Colors
Colors are fundamental in dermoscopic evaluation. Most of the colors present in the skin originate from an increase in a given chromophore on the skin, such as pigment (brown, black, gray, blue), lipids or keratin (yellow), collagen (white) or blood (red) (Marghoob and Braun, 2012; Woltsche et al., 2017). The most important chromophore in pigmented lesions is melanin (Marghoob and Braun, 2012).
When melanin is located in the stratum corneum or the upper epidermis appears as black on dermoscopy; when it located in the mid or low epidermis it appears as brown, and it appears blue-gray when it is present in the dermis (figure 1) (Malvehy et al., 2006; Woltsche et al., 2017). The knowledge of colors on dermoscopy is relevant since this allows to identify the deepest component of a melanocytic tumor (blue area).
Other important determinants of lesion color include hemoglobin in red blood cells (pink to red colors), lipids or keratin (yellow) and collagen fibers in the dermis (white color). Some colors, especially when associated with selected dermoscopic structures, also have important histopathologic correlates, such as white globules (associated with balloon-cell changes) [1], homogeneous yellow to orange areas (associated with cell xanthomization) [2] or black lacunae (associated with blood thrombosis).
Some colors, especially when associated select dermoscopic structures, also have important histopathologic correlates:
- white globules (associated with balloon-cell changes) (Jaimes et al., 2011),
- homogeneous yellow to orange areas (associated with cell xanthomization) (Bañuls et al., 2015)
- black lacunae (associated with blood thrombosis).
