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© Cardiff University Department of Dermatology

FeaturesCheck Answers

What dermoscopic features can you see?
Blue white veil
Streaks
Comedo-like openings
Irregular dots and globules
Spoke wheel-like structures
Maple leaf pigment pattern




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FeaturesDiagnosis

Blue-white veil, streaks and irregular dots and globules.
Blue white veil
Streaks
Comedo-like openings
Irregular dots and globules
Spoke wheel-like structures
Maple leaf pigment pattern




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Pigmented basal cell carcinoma
Invasive melanoma
Superficial melanoma
Spitz/Reed naevus
Reticular naevus
Seborrhoeic keratosis
This is an invasive melanoma with a blue-white veil corresponding to the palpable part of the lesion. Several irregular dots and globules are evident with streaks. There is a melanocytic naevus adjacent to the melanoma

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What dermoscopic features can you see?
Blue white veil
Arborizing vessels
Glomerular/dotted vessels
Pigment network
Crown vessels
Hair pin vessels




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FeaturesDiagnosis

Blue-white veil, irregular hairpin and glomerular/dotted vessels
Blue white veil
Arborizing vessels
Glomerular/dotted vessels
Pigment network
Crown vessels
Hair pin vessels




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Basal cell carcinoma
Hypomelanotic melanoma
Seborrhoeic keratosis
Lentigo maligna melanoma
Blue neavus
Clear cell acanthoma
This is a hypomelanotic melanoma (note remnants of pigment – marked X) with blue-white veil and polymorphous vessels which include glomerular, dotted and irregular hairpin vessels.

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What dermoscopic features can you see?
Regression
Grey ovoid nests
Crown vessels
Comma vessels
Milia-like cysts
Comedo-like openings




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FeaturesDiagnosis

Comedo-like openings, milia-like cysts and comma vessels
Regression
Grey ovoid nests
Crown vessels
Comma vessels
Milia-like cysts
Comedo-like openings




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Seborrhoeic keratosis
Sebaceous hyperplasia
Solar lentigo
Dermal naevus
Amelanotic melanoma
Superficial basal cell carcinoma
This is a dermal naevus with typical comma vessels. Note the presence of comedo-like openings and few milia-like cysts which can sometimes be seen in these lesions.

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What dermoscopic features can you see?
Milia-like cysts
Arborizing vessels
Comedo-like openings
Lacunas
Scale/crust
Chrysalis structures




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FeaturesDiagnosis

Blue-grey lacunas. Some of the lacunas are thrombosed.
Arborizing vessels
Comedo-like openings
Lacunas
Scale/crust
Chrysalis structures




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Pigmented basal cell carcinoma
Blue naevus
Nodular melanoma
Angiokeratoma
Cherry angioma
Squamous cell carcinoma
This is an angiokeratoma with distinctive lacunas some of which are thrombosed. Scales and crusts are typically seen as whitish-yellow keratotic areas. There is also a blue-whitish veil which corresponds to an acanthotic epidermis.

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What dermoscopic features can you see?
Blue-white veil
Lacunas
Blue ovoid nests
Streaks
Parallel ridge pattern of pigmentation
Red/black dots




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FeaturesDiagnosis

Streaks at the distal end of pigmented part of the nail and red/black dots.
Blue-white veil
Lacunas
Blue ovoid nests
Streaks
Parallel ridge pattern of pigmentation
Red/black dots




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Subungual melanoma
Acral melanocytic naevus
Spitz naevus
Subungual haemorrhage
Blue naevus
Angiokeratoma
This is a subungual haemorrhage characterised by sharply circumscribed black-red structureless pigmentation with the distal end forming streaks. Several red-black tiny dots representing blood spots are seen further distally.

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What dermoscopic features can you see?
Hairpin vessels
Crown vessels
Milia-like cysts
Chrysalis structures
Dotted vessels in clusters
Scales




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FeaturesDiagnosis

Dotted vessels arranged in clusters and scales.
Hairpin vessels
Crown vessels
Milia-like cysts
Chrysalis structures
Dotted vessels in clusters
Scales




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Amelanotic melanoma
Spitz/Reed naevus
Actinic keratosis
Bowen’s disease
Solar lentigo
Superficial basal cell carcinoma
This is Bowen’s disease characterized by dotted vessels arranged in clusters. There is also scaling which is a common feature of this lesion.

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What dermoscopic features can you see?
Typical network
Dotted vessels
Regression
Atypical network
Maple leaf-like structures
Linear irregular vessels




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FeaturesDiagnosis

Atypical network with a large area of regression and linear irregular vessels.
Typical network
Dotted vessels
Regression
Atypical network
Maple leaf-like structures
Linear irregular vessels




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Seborrhoeic keratosis
Solar lentigo
Superficial basal cell carcinoma
Melanoma in-situ
Reticular naevus
Spitz/Reed naevus
This is a melanoma in-situ with an atypical pigment network of varying shades of brown. There is a large area of regression (>10%) with linear irregular vessels. Asymmetry of the lesion in two planes is clearly evident.

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What dermoscopic features can you see?
Brown pseudonetwork
Globules
Streaks
Typical network
Blue-white veil
Regression




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FeaturesDiagnosis

Brown pseudonetwork and brown globules
Brown pseudonetwork
Globules
Streaks
Typical network
Blue-white veil
Regression




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Solar lentigo
Seborrhoeic keratosis
Globular naevus
Reticular naevus
Pigmented actinic keratosis
Lentigo maligna melanoma

This is a globular melanocytic naevus. These lesions commonly have brown globules and a brown pseudonetwork (as shown) when located on the face.

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FeaturesCheck Answers

What dermoscopic features can you see?
Brown globules
Pigment network
Maple leaf-like structures
Red-white structureless areas
Comedo-like openings
Streaks




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FeaturesDiagnosis

Maple leaf-like structures and structureless red-white areas.
Brown globules
Pigment network
Maple leaf-like structures
Red-white structureless areas
Comedo-like openings
Streaks




Diagnosis

DiagnosisMain Menu

What is your diagnosis?
Seborrhoiec keratosis
Superficial basal cell carcinoma
Hypomelanotic melanoma
Solar lentigo
Bowen’s disease
Inflamed dermatofibroma
This is a superficial basal cell carcinoma. The maple leaf-like areas and structureless red-white areas are characteristic features of this lesion.

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