From dermoscopedia
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 Author(s): Harald Kittler
Description In this chapter we will describe the terminology as proposed by the 3rd consensus conference of the International Dermoscopy Society (IDS)
Author(s) Harald Kittler
Responsible author Harald Kittler→ send e-mail
Status unknown
Status update May 24, 2019
Status by Ralph P. Braun

In this chapter we will describe the terminology as proposed by the 3rd consensus conference of the International Dermoscopy Society (IDS)

It has the following subchapters:

Two competitive terminologies exist, a more metaphoric terminology that includes numerous terms and a new descriptive terminology There was uniform consensus that both terminologies are suitable, that metaphoric terms need definitions, that synonyms should be avoided, and that the creation of new metaphoric terms should be discouraged. The expert panel proposed a dictionary of standardized terms taking account of metaphoric and descriptive terms.This dictionnary can be found in this chapter

Pigment network

Metaphoric term Definition
Pigment network Grid-like pattern consisting of interconnecting pigmented lines surrounding hypopigmented holes.
typical network Network with minimal variability in the color, thickness, and spacing of the lines; symmetrically distributed
delicate network light brown, thin network lines
atypical network Network with increased variability in the color, thickness, and spacing of the lines of the network; asymmetrically distributed; gray color
broadened network widening of the network lines
negative network Serpiginous interconnecting broadened hypopigmented lines that surround elongated and curvilinear globules.

Shiny white structures

Metaphoric term Definition
shiny white streaks Short discrete white lines oriented parallel and orthogonal (perpendicular) to each other seen only under polarized dermoscopy.
shiny white blotches and strands White structures in the form of circles, oval structures, or large structureless areas that are bright-white longer and less well defined lines oriented parallel or distributed haphazardly, or forming blotches (shiny white clods). Seen only under polarized dermoscopy.
rosettes Four bright white dots or clods arranged together as a square (or a four leaf clover)


Metaphoric term Definition
regular Globules Globules with minimal variability in their color, size and shape
cobblestone Globules Polygonal globules symmetrically distributed throughout lesion
rim of brown globules Globules distributed at the periphery of lesion
irregular Gobules Globules with variability in color, size, shape or spacing and distributed in an asymmetric fashion


Metaphoric term Definition
regular dots Dots clustered at the center of the lesion, or located on the network lines (also called target network)
irregular dots Any distribution of dots other than dots as described for regular dots.


Metaphoric term Definition
radial streaming Radial linear extensions at the lesion edge
pseudopods Bulbous and often kinked projections seen at the lesion edge, either directly associated with a network or solid tumor border.
branched streaks Broadened or widened network with broken lines and incomplete connections


Metaphoric term Definition
starburst pattern This pattern consists of peripheral globules, pseudopods or streaks (or a combination of them), located around the entire perimeter of the lesion
homogeneous pattern A pattern lacking any definable pigment structures, structureless pattern
ceribriform pattern Thick curved lines created by gyri and keratin filled sulci. These gyri and sulci coalesce forming a brain-like appearance pattern.
fingerprint pattern Light brown thin curved lines that do not interconnect to form a network. These tend to be linear to curvilinear. They correspond to small and thin gyri.
rainbow pattern Circumscribed structureless areas displaying colors of the whole spectrum of visible light
strawberry pattern Reddish pseudo-network (erythema and wavy fine vessels) around hair follicle openings which are accentuated with a white halo appearance


Metaphoric term Definition
Blotch Dark structureless areas
regular blotch One blotch within center of lesion and surrounded by network
irregular blotch More than one blotch or a blotch that is located off center

Regression structures

Metaphoric term Definition
peppering / granularity Consists of fine dots with a blue grey color
Scar-like depigmentation Area of white that is whiter than surrounding normal skin (true scarring). It should not be confused with hypo- or depigmentation due to simple loss of melanin. Shiny white structures and blood vessels are not seen in areas of regression.

Facial skin

Metaphoric term Definition
Annular granular pattern Dots and structureless areas arranged around follicle openings (and involving adnexal opening)
Rhomboids Gray-brown angulated lines forming a polygonal shape around adnexal ostial openings.
Pseudonetwork A structureless pigment area interrupted by non-pigmented adnexal openings
Asymmetric pigmented follicular openings Pigment associated with adnexal opening that does not uniformly surround the entire opening or curved (or crescent shaped) pigment lines partially surrounding adnexal openings

Volar skin

Metaphoric term Definition
Parallel furrow pattern Volar 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.
Parallel ridge pattern Volar pigmentation forming lines, parallel, diffuse and irregular, along the ridges or cristae superficiales (raised portion of the dermatoglyphics)
Lattice-like pattern Volar pigmentation forming thin lines, parallel on the furrow or sulci superficialis (invaginations in dermatoglyphics) and crossing perpendicular on the ridges
Fibrillar pattern Linear 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

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