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 Author(s): Oriol Yélamos
Description This chapter describes the dermoscopy correlation of globules
Author(s) Oriol Yélamos
Responsible author Oriol Yélamos→ send e-mail
Status unknown
Status update March 1, 2023
Status by Ralph P. Braun


Globular pattern schematic.jpg

Globules are round to oval well-demarcated structures larger than 0.1mm[1]. They can be aggregated or located along the periphery of a melanocytic lesion (Kittler et al., 2016a). On histologic evaluation brown or black globules correspond to nests of melanocytes located at the epidermis or DEJ.



Globules histology.jpg

Blue Globules

Blue globules represent melanocytic nests situated in the dermis [2].

White Globules

White globules correspond to melanocytes undergoing balloon cell changes [3].

Peripheral Globules

Distribution of globules is important: globules along the periphery of a melanocytic lesion reveal a horizontal growing phase, which can occur either in a growing nevus or in a superficial spreading melanoma.

Irregular Globules

In melanoma, globules vary in size, shape and color, and can be frequently found focally and irregularly at the periphery of the lesion [2].

Irregular globules and dots.jpg

Globules in BAP1-inactivated melanocytic tumors (BIMT, BAPOMA

However, irregular pigmented globules located eccentrically at the periphery of a raised, otherwise homogeneous melanocytic lesion may raise suspicion for a BAP1-inactivated melanocytic tumor (BIMT), also known as Wiesner nevus or “bapoma” [3].BIMT are a special subset of melanocytic lesions which have two components histologically: a more banal-looking population which corresponds to the globular component located at the periphery, plus an atypical spitzoid population which has a loss of expression of BAP1 and corresponds to the homogenous area of the lesion. Multiple BIMT have been associated with a cancer syndrome with increased risk for uveal melanoma, cutaneous melanoma, mesothelioma, renal cell carcinoma, among others (Wiesner et al., 2012, 2011).

  1. Yélamos et al.: Dermoscopy and dermatopathology correlates of cutaneous neoplasms. J Am Acad Dermatol 2019;80:341-363. PMID: 30321581. DOI.
  2. 2.0 2.1 Woltsche et al.: Abundance of the benign melanocytic universe: Dermoscopic-histopathological correlation in nevi. J. Dermatol. 2017;44:499-506. PMID: 28447347. DOI.
  3. 3.0 3.1 Jaimes et al.: White globules correlate with balloon cell nevi nests. J. Am. Acad. Dermatol. 2011;65:e119-e120. PMID: 21920229. DOI.
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