment network
-irregular hypopigmented areas
-structureless areas
-branched streak
-terminal hair
-erythema
-comedo-like opening
Excision was indicated
Histopathological correlation: mild dysplastic nevus
In a 54-year-old woman, on the leg; “dimple” sign was present
What to see at dermoscopy
-erythema
-chrysalis structures
-scar-like depigmentation
-remnants of pigment network at periphery
Dermoscopy in favor of Dermatofibroma
Comments: remember that differential diagnosis of chrysalis structures includes: melanoma, Spitz nevi and basal cell carcinoma.
In a 64-year-old woman, on the chest
What to see at dermoscopy:
-cerebriform pattern: fissures and ridges (generally associated with acanthotic seborrheic keratosis)
-comedo-like openings
-milia-like cysts
-hairpin vessels
-erythema
Dermoscopy signs in favor of seborrheic keratosis
In a 45-year-old woman, a kidney transplant recipient; present lesion nearby a invasive melanoma excision scar (on the abdominal wall)
What to see at dermoscopy:
-chrysalis structures (white linear streaks seen on left side portion of lesion)
-erythema
-telangectasias, dotted and arborizing blood vessels
-crust corresponds to biopsy site
Histopathological correlation: amelanotic melanoma
Comments: chrysalis structures are defined as shiny, bright white, orthogonal linear streaks seen under dermoscopy. Skin lesions with increased amount of collagen in the stroma ( melanoma, basal cell carcinoma, dermatofibroma and Spitz nevi) will often reveal chrysalis structures (Marghoob AA et al. Arch Dermatol in press).