From dermoscopedia

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 Editor: Ralph P. Braun

 Author(s): Ralph P. Braun     ·  Katrin Kerl
Description In this chapter we describe the term globules 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

Regular Globules

Irregular Globules

Globular pattern schematic.jpg
Globules are symmetrical, round to oval, well-demarcated structuresThis glossary term has not yet been described. with a diameter that is larger than 0.1 mm. They usually correspond to nests of pigmented benignis any condition that is harmless in the long run or malignant melanocytes situated in the lower epidermis, at the DEJ, or in the papillary dermis. On occasion globules may correspond to large clumps of melanin, melanophages, or pigmented milia cysts. Like 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)., the color of globules may be brown, black, blue-gray, or red. The significance of these colorsThis glossary term has not yet been described. is the same as discussed for dots. White globules correspond to melanocytes undergoing balloon cell changes [1].

Both dots and globules may occur in neviThis glossary term has not yet been described. as well as in melanomaThis glossary term has not yet been described.. In nevi, the globules are uniform in size, shape, and color (mostly brown), and are either: (1) evenly distributed in the lesion; (2) mostly present at its center, surrounded by a networkThis glossary term has not yet been described.; (3) uniformly distributed throughout the nevusThis glossary term has not yet been described.; or (4) circumstantially along the entire perimeter of the nevus, which correspond to a horizontal growing phase, that can occur either in a growing nevus or in a superficialThis glossary term has not yet been described. spreadingThis glossary term has not yet been described. melanoma.

Globules histology.jpg
In melanomas, globules and dots vary in size, shape, and colorColor (American English) or colour (Commonwealth English) is the characteristic of human visual perception described through color categories, with names such as red, yellow, purple, or blue., are unevenly distributed in the lesion, and are frequently found focally at the periphery of lesions [2]. Because both dots and globules frequently correlate with nests of melanocytes, they are often described for simplicity and reproducibility as a combined term “dots and globulesThis glossary term has not yet been described.”.

Irregular globules and dots.jpg

However, irregular pigmented globules located eccentrically at the periphery of a raised, otherwise homogeneous melanocyticThis glossary term has not yet been described. 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 othersThis glossary term has not yet been described.This glossary term has not yet been described. [4][5].

ReferencesThis is material contained in a footnote or bibliography holding further information.
  1. Jaimes et al.: White globules in melanocytic neoplasms: in vivo and ex vivo characteristics. Dermatol Surg 2012;38:128-32. PMID: 22093002. DOI.
  2. Woltsche et al.: Abundance of the benign melanocytic universe: Dermoscopic-histopathological correlation in nevi. J. Dermatol. 2017;44:499-506. PMID: 28447347. DOI.
  3. Yélamos et al.: Clinical and dermoscopic features of cutaneous BAP1 inactivated melanocytic tumors: results of a multicenter case-control study by the International 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. Society (IDSIDS stands for the International Dermoscopy Society.). J. Am. Acad. Dermatol. 2018;. PMID: 30244062. DOI.
  4. Wiesner et al.: Toward an improved definition of the tumor spectrum associated with BAP1 germline mutations. J. Clin. Oncol. 2012;30:e337-40. PMID: 23032617. DOI.
  5. Wiesner et al.: Germline mutations in BAP1 predispose to melanocytic tumors. Nat. Genet. 2011;43:1018-21. PMID: 21874003. DOI.