Dots

From dermoscopedia

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 Editor: Ralph P. Braun

 Author(s): Ralph P. Braun     ·  Katrin Kerl
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Description In this chapter we describe dots and its histopathological correlation
Author(s) Ralph P. Braun · Katrin Kerl
Responsible author Ralph Braun→ send e-mail
Status unknown
Status update May 27, 2017
Status by Ralph P. Braun
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Regular dots

Irregular dots


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DotsDots are small, round structures of less than 0.1 mm in diameter that have a red color when corresponding to blood vessels; however, when due to melanin, their color ranges from black, brown, to blue-gray depending on the depth and concentration of the melanin in the skin (Tyndall effect).

Dots are small, round structuresThis glossary term has not yet been described. of less than 0.1 mm in diameter (similar to the diameter of a terminal hair follicle) [1] that correlate with blood vesselsare the part of the circulatory system, and microcirculation, that transports blood throughout the human body or melanin pigment. When blood vessels appear as dotsDots are small, round structures of less than 0.1 mm in diameter that have a red color when corresponding to blood vessels; however, when due to melanin, their color ranges from black, brown, to blue-gray depending on the depth and concentration of the melanin in the skin (Tyndall effect)., their color is red; however, when the underlying structure is melanin, their color ranges from black, brown, to blue-gray depending on the depth and concentration of the melanin in the skin (Tyndall effectCaused by light scattering by particles in a medium. The longer-wavelength light is more transmitted while the shorter-wavelength light is more reflected via scattering.). Black dots are often due to melanin pigment accumulation in the stratum corneum, but can also be due to vertical stacking of pigment within the epidermis or due to heavy aggregates of melanin in small clusters of melanocytes or keratinocytes located in the upper layers of the epidermis (just below the stratum corneum). Black dots that are in the stratum corneum are usually found overlying the grid lines of the pigmented networkThis glossary term has not yet been described. and they can easily be tape stripped off the skinThis glossary term has not yet been described.. Brown dots are often associated with focal melanin accumulations at the DEJ or spinous layer and they usually correspond histologically to small junctional melanocyticThis glossary term has not yet been described. nests. The dots, resulting from nevus nests located at the tips of rete ridgesEpidermal extensions that project into the underlying dermis, tend to be situated overlying the network linesstreaksThis glossary term has not yet been described.. Less frequently, brown dots correspond to melanocytic nests located in the skin below the stratum corneum or even within the stratum corneum. The nests present within the stratum corneum are probably in the process of being extruded from the skin via trans-elimination. Brown dots corresponding to small melanocytic nests situated in the papillary dermis appear as dots situated within the holes of the network. These so-called target networks with dots/globules or halo dots/globules are a common finding in congenital melanocytic neviThis glossary term has not yet been described.. Although on rare occasions brown dots can be tape stripped off the skin, most brown dots cannot be removed via tape strippingThis glossary term has not yet been described.. 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 pepperingGray dots) are due to fine melanin particles within melanophages or as extracellular “dust” in the superficialThis glossary term has not yet been described. dermis; this feature is associated with regressionThis glossary term has not yet been described..

Dots 28.jpg


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

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

Regular dots 24.jpg
Dots.jpg

Irregular dotsAny distribution of dots other than dots as described for regular dots.

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 BCCAbbreviation for Basal Cell Carcinoma. Red dots are equivalent to dotted vesselstiny pinpoint vessels and can be seen in diverse cutaneous tumors such as keratinocyte carcinomas, Spitz neviThis glossary term has not yet been described. and melanomas [2].

Dots schematic 24.jpg


ReferencesThis is material contained in a footnote or bibliography holding further information.
  1. Kittler et al.: Standardization of terminology in dermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections./dermatoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections.: Results of the third consensus conference of the International Society of DermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections.. J. Am. Acad. Dermatol. 2016;74:1093-106. PMID: 26896294. DOI.
  2. Massi et al.: Histopathologic correlates of dermoscopic criteriameasure of how well one variable or set of variables predicts an outcome. Dermatol Clin 2001;19:259-68, vii. PMID: 11556235.