4 курс / Дерматовенерология / Дерматоскопия (3)

360

Cases

Table 10.26

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one pattern

Brown

Terminal hairs are

"Superficial and deep"

Not excised

(reticular in the

clues to a congenital

congenital nevus

periphery, structureless

nevus

in the center) arranged

symmetrically

Middle

More than one pattern

Central

None

"Superficial and deep"

Not excised

(reticular in the

hypopigmentation

congenital nevus

periphery, structureless

in the center) arranged

symmetrically

Bottom

More than one pattern

Brown

Terminal hairs are

"Superficial and deep"

Not excised

(reticular in the

clues to a congenital

congenital nevus

periphery, structureless

nevus

in the center) arranged

symmetrically

362

Cases

Table 10.27

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one

Brown and gray

Clues to melanoma:

Melanoma

Melanoma

pattern (reticular

Gray dots, peripheral

and dots) arranged

black dots

asymmetrically (chaos)

Middle

One pattern (clods)

Brown

None

"Superficial and deep"

"Superficial and deep"

congenital nevus

congenital nevus

Bottom

More than one

Brown, orange, gray,

White and orange

Most likely seborrheic

Seborrheic keratosis

pattern (clods, dots,

and white

clods are clues to a

keratosis

structureless) arranged

seborrheic keratosis.

asymmetrically (chaos)

Gray clods are clues to

basal cell carcinoma.

However, the sharp

circumscription and

coiled vessels favor the

diagnosis of seborrheic

keratosis over basal

cell carcinoma.

364

Cases

Table 10.28

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one

Clods are blue and

Clues to basal cell

Basal cell carcinoma

Basal cell carcinoma

pattern (clods and

gray

carcinoma:

structureless) arranged

Blue and gray clods;

asymmetrically (chaos)

serpentine, branched

vessels

Middle

One pattern (large

Brown

None

Unna nevus (a

Not excised

polygonal clods)

congenital nevus of

one type)

Bottom

More than one

More than one color

Clues to melanoma:

Melanoma

Melanoma

pattern (clods, and

(melanin dominant)

White lines and gray

structureless) arranged

clods

asymmetrically (chaos)

366

Cases

Table 10.29

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

More than one

Black, gray and brown

Some seborrheic

Seborrheic keratosis

Seborrheic keratosis

pattern (clods and

(melanin dominates)

keratosis are so

structureless) arranged

heavily pigmented that

asymmetrically (chaos)

the clods appear black

or dark brown and

not yellow, orange, or

white

Middle

One pattern (large

Brown and skin-

Large polygonal, skin-

Unna nevus (a

Unna nevus

polygonal clods)

colored

colored or light brown

congenital nevus of

clods are clues to a

one type)

mainly intradermal

congenital nevus

(Unna nevus)

Bottom

More than one

More than color

Clues to melanoma:

Melanoma

Melanoma

pattern (clods, and

(melanin dominant)

Gray clods, white

structureless) arranged

lines, pseudopods,

asymmetrically (chaos)

eccentric structureless

area

368

Cases

Table 10.30

Pattern

Color

Clues

Dermatoscopic

Histopathologic

diagnosis

diagnosis

Top

One pattern (clods).

Brown

None

"Superficial and deep"

"Superficial and deep"

The clods are arranged

congenital nevus

congenital nevus

in the furrows but this

does not make them

parallel lines.

Middle

More than one

Clods are gray and

Clues to malignancy:

Basal cell carcinoma

Basal cell carcinoma

pattern (clods, and

brown

Gray clods and white

structureless) arranged

lines. The small zone

asymmetrically (chaos)

of ulceration (small red

clod) favors basal cell

carcinoma.

Bottom

More than one

More than one color

Clues to melanoma:

Melanoma

Melanoma

pattern (clods and

(melanin dominant)

Black dots in the

structureless) arranged

periphery, segmental

asymmetrically (chaos)

radial lines, eccentric,

structureless area