Flashcards

Dermatoscopia

Vando Sousa Portuguese 35 cards

Cards in this deck (35)

1—Clinicamente - atipico
Dermatoscopicamente - nevo comum
Clinically this nevus reveals border irregularity and an asymmetric shape (A), while dermoscopy (B) shows a striking symmetry of colors (brown) and
structures (reticular pattern). The red globule-like structure (arrow) is a small angioma in close vicinity to the nevus.
2—Nevo comum.
Dermoscopy of a nevus showing a multifocal pigment distribution
characterized by small areas revealing dark and light brown color
3—Nevo comum.
Nevus showing dermoscopically eccentric hypopigmentation. This
pigmentation type is quite infrequent, but it is important to differentiate it from
an eccentric focus of regression. This can be facilitated by examining the surrounding
normal skin. The structureless hypopigmented area will have the same
or slightly darker hue as compared with the normal uninvolved skin.
4—Nevo comum.
Dermoscopy of a nevus showing central hypopigmentation.
5—Nevo comum.
Dermoscopy of a nevus showing central hyperpigmentation
6—Nevo comum.
Dermoscopy of a nevus revealing eccentric hyperpigmentation.
Note that the pattern (in this case a reticular pattern) corresponding to the area
of hyperpigmentation is the same as in the rest of the nevus
7—Nevo comum.
Dermoscopy of a reticular nevus reveals a regular network with
regular network meshes and holes. The pigmented lines typically fade out at the
periphery.
8—Nevo comum.
Classic appearance of a nevus of an individual with dark skin type
(so-called black nevus) exhibiting dark brown and black color, reticular network,
and central hyperpigmentation. The central hyperpigmentation is caused by a black
lamella (arrow) corresponding histopathologically to pigmented parakeratosis.
9—Nevo comum.
Dermoscopy of a nevus composed of brown to gray globular and
cobblestone pattern.
10—Nevo comum intradermico.
a striking asymmetry
of colors and structures. The nonpigmented area
reveals comma-like vessels of different size and diameter,
and the pigmented area reveals a mixture of structureless
homogenous pattern and residual globules and
cobblestones. Terminal hairs or few comedo-like openings
(arrows) are often present in such nevi
11—Nevo comum intradermico.
Only residual pigmentation appearing as
irregularly distributed brown-to-gray blotches are visible.
The short but large caliber vascular pattern
(comma-like vessels) appears blurred, which is an
important criterion to differentiate dermal nevi on the
face from nodular basal cell carcinoma. In the latter,
the vessels are typically elongated and sharply in focus
12—Nevo comum.
Globular–reticular nevi are composed of a central dermal component
with globules surrounded by a regular reticular network
13—Nevo comum.
Example of globular-reticular nevus exhibiting in the center predominantly
structureless hypopigmentation with a few globules
14—Nevo comum.
The peripheral rim of small brown globules is indicative for a
growing nevus.
15—Nevo atípico.
features concerning for melanoma (asymmetric growth and blue-white veil). The lesion was excised and the pathology
report was that of a dysplastic nevus
16—Nevo atípico.
Dermoscopy reveals a diffuse reticular
pattern nevus. Dots overlying the network lines can
be ignored. They represent small junctional nests
located at the tips of rete ridges—a feature that speaks
in favor of a benign nevus.
17—Nevo atípico.
Dermoscopy reveals a patchy network
pattern nevus.
18—Nevo atípico.
This nevus has a pattern with peripheral
network with central hypopigmentation. This
pattern is commonly seen in fair skin individuals
19—Nevo atípico.
Dermoscopy reveals a nevus with
peripheral reticulation (network) and central hypopigmentation.
20—Nevo atípico.
Dermoscopy of this biopsy-proven
dysplastic nevus reveals a globular pattern
21—Nevo atípico.
This nevus has a homogenous pattern.
22—Nevo atípico.
Dermoscopy reveals a starburst pattern
consisting of peripheral globules that are tiered,
one on top of the other. Notice how this differs from the
peripheral globular pattern shown in Figure 7b.19
where only one rim of globules are present. This tiered
globular patter can be seen in Spitz nevi and in DN
with spitzoid features. This lesion was biopsied and the
pathology was consistent with a dysplastic nevus with
spitzoid features.
23—Nevo atípico.
Dermoscopy reveals a two- component
pattern nevus
24—Nevo atípico.
This nevus has a relatively symmetric
multicomponent pattern. It has network, blotches,
