Dermoscopic Color Perspective

Clinic of Dermatology, Hørsholm Hospital, Hørsholm, Denmark.
Archives of Dermatology (Impact Factor: 4.79). 10/2006; 142(9):1250. DOI: 10.1001/archderm.142.9.1250
Source: PubMed
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    • "In this context, “non-pigmented” means lesions with no melanin pigmentation (which may be black, brown, gray, or blue, depending on depth in the skin [18]). Such lesions may still have pigment due to keratin (yellow or orange) or hemoglobin (red, purple, blue or black). "
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    ABSTRACT: While there are several published comprehensive stepwise algorithmic methods for diagnosing pigmented skin malignancy, only limited material has been published for the stepwise assessment of non-pigmented lesions. We present a method based on pattern analysis, with a stepwise assessment, first, for ulceration, second, for white clues (defined as white lines, or in the case of a raised lesion any of the keratin clues: dermatoscopic white circles, dermatoscopic white structureless areas or surface keratin), and third, if no ulceration or white clues are present, proceed to vessel pattern analysis. This is a novel method, and apart from the assessment of white clues in raised lesions, it has not been formally tested. The priority of keratin clues in raised lesions over vessel pattern analysis has, however, been verified. It is conceded that this method is less specific than methods which have clues of pigmented structures, and accepting these limitations, Prediction without Pigment is a decision algorithm intended to guide the clinician in the decision as to whether to perform a biopsy rather than consistently leading to a specific diagnosis. Reaching a more specific diagnosis at the end of our flowchart can be achieved by weighing of clues both clinical and dermatoscopic, and that ability can be expected to improve with both knowledge and experience, but no diagnostic method, including this one, can be 100% sensitive in diagnosing malignancy, in particular, melanoma. Taking these limitations into account, any non-pigmented lesion, regardless of pattern analysis, which is raised and firm (nodular) and for which a confident, specific benign diagnosis cannot be made, should be excised to exclude the nodular variant of amelanotic melanoma.
    01/2014; 4(1):59-66. DOI:10.5826/dpc.0401a09
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    ABSTRACT: Pigmented cutaneous invasive SCC is uncommon with few reports in the literature. Four out of five previously reported cases with dermatoscopy had a blue structureless zone. The case we report, like previous cases, had clues to malignancy and in this case these included asymmetry, a blue structureless zone and polymorphic vessels. The presence of surface scale and the presence of white circles may be clues to squamous cell carcinoma. The dermatoscopic finding of white circles as a clue to invasive squamous cell carcinoma needs to be confirmed with the study of more cases.
    01/2011; 1(1):69-72. DOI:10.5826/dpc.0101a14
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