Terminology

From dermoscopedia

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 Editor: Harald Kittler

 Author(s): Harald Kittler
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Description In this chapter we will describe the terminology as proposed by the 3rd consensus conference of 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.)
Author(s) Harald Kittler
Responsible author Harald Kittler→ send e-mail
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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:

Metaphotic terminology Harald Kittler
Descriptive terminology Harald Kittler
Terminology for blood vessels Harald Kittler
Dictionnaries Harald Kittler


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Two competitive terminologies exist, a more metaphoric terminologyThis glossary term has not yet been described. that includes numerous terms and a new descriptive terminologyTerminology using descriptive terms 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 dictionnaryThis glossary term has not yet been described. can be found in this chapter

Pigment networkGrid-like pattern consisting of interconnecting pigmented lines surrounding hypopigmented holes.

Metaphoric termThis glossary term has not yet been described. Definition
Pigment network Grid-like pattern consisting of interconnecting pigmented lines surrounding hypopigmented holes.
typical networkNetwork with minimal variability in the color thickness and spacing of the lines; symmetrically distributed NetworkThis glossary term has not yet been described. with minimal variability in the 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., thickness, and spacing of the linesstreaksThis glossary term has not yet been described.; symmetrically distributed
delicate networklight brown, thin network lines light brown, thin networkThis glossary term has not yet been described. lines
atypical networkNetwork with increased variability in the color, thickness, and spacing of the lines of the network; asymmetrically distributed; gray color Network with increased variability in the color, thickness, and spacing of the lines of the network; asymmetrically distributed; gray color
broadened networkwidening of the network lines widening of the network lines
negative networkSerpiginous interconnecting broadened hypopigmented lines that surround elongated and curvilinear globules. Serpiginous interconnecting broadened hypopigmented lines that surround elongated and curvilinear globulesThis glossary term has not yet been described..

Shiny white structuresThis glossary term has not yet been described.

Metaphoric term Definition
shiny white streaksWhite lines that appear parallel and perpendicular to each other on polarized dermoscopy Short discrete white lines oriented parallel and orthogonal (perpendicular) to each other seen only under polarized 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..
shiny white blotches and strandsWhite 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. White structuresThis glossary term has not yet been described. in the form of circlesThis glossary term has not yet been described., 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 clodsThis glossary term has not yet been described.). Seen only under polarized dermoscopy.
rosettesFour bright white dots or clods arranged together as a square (or a four leaf clover) Four bright white dots or clods arranged together as a square (or a four leaf clover)


GlobulesThis glossary term has not yet been described.

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 globulesGlobules distributed at the periphery of lesion Globules distributed at the periphery of lesion
irregular Gobules Globules with variability in color, size, shape or spacing and distributed in an asymmetric fashion


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).

Metaphoric term Definition
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)
irregular dotsAny distribution of dots other than dots as described for regular dots. Any distribution of dots other than dots as described for regular dots.

Streakslines radial (always at periphery) streaks Reed nevus melanoma recurrent nevus

Metaphoric term Definition
radial streamingRadial linear extensions at the lesion edge Radial linear extensions at the lesion edge
pseudopodsBulbous and often kinked projections seen at the lesion edge, either directly associated with a network or solid tumor border. Bulbous and often kinked projections seen at the lesion edge, either directly associated with a network or solid tumorThis glossary term has not yet been described. border.
branched streaksBroadened or widened network with broken lines and incomplete connections Broadened or widened network with broken lines and incomplete connections

Pattern

Metaphoric term Definition
starburst patternThis pattern consists of peripheral globules, pseudopods or streaks (or a combination of them), located around the entire perimeter of the lesion This pattern consists of peripheral globulesThis glossary term has not yet been described., pseudopods or streakslines radial (always at periphery) streaks Reed nevus melanoma recurrent nevus (or a combinationThis glossary term has not yet been described. of them), located around the entire perimeter of the lesion
homogeneous patternA pattern lacking any definable pigment structures, structureless pattern A pattern lacking any definable pigment structures, structureless pattern
ceribriform patternThick curved lines created by gyri and keratin filled sulci. These gyri and sulci coalesce forming a brain-like appearance pattern. Thick curved lines created by gyri and keratin filled sulci. These gyri and sulci coalesce forming a brain-like appearancelines, curved and thick to describe the pattern and fissures and ridges (former synonyms “gyry and sulci” and “fat fingers”) to describe the structural components of the pattern SK pattern.
fingerprint patternLight 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. 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 patternCircumscribed structureless areas displaying colors of the whole spectrum of visible light Circumscribed structureless areas displaying colorsThis glossary term has not yet been described. of the whole spectrum of visible light
strawberry patternReddish pseudo-network (erythema and wavy fine vessels) around hair follicle openings which are accentuated with a white halo appearance Reddish pseudo-networkstructureless brown interrupted by follicular openings (facial-skin) (erythema and wavy fine vesselsThis glossary term has not yet been described.) around hair follicle openingsThis glossary term has not yet been described. which are accentuated with a white halo appearance

Blotches

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

Regression structuresThis glossary term has not yet been described.

Metaphoric term Definition
peppering / granularityConsists of fine dots with a blue grey color Consists of fine dots with a blue grey color
Scar-like depigmentationArea 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. 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 vesselsare the part of the circulatory system, and microcirculation, that transports blood throughout the human bodyThis glossary term has not yet been described. are not seen in areas of regressionThis glossary term has not yet been described..

Facial skinThis glossary term has not yet been described.

Metaphoric term Definition
Annular granular patternDots and structureless areas arranged around follicle openings (and involving adnexal opening) Dots and structureless areas arranged around follicle openings (and involving adnexal opening)
RhomboidsGray-brown angulated lines forming a polygonal shape around adnexal ostial openings. Gray-brown angulated lines forming a polygonal shape around adnexal ostial openings.
PseudonetworkA structureless pigment area interrupted by non-pigmented adnexal openings A structureless pigment area interrupted by non-pigmentedThis glossary term has not yet been described. adnexal openings
Asymmetric pigmented follicular openingsPigment associated with adnexal opening that does not uniformly surround the entire opening or curved (or crescent shaped) pigment lines partially surrounding adnexal 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 skinThis glossary term has not yet been described.

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


ReferencesThis is material contained in a footnote or bibliography holding further information.