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skINsight
August 2003

Dermoscopy of Melanocytic NeoplasmsSubpatterns of Melanoma

Author Affiliations
 

JAMES M.GRICHNIKMD, PhD

Arch Dermatol. 2003;139(8):1104. doi:10.1001/archderm.139.8.1104

THE LESIONS are from the abdomen of a 47-year-old white woman (Figure 1), the upper back of a 57-year-old white man (Figure 2), and the chest of 31-year-old white man (Figure 3). All 3 lesions reveal a similar pattern. Multiple focal areas can be identified each with a unique color (black, brown, red, and/or blue) and structural pattern (network, dots, diffuse, etc). The areas are haphazardly distributed. This pattern relatively common in superficial spreading melanomas (Figure 1, 0.42 depth; Figure 2, 0.9 depth; Figure 3, in situ [size bar, 5 mm]). Theoretically, this pattern could be caused by genetic instability (each focus having different mix of mutations) or a loss of differentiation control genes allowing the cells to swing from one pigmentation state to another at will. (Figure 2 and Figure 3 reprinted from Lucas et al, "Early Melanoma Detection: Nonuniform Dermoscopic Features and Growth." J Am Acad Dermatol. 2003;48:663-671, with permission from the American Academy of Dermatology.)

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