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May 2009

Observation of Chrysalis Structures With Polarized Dermoscopy

Author Affiliations

Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Dermatol. 2009;145(5):618. doi:10.1001/archdermatol.2009.28

Collagen bundles have birefringent properties that cause a rapid randomization of polarized light, explaining why collagen is more conspicuous under polarized dermoscopy.1 Skin lesions with an increased amount of collagen will often reveal shiny, bright white, orthogonal linear streaks, which we have termed “chrysalis structures.” These structures are not apparent to the unaided eye nor are they visible with nonpolarized dermoscopy. The most obvious examples of lesions that display chrysalis structures are dermatofibromas (Figure 1)2,3 and scars. In basal cell carcinoma, chrysalis structures are often observed, probably owing to the associated fibroplasia (Figure 2).4,5 In addition, chrysalis structures are seen on occasion in Spitz nevi (Figure 3 [courtesy of Harold Rabinovitz, MD, Skin and Cancer Associates, Plantation, Florida]) and in melanoma (Figure 4), probably corresponding to changes in the composition and orientation of collagen in the stroma that underlies these melanocytic neoplasms.6-8 Interestingly, it has been suggested that collagen remodeling in the stroma of melanoma is important for the invasion of tumor cells into the dermis.9

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