Color Atlas of Dermoscopy Horacio Antonio Cabo
INDEX
Page numbers followed by f refer to figure and t refer to table
A
ABCD rule 189, 250, 251f, 251t, 341
Acanthotic rete ridges, basal hyperpig mentation of 277f
Acquired melanocytic nevi 135, 136f138f
Acral melanoma 184, 187f, 188f, 244f
Acral nevus 17f, 35f, 185f
Actinic keratosis 83, 84f86f, 207, 213, 224f, 225f
Age-related nevus patterns 122f
Aggregated globules 16, 113, 114f, 115f
Alopecia areata 301, 302f
Amelanotic melanoma 189
American College of Rheumatology 314
Amorphous structures 288f
Ancylostoma braziliense 290
Androgenetic alopecia 301, 301f
Angiogenesis 314
Angiokeratoma 72, 74, 74f, 75f
Angioma 17t, 19f, 25f, 28, 72, 72f, 73f, 218f, 238, 240f
Arborizing telangiectasias 297f
Arborizing vessels 18f, 26f, 28, 29, 36f, 68
Asymmetric blue nevus 152f
Asymmetric pigmentation 250
Atypical blue nevus 212f
Atypical globular pattern 162
Atypical mole syndrome 262f
Atypical pigment network 4f, 162, 252
Atypical reticular pattern 162
Atypical Spitz
nevus 212f
tumor 149, 150f
Atypical vascular pattern 252
B
Basal cell carcinoma 15f, 17t, 18f, 26f, 34f, 36f, 54, 54f65f, 68t, 69f, 69t, 70f, 71f, 101, 207, 207f, 211, 213, 217, 218f, 219, 219f, 277f, 279f, 328, 343f
concentric structures 66f68f
multiple blue 65f, 66f
small multiple erosions 68f
Basaloid cell strings 54f
Big ovoid nests 17
Biopsy 237
Blood spots 89
Blue cellular nevus 152f
Blue globular pattern 42, 48f
Blue nevus 6, 17f, 35f, 152, 155, 155f, 207, 213
Blue-black pigmented lesion 6
Blue-gray globules 36f
multiple 61, 68
Blue-gray ovoid nests, large 61, 68
Blue-gray pigmentation 18f, 58, 65, 68
Blue-red lacunes 17
Blue-white veil 4f, 42, 116, 118f, 166, 169f, 250, 252
Bowen's disease 88, 89, 333
Bowenoid papulosis 109, 109f
Brain-like
appearance 41, 42f
pattern 18f
Brown globules 15f, 16f, 35f
Brown-black globules, multiple 69
C
Capillaroscopic patterns 315t
Capillaroscopic scleroderma pattern 315f, 316f
Capillaroscopy
qualitative 311
quantitative 311
Capillary comb 309
Capillary density 313
Capillary dilation 311, 312f
Capillary erythrocyte extravasation 313
Capillary loss 314
Capillary neoangiogenesis 313
Capillary thrombosis 312
Central hyperkeratosis 88f, 89, 89f
Central mixed pattern 127f
Central white patch 78
Cicatricial alopecia 302
Cladosporium werneckii 288
Clark's nevus 124, 207, 211, 213, 271, 275f
Clear cell acanthoma 28f, 99, 99f
Clod vessels 25f
Cobblestone pattern 127f, 250
Collarette scale 296
Collision tumors 207, 211f, 213
Comma-like vessels 26f, 29
Congenital
melanocytic nevus 124, 135
medium 132f
nevus 134f, 219f, 234, 235f, 275f, 277f
Constitutional pathway 120, 121
Crown curved linear vessels 27
Crown vessels 27f, 29
Curvilinear vessels 27
Cylindroma 100, 100f
D
Delicate peripheral pigment network 78
Dendritic cell
melanoma 324
type melanoma 325
Dermatobia hominis maggots 290, 290f
Dermatofibroma 77, 77f80f, 207, 209f, 213, 217, 218f, 269, 271f
Dermatomyositis 309, 315, 316, 316f
Dermatoscopy 339
application of 341
Dermoepidermal junction 114f
Dermoscope 309f
Dermoscopic atypia, signs of 258f
Dermoscopic pattern 77, 237
Dermoscopy 24t
digital 257, 262
images, sequential digital 255
Diabetes 317
mellitus 309
Diffuse hairpin vessels 27, 28f
Discoid lupus 296
erythematosus 304, 305f
lesions 297f
Dynamic polarized dermoscopy 82
Dysplasia
mild 141f
severe 142f, 143f
Dysplastic nevi 140
E
Eccrine poroma 96, 96f98f, 207, 210f
