Special Article - Diagnosis and Usefulness of Dermoscopy
Austin J Dermatolog. 2017; 4(2): 1076.
Togawa Y*, Wakabayashi S, Suehiro K and Matsue H
Department of Dermatology, Chiba University of Graduate School of Medicine, Japan
*Corresponding author: Yaei Togawa, Department of Dermatology, Chiba University of Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan
Received: September 11, 2017; Accepted: October 04, 2017; Published: October 11, 2017
Acral melanoma; Dermoscopy; Fibrillar pattern
A 50-year-old female presented with a black macule on the heel that appeared 2 years ago. Clinical examination revealed a black macule with ill-defined border on the lateral side of the sole, measuring 13 x 10mm. Dermoscopic examination showed Fibrillar Pattern (FP) with irregular black dots in the center and a parallel ridge pattern in the periphery (Figure 1). The lesion was removed with a 5mm margin and pathologically diagnosed as an acral melanoma in-situ (Figure 2). In general, a regular FP can be seen in melanocytic nevi on the pressure-loaded area of the sole with mechanical stress . Meanwhile, a recent report shows acral melanomas tend to appear on such areas . A case of irregular FP in acral melanoma has been reported, though the difference between regular and irregular FP was indistinct . We assumed that irregular black dots may be one feature of irregular “malignant” FP.
Figure 1: A fibrillar pattern with irregular black dots in the center (arrows) and a parallel ridge pattern in the periphery were detected in dermoscopy.
Figure 2: Proliferation of atypical melanocytes is distinct in the crista profunda intermedia. A small amount of melanin pigment can be seen in the cornified layer arranged in a slanting.
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