and a few globules. It is clinically often diffi cult to rule
out melanoma in lesions with this pattern. If this is a
clinical or dermoscopic outlier lesion then a biopsy
would be the prudent management decision. However,
if the pattern in this nevus is similar to the
patient’s other nevi then monitoring would be an
acceptable alternative to biopsy
25—Nevo atípico.
Dermoscopy reveals a symmetric
multicomponent pattern. This acquired lesion has
network, globules, homogenous areas, and blue-white
veil. The differential diagnosis for this lesion is
between dysplastic nevus and melanoma. Excisional
biopsy and pathology proved that this was a dysplastic
nevus.
26—This is an asymmetrically patterned
multicolored lesion. It lacks symmetry of pattern over
every axis through the center of the lesion (see chap. 7b)
and has more than one color; scored from tan, dark
brown, gray, black, blue, and red. It has the positive
melanoma features of a broadened atypical network
(thick arrow), and the pseudopod (thin arrow), and
radial streaming (red arrow) are very subtle. Note the
peripheral light brown structureless area occupying
more than 10% of the lesion surface from 3 to 7 o’clock
in position. Diagnosis: in situ superfi cial spreading melanoma.
27—This asymmetrically patterned multicolored
lesion has the positive melanoma feature of
broadened atypical network (arrows). Broadened network
is usually seen focally rather than in a uniform
distribution. It is probably the most important (sensitive)
feature of early nonregressing superfi cial spreading
melanoma (SSM). Note the blue pigmentation
formed by confl uent melanophages in the dermis.
Diagnosis: in situ SSM.
28—This asymmetrically patterned multicolored
lesion has the one positive melanoma feature
of focal broadened network (arrows). Note the amelanotic
contiguous nevus. Diagnosis: superfi cial spreading
melanoma, Breslow thickness 0.35 mm with a
contiguous compound nevus
29—This asymmetrically patterned multicolored
lesion (dark brown, tan, and gray) has the
positive features of focal broadened network (thin
arrow) and subtle radial streaming (large arrow).
Diagnosis: superfi cial spreading melanoma, Breslow
thickness 0.35 mm.
30—This asymmetrically patterned multicolored
lesion has the positive features of scar-like
depigmentation, blue-white veil, and focal broadened
network (arrow). In addition, note the widespread
peripheral light brown structureless areas occupying
more than 10% of the lesion surface. Diagnosis:
regressing superfi cial spreading melanoma, Breslow
thickness 0.4 mm.
31—This asymmetrically patterned multicolored
lesion has the positive melanoma features of
multiple brown dots, found in the classical focal distribution
(thin arrows), radial streaming (thick arrows),
and multiple blue-gray dots (asterisk). Note the contiguous
banal nevus at the left half of the lesion. Diagnosis:
regressing superfi cial spreading melanoma, Breslow
thickness 0.45 mm with a contiguous compound nevus
32—This melanoma has the positive feature
of multiple (5–6) colors. Diagnosis: superfi cial
spreading melanoma, Breslow thickness 0.55 mm.
33—This hypomelanotic asymmetrically
patterned multicolored lesion has the positive features
of extensive scar-like depigmentation and blue-white
veil. Note the pin-point (dotted) vessels within the
amelanotic component (small arrow). Also note the
negative pigment network (large arrow), which is a
signifi cant fi nding in both Spitz nevi and invasive
melanoma (Menzies et al., 1996b). Diagnosis: superfi -
cial spreading melanoma, Breslow thickness 0.7 mm.
34—This amelanotic lesion has some
linear irregular and arborising vessels. Because of overlap
between amelanotic melanoma and other malignant
amelanotic lesions, it is easier to distinguish all
malignant amelanotic/hypomelanotic lesions from all
benign lesions rather than to attempt to discriminate
melanoma from other malignant lesions, such as basal
cell carcinoma. This illustrates the importance of biopsy
prior to any nonsurgical treatment of amelanotic
lesions. Diagnosis: amelanotic superfi cial spreading
Figure 8a.16a Clinical image. melanoma, Breslow thickness 0.8 mm.
35—This asymmetrically patterned multicolored
SSM has the positive melanoma features of
focal multiple brown dots (arrows) and small areas of
blue-white veil. Note also the extensive negative pigment
network (red arrow). Diagnosis: SSM, Breslow
thickness 1.2 mm with associated compound nevus.
Abbreviation: SSM, superfi cial spreading melanoma.