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© Cardiff University Department of Dermatology

FeaturesCheck Answers

What dermoscopic features can you see?
Black blotches
Lanugo hairs
Glomerular/dotted vessels
Comma vessels
Unspecific pattern
Brown globules




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FeaturesDiagnosis

Multiple comma vessels, brown globules and terminal hairs.
Black blotches
Lanugo hairs
Glomerular/dotted vessels
Comma vessels
Unspecific pattern
Brown globules




Diagnosis

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What is your diagnosis?
Seborrhoeic keratosis
Dermal naevus
Superficial melanoma
Junctional naevus
Spitz/Reed naevus
Basal cell carcinoma
This is a dermal melanocytic naevus with a few globules and remnants of brown pigment. Multiple comma vessels and terminal hairs are characteristic.

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What dermoscopic features can you see?
Arborizing vessels
Red lacunas
Comma vessels
Regression
Unspecific pattern
Dotted vessels




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FeaturesDiagnosis

Dotted vessels are visible.
Arborizing vessels
Red lacunas
Comma vessels
Regression
Unspecific pattern
Dotted vessels




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Basal cell carcinoma
Amelanotic melanoma
Bowen’s disease
Clear cell acanthoma
Haemangioma
Seborrhoeic keratosis
The diagnosis is highly suggestive of clear cell acanthoma because of the presence of dotted vessels distributed like a necklace of pearls or in a string-like pattern (see inset).

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What dermoscopic features can you see?
Crusted glomerular vessels
Ulcerations
Reticular network
Regression structures
Streaks
Red lacunas




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FeaturesDiagnosis

Red Lacunas are visible on the image.
Crusted glomerular vessels
Ulcerations
Reticular network
Regression structures
Streaks
Red lacunas




Diagnosis

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What is your diagnosis?
Pyogenic granuloma
Angiokeratoma
Basal cell carcinoma
Amelanotic melanoma
Cherry angioma
Dermatofibroma
This is a cherry angioma with striking red lacunas. These are roundish, globular, sharply demarcated red structures.

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What dermoscopic features can you see?
Regular network
Irregular network
Milia like cysts
Central white patch
Finger-like projections
Pseudonetwork




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FeaturesDiagnosis

Pigment network at the periphery and a central white patch
Regular network
Irregular network
Milia like cysts
Central white patch
Finger-like projections
Pseudonetwork




Diagnosis

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What is your diagnosis?
Keratoacanthoma
Melanoma with regression
Dermatofibroma
Reticulated seborrhoeic keratosis
Naevus in type 1 skin
Basal cell carcinoma
This is a classic dermatofibroma with a delicate pigment network at the periphery and a central white scar-like patch. The central patch is described as scar-like because it is whiter than the surrounding skin.

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What dermoscopic features can you see?
Regression
Homogeneous blue pigmentation
Blue-grey blotches
Blue lacunas
Blue globules
Chrysalis structures




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FeaturesDiagnosis

Homogeneous blue pigmentation
Regression
Homogeneous blue pigmentation
Blue-grey blotches
Blue lacunas
Blue globules
Chrysalis structures




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Melanoma metastasis
Pigmented basal cell carcinoma
Nodular melanoma
Blue naevus
Haemangioma
Globular naevus
This is a blue naevus characterised by a homogeneous pattern of structureless blue pigmentation. The history of a long lasting lesion with no change is typical.

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What dermoscopic features can you see?
Globules
Pigment network
Streaks
Blue-white veil
Black blotches
Irregular vessels




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FeaturesDiagnosis

Streaks and peripheral globules
Globules
Pigment network
Streaks
Blue-white veil
Black blotches
Irregular vessels




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Melanoma
Basal cell carcinoma
Globular naevus
Seborrhoeic keratosis
Spitz/Reed naevus
Ink spot lentigo
This is a Spitz/Reed naevus typified by multiple streaks of pigmentation with globules arranged symmetrically at the periphery of the lesion in a radiating pattern (starburst).

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FeaturesCheck Answers

What dermoscopic features can you see?
Arborizing vessels
Structureless blue pigmentation
Regression
Atypical network
Streaks
Dots/globules




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FeaturesDiagnosis

Large blue-white structure (regression), atypical network, peripheral streaks, dots and globules
Arborizing vessels
Structureless blue pigmentation
Regression
Atypical network
Streaks
Dots/globules




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Spitz/Reed naevus
Basal cell carcinoma
Reticulated seborrhoeic keratosis
Melanoma
Globular naevus
Squamous cell carcinoma
This is a melanoma with a multicomponent pattern with polychromatism, an atypical pigment network with an abrupt cut-off at the periphery, a large blue-white structure in keeping with regression and dots/ small globules with peripheral streaks.

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What dermoscopic features can you see?
Arborizing vessels
Comedo-like openings
Comma vessels
Globules
Unspecific pattern
Blotches




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FeaturesDiagnosis

Comedo-like openings, multiple comma vessels and globules at the periphery.
Arborizing vessels
Comedo-like openings
Comma vessels
Globules
Unspecific pattern
Blotches




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Seborrhoeic keratosis
Basal cell carcinoma
Dermal naevus
Junctional naevus
Invasive Melanoma
Clear cell acanthoma

A dermal naevus with comma vessels, comedo-like openings and small brown globules at the periphery. These are typical features of a papillomatous dermal naevus (Unna type).

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FeaturesCheck Answers

What dermoscopic features can you see?
Streaks
Structureless blue pigmentation
Globules
Linear vessels
Central pore
Crown vessels




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FeaturesDiagnosis

Linear vessels, globules and streaks
Streaks
Structureless blue pigmentation
Globules
Linear vessels
Central pore
Crown vessels




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Squamous cell carcinoma
Spitz/Reed naevus
Melanoma in-situ
Sebaceous hyperplasia
Invasive melanoma
Compound naevus
There are centrally located, thick and elongated linear vessels over a pink background corresponding to the thick invasive part of this melanoma. The presence of pigmented melanoma-specific criteria, namely irregular globules and streaks further facilitates the diagnosis.

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