4 курс / Дерматовенерология / Дерматоскопия (3)

340

Cases

Table 10.16

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one

Brown, gray, and skin

Serpentine vessels are

Basal cell carcinoma

Basal cell carcinoma

pattern (dots and

colored

a clue to basal cell

structureless) arranged

carcinoma, one or two

asymmetrically (chaos)

blue clods (too few to

form a pattern) support

this diagnosis

Middle

More than one

Clods are mostly black

Clues to seborrheic

Seborrheic keratosis

Seborrheic keratosis

pattern (clods, dots,

and dots are gray

keratosis:

in regression (lichen

structureless) arranged

White and yellow

planus-like keratosis)

asymmetrically

clods, looped vessels,

sharp demarcation

Bottom

One pattern (reticular)

Eccentric

Clues to melanoma:

Melanoma

Clark nevus

hyperpigmentation

thick reticular lines

342

Cases

Table 10.17

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

One pattern (dots).

Gray (dots) and red

Clues to melanoma:

Melanoma

Melanoma

If one prefers

Gray dots and white

structureless it would

lines

lead to the same

diagnosis.

Middle

One pattern (clods)

Clods are grey, yellow

Clues to seborrheic

Seborrheic keratosis

Seborrheic keratosis

and white

keratosis:

Yellow and white clods

Bottom

One pattern (reticular)

Eccentric

None

Clark nevus,

Clark nevus

hyperpigmentation

"superficial"

congenital nevus, or

"superficial and deep"

congenital nevus

344

Cases

Table 10.18

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one pattern

Eccentric

None

Clark nevus,

Clark nevus

(reticular and clods).

hyperpigmentation

"superficial"

If one prefers only

congenital nevus, or

reticular it would lead

"superficial and deep"

to the same differential

congenital nevus

diagnosis.

Middle

One pattern (reticular)

Eccentric

None

Clark nevus

Clark nevus

hyperpigmentation

Bottom

One pattern (reticular)

Central

None

Clark nevus

Not excised

hyperpigmentation

346

Cases

Table 10.19

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one

Central

Clues to melanoma:

"Superficial and

"Superficial and deep"

pattern (reticular

hypopigmentation

Gray dots

deep" congenital

congenital nevus

in the periphery,

nevus. Symmetry of

structureless in the

pattern and color takes

center), arranged

precedence over a

symmetrically

single clue (gray dots).

Middle

One pattern (reticular)

Central

Clue to melanoma:

As a general

Clark nevus

hyperpigmentation

Thick reticular lines

principle symmetry

of pattern and color

takes precedence

over a single clue.

Therefore the most

likely diagnosis is

Clark nevus. However,

a melanoma in situ

cannot be excluded

with certainty.

Bottom

More than one pattern

Central

Clue to melanoma:

As a general

Clark nevus

(reticular in the

hyperpigmentation

Gray clods

principle symmetry

periphery, clods in

of pattern and color

the center), arranged

takes precedence

symmetrically.

over a single clue.

Note that the two

Therefore the most

eccentric clods are too

likely diagnosis is

insignificant to disturb

Clark nevus. However,

the overall symmetry.

a melanoma in situ

cannot be excluded

with certainty.

348

Cases

Table 10.20

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one

Brown, orange, yellow,

Clues to seborrheic

Seborrheic keratosis

Seborrheic keratosis

pattern (clods and

white

keratosis:

structureless)

White and yellow

clods, looped vessels

Middle

More than one

Brown and skin-

Clue to melanoma:

Most likely "superficial

"Superficial and deep"

pattern (dots and

colored, central

None, the brown dots

and deep" congenital

congenital nevus

structureless), arranged

hypopigmentation

at the periphery are

nevus

asymmetrically (chaos)

not specific

Bottom

More than one

More than one color

Clues to melanoma:

Melanoma

Melanoma

pattern (reticular and

Gray clods and white

structureless), arranged

lines

asymmetrically (chaos)