Colors seen in Dermoscopy
In dermoscopy, color analysis is paramount as it provides insights into the underlying biology of skin lesions. Chromophores, the skin components that produce color, vary depending on their concentration and location within the skin layers.
Melanin, the primary chromophore in pigmented lesions, manifests as black when concentrated in the stratum corneum or upper epidermis. When it descends to the mid or lower epidermis, it presents as brown, and it appears blue-gray when located in the dermis due to the Tyndall effect. The distribution of melanin aids in assessing the depth of melanocytic tumors, with deeper colors indicating more profound components (Malvehy et al., 2006; Woltsche et al., 2017).
Colors in dermoscopy are not limited to melanin. Hemoglobin within red blood cells imparts pink to red hues; lipids and keratin can give a yellowish appearance; and collagen appears white. Certain colors, when seen alongside specific dermoscopic structures, can indicate particular histopathologic changes. For instance, white globules are indicative of balloon-cell nevi, homogeneous yellow to orange regions suggest xanthomatization of cells, and black lacunae often correlate with thrombosed blood vessels (Jaimes et al., 2011; Bañuls et al., 2015). Understanding these associations allows clinicians to infer histological characteristics from non-invasive dermoscopic examination, underscoring the technique's diagnostic value.