Eczemas 296
Endothelial markers, active 317
Entomodermoscopy 285
Erythema 316f
Exophiala phaeoannellomyces 288
Exophiala werneckii 288
F
Face 223
Fact congenital nevus 278f
Fat fingers 42
Fibrillar pattern 188, 227, 232f, 233
Fibrosis 117f
Fibrous stroma 331f
Fibrovascular stroma 54f
Fingerprint-like
pattern 238, 238f
structures 16, 49, 223
Fish scale-like pattern 213f, 238, 238f, 239f
Fissures and ridges 16, 41
Flat warts 288f
Flower-like appearance 98f
Follicular openings 276f
asymmetric pigmentation of 52f, 53f
brown pigmentation of 52f, 53f
pigmentation of 85f, 86f, 224
Follicular pseudocysts 35f
Folliculitis decalvans 304, 304f
Frontal fibrosing alopecia 303, 304f
Fungal infections 288
Furrow parallel pattern 17f
Furuncular myiasis 290, 290f
G
Genital melanotic macule 237f238f
Genitalia 10f
Giant congenital melanocytic nevus 132f
Globular pattern 5f, 124, 127f, 146, 227, 233f, 250
Globules 251
multiple 17
Glomerular vessels 9f, 26f
Gottron papules 316f
Granuloma annulare 298f
H
Hair follicle openings, multiple 304f
Hairpin vessels 26f, 27, 28f, 29, 43, 43f, 189
multiple 4f
Halo melanoma 189
Hemangioma 18f, 27f, 34f, 36f, 217, 277f
dermoscopic image of 6f
Hematomas 207, 213
Hemorrhagic spots 242
Homogeneous
blue coloration 6
blue pigmentation 16, 17f, 35f, 113, 115f
pattern 130f, 135, 146, 227, 233f, 250
Human papillomavirus 287
Hyperkeratosis 88f, 94f
Hyperkeratotic follicles 86
Hyperpigmented central mixed pattern 128f
Hyperpigmented Spitz nevus 147f
Hypertension 309
Hypertrichosis 131, 134f
Hyphal pattern 238
Hypomelanotic melanoma 23f, 27, 29f, 193f
dermoscopic classification of 189
in situ 190f193f
Hypopigmented central mixed pattern 128f
Hypopigmented melanoma 189, 281f
I
In situ melanoma 279f
In situ squamous cell carcinoma 334f, 335f
Infiltrative basal cell carcinoma 331f
Ink-spot lentigo 49, 51f, 207, 208f, 213
Intradermal nevus 26f, 28f
Irregular lineal vessels 29, 189
Irregular pigmentation 166, 252
Irregular vascular pattern 166, 171f
Irritative dermatitis 291
Ixodes ricinus 291
J
Jelly sign 16, 49, 50, 223
Junction nevus 34f, 217f, 218f
K
Kaposi's sarcoma 271f
Keratinocytic categories, benign 273, 274
Keratoacanthoma 27f, 28f, 88, 88f, 89f
Keratosis 279f
Keratotic central mass 28f
L
Labial melanotic macule 237f240f
Lacunae 6f, 29, 72
Larva migrans 290, 291f
Leishmania 291
infantum 291
Leishmaniosis 291
Lentiginous melanocytic proliferation 121f
Lentigo 217
Lentigo maligna 83, 177, 178f181f, 185f, 186f, 226f
melanoma 177, 181f, 223
progression model 177, 178f
Lentigo solaris 16
Lesions
assessment of multiple 200
combined 215, 217
Lice 290
Lichen planopilaris 302, 303, 303f
Lichen planus 108, 108f, 225, 275, 279f, 295, 296f
like keratosis 271f, 225f
Lichen sclerosus 296
Lichenoid chronic cheilitis 240f
Light reflection scheme 15f
Lineal network fragments 133f
Linear vessels 25
Little red riding hood sign 203f, 204f
Longitudinal melanonychia 207, 213, 213f
Lupus vulgaris 291
M
Malar erythema 316f
Malignant tissue, chaotic behavior of 275f
Melanic pigment 19f
Melanocytes, upward migration of 120
Melanocytic category 275
Melanocytic lesion 3f, 4f, 16t, 33f, 37t, 65, 111, 113, 116
benign 257, 323
rule out 34f
Melanocytic maculae 207
Melanocytic melanoma simulators 207
Melanocytic nevus 237f
Melanoma 4f, 7f, 8f, 11f, 17f, 19f, 25f, 26f, 37f, 162, 217, 238, 241f, 249f, 257, 258f, 259f, 261f, 262f, 272, 273f, 276f, 279f, 281f, 323
