The blue globular pattern in dermoscopy

Dermatology. 2013;226(3):260-6. doi: 10.1159/000350257. Epub 2013 Jun 21.

Abstract

Background: Seborrheic keratosis (SK) is a frequent benign epithelial skin tumor. Generally its diagnosis is clinical, however SK can sometimes clinically simulate a melanocytic lesion; therefore we need dermoscopy to reach a correct diagnosis. Milia-like cysts and comedo-like openings are the common dermoscopic features of SK, but it is not a rare finding that SK can display one or more dermoscopic patterns suggestive of a melanocytic origin.

Objectives: We describe a case series of SKs with a blue globular pattern simulating a melanocytic lesion.

Methods: We retrospectively evaluated 224 SKs seen during 2011 at the Dermatoscopy Unit of the Department of Dermatology, University of Rome 'Sapienza'.

Results: Five SKs showed a blue globular pattern, without the SK main features generally seen in dermoscopy; globules were multiple, round or oval, well-demarcated, small and medium-sized, blue-colored and equally distributed within the lesion. Histopathologic examination was consistent with acanthotic SK.

Conclusions: Identification of the blue globular pattern can be helpful for the dermoscopic diagnosis of SK, especially when its common dermoscopic features are absent.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dermoscopy*
  • Diagnosis, Differential
  • Female
  • Humans
  • Keratosis, Seborrheic / pathology*
  • Male
  • Melanoma / pathology*
  • Middle Aged
  • Pigmentation*
  • Retrospective Studies
  • Skin Neoplasms / pathology*