Dots

From dermoscopedia

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Description This chapter describes the correlation of dots in dermoscopy
Author(s) Oriol Yélamos
Responsible author Oriol Yélamos→ send e-mail
Status unknown
Status update August 25, 2021
Status by Ralph P. Braun


Dots are small, round and well circumscribed structures smaller than globules (less than 0,1 mm, similar to the diameter of a terminal hair follicle[1] . Their color vary from brown, black, gray, blue to red. Histologically, they correspond to pigmentation along different levels of the epidermis or dermis. Black dots reveal pigmentation of the upper epidermis or the stratum corneum. Brown dots reveal small melanocytic nests in the epidermis or in the DEJ. Blue-gray dots correspond to the presence of pigment in the upper dermis or in dermal melanophages (the equivalent to peppering). In melanomas, dots are irregularly distributed and may be found focally at the periphery of lesions. Blue-gray dots can also correspond with small dermal aggregates of pigmented BCC. Red dots are equivalent to dotted vessels and can be seen in diverse cutaneous tumors such as keratinocyte carcinomas, Spitz nevi and melanomas (Massi et al., 2001b; Yadav et al., 1993). Black or brown dots may appear after acute ultraviolet exposure; however, these dots tend to disappear over time. It is interesting to note that many non–ultraviolet-induced dots that are successfully tape stripped off the skin reappear with time.

Gray-blue dots (also called granules or peppering) are due to fine melanin particles within melanophages or as extracellular “dust” in the superficial dermis; this feature is associated with regression.

Dots 28.jpg



Regular dots[edit]

Dots clustered at the center of the lesion, or located on the network lines (also called target network)

Regular dots 24.jpg
Dots.jpg
Dots schematic 24.jpg

Irregular dots[edit]

Irregular dots tend to be heterogenous in size, shape and color and are frequently found at the periphery of a given lesion or scattered throughout the lesion.

In melanomas, dots are irregularly distributed and may be found focally at the periphery of lesions. Blue-gray dots can also correspond with small dermal aggregates of pigmented BCC. Red dots are equivalent to dotted vessels and can be seen in diverse cutaneous tumors such as keratinocyte carcinomas, Spitz nevi and melanomas [2].



References

  1. Yélamos et al.: Dermoscopy and dermatopathology correlates of cutaneous neoplasms. J Am Acad Dermatol 2019;80:341-363. PMID: 30321581. DOI.
  2. Massi et al.: Histopathologic correlates of dermoscopic criteria. Dermatol Clin 2001;19:259-68, vii. PMID: 11556235.