Correlation of dermoscopic structures on volar skin (palms and soles)

From dermoscopedia

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 Editor: Oriol Yélamos

 Author(s): Oriol Yélamos     ·  Ralph P. Braun
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Description This chapter describes the histopathologcal correlation of dermoscopic structuresThis glossary term has not yet been described. on volar skinThis glossary term has not yet been described.
Author(s) Oriol Yélamos · Ralph P. Braun
Responsible author Oriol Yélamos→ send e-mail
Status released
Status update January 1, 2019
Status by Ralph P. Braun


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The palmoplantar skin is characterized by a thick cornified layer, the presence of dermatoglyphics and absence of hair follicles. In volar skin, pigment predominates in the furrows or the ridges of the dermatoplyphics. Thus, two main patternsThis glossary term has not yet been described. have been described for melanocyticThis glossary term has not yet been described. volar lesions: the parallel furrow patternVolar pigmentation forming solid or dotted lines, parallel, thin, on the furrows (sulci superficiales or invaginations in dermatoglyphics). The lines are occasionally doubled, each line is beside the furrows. and the parallel ridge patternVolar pigmentation forming lines, parallel, diffuse and irregular, along the ridges or cristae superficiales (raised portion of the dermatoglyphics).

Parallel furrow patternVolar pigmentation forming solid or dotted lines, parallel, thin, on the furrows (sulci superficiales or invaginations in dermatoglyphics). The lines are occasionally doubled, each line is beside the furrows.

is characterized by thin parallel pigmented lines in the furrows and is generally associated with benign melanocytic lesions. Histologically, it corresponds to melanocytes transferring pigment to keratinocytes located on the crista limitans (furrows) (Ishihara et al., 2006).

Parallel ridge patternVolar pigmentation forming lines, parallel, diffuse and irregular, along the ridges or cristae superficiales (raised portion of the dermatoglyphics)

is characterized by thick parallel pigmented lines on the ridges and is associated with acral melanomaThis glossary term has not yet been described.. Histologically, it reveals melanocyte proliferations around the rete ridgesEpidermal extensions that project into the underlying dermis associated with the acrosyringia (crista intermedia) (Ishihara et al., 2006). The presence of stem cells and the microenvironment associated with the acrosyringia could explain the proliferation of malignant cells that proliferate in this location (Okamoto et al., 2014).

Other patterns that can be observed in volar skin are fibrillar pattern and lattice-like patternVolar pigmentation forming thin lines, parallel on the furrow or sulci superficialis (invaginations in dermatoglyphics) and crossing perpendicular on the ridges.

Fibrillar patternLinear pigmented filamentous lines of similar length with one end at the furrows and oriented at a certain angle to the furrows and crossing the ridges

(fine or fibrillar pigmentation arranged in the direction crossing the parallel skin markings) is secondary to the mechanical pressure and it is an artifactual modification of the furrow pattern (Miyazaki et al., 2005).

Lattice-like patternVolar pigmentation forming thin lines, parallel on the furrow or sulci superficialis (invaginations in dermatoglyphics) and crossing perpendicular on the ridges

(pigmented lines across the furrows) the pigmentation is seen along the sulci of the skin markings, therefore the lattice-like pattern can be considered an anatomical modification of the parallel furrow pattern (Saida and Koga, 2007).