in situ 8f, 164f, 170f, 194f
metastasis 153, 153f
simulators 205, 213t
Melanosis 117f
Melanotic labial macule 213f
Melanotic maculae 213
Menzies method 341
Microhemorrhages 312, 313f, 314
Micro-Hutchinson sign 245
Milia-like cysts 16, 41, 43f, 44f, 131
Mixed connective tissue disease 309, 317, 317f
Molluscum contagiosum 103, 103f, 287, 288f
Moth-eaten border 49, 223
Mucosa 237
Multicomponent pattern 131f, 135, 162, 241f, 250
Mycological culture 302
N
Nailfold capillaroscopy 309
Necrobiosis lipoidica 297f
Negative pigment network 4f, 162, 250
Neoangiogenesis 313, 313f
Neoformed vessels 313
Nevogénesis 120
constitutional pathway of 120f, 121f, 122
dual concept of 121t
two pathways of 120
Nevus 7f, 18f, 217, 218f, 243f, 244f
atypical 140, 140f143f, 207
combined 152, 156f, 207, 212f, 213
compound 6, 15f, 35f
multiple 196, 197f
excisions of typical 10f
recurrent 158, 159f, 160f, 207, 211f, 213
Nodular basal cell carcinoma 330f
Nodular melanoma 123, 173, 174f, 175f
Nonarborizing vessels 65, 69
Noncicatricial alopecia 301
Noninfectious granulomas 296
Nonmelanocytic lesion 3f, 4f, 96
Nonmelanocytic melanoma simulators 207
Nonpigmented actinic keratosis 84
Nonpigmented Bowen's disease 89f91f
Nonpolarized light 24
dermatoscope 23f
Normal capillaroscopy 309, 310f
O
Onychomycosis 289, 289f
P
Pagetoid cells 323
Pagetoid melanoma 324
Papillomatosis 109f
Parallel furrow pattern 7f, 116f, 227, 227f231f
Parallel lineal pattern 243f
Parallel ridge pattern 184
Parasitic infestations 289
Patched reticular pattern 126f
Pediculus humanis capitis 290
Perifollicular pigmentary changes 131
Perifollicular whitish halo 297f
Peripheral black dots and clods 272
Peripheral hairpin vessels 89f
Peripheral mixed pattern 129f
Peripheral streaks pattern 162
Peripheral telangiectatic vessels 288f
Peripheral vessels 88f
Phaeoannellomyces werneckii 288
Phthirus pubis 290
Pigment network 4f, 16, 16f, 65, 69, 113, 113f, 114f, 250, 251
Pigment traces 189
Pigmentation, drug-induced 245f
Pigmented actinic keratosis 83f, 84, 85f86f, 208f, 224f, 268, 271f
Pigmented basal cell carcinoma 54f, 271f, 273
simulating melanoma 68f
Pigmented Bowen's disease 91, 91f94f
Pigmented lesion 3f, 4f, 10f
dermoscopy of 177
Pigmented lichen planus 240
Pigmented nodular basal cell carcinoma 330f
Pigmented seborrheic keratosis 209f
Pigmented skin lesion 267f
Pigmented Spitz nevus 147f, 148f
Pigmented squamous cell carcinoma 267f, 271f
in situ 280f, 336f
Pityriasis rosea 295, 296
Plaque psoriasis 295f
Polarized light 24
dermatoscope 23f
Polygons 273, 283
Polymorphic vascular pattern 96
Polymorphous vessels 273, 283, 344f
Porokeratosis 106, 106f
Predictive value 312
Predominant nevus pattern 10, 200
Pseudocysts, multiple 3f, 18f
Pseudofollicular openings 3f, 41, 43f
Pseudoparallel-ridge pattern 234, 235f, 236f
Pseudopod 69, 252, 267
pattern of 275
segmental 273, 282, 344
Pseudo-red appearance 97f
Psoriasis 24f, 295, 317
Pyogenic granuloma 107, 107f, 207, 210f, 213
R
Radial peripheral distribution 28f
Radial vessels 27f
Raynaud's phenomenon 309, 315f, 316f
Red rhomboidal structures 182f
Reflectance confocal microscopy 120, 321, 323, 328, 332, 333
Regression 42, 116, 252
structures 166, 250, 252
Regular parallel longitudinal lines 243
Reticular pattern 4, 124, 125f, 146, 227, 233f, 234f, 250
Rheumatoid arthritis 317, 317f
Rhomboidal structures 87, 87f, 180f, 181f, 182, 226
Ring-like pattern 238, 240f
Rosette-like structures 84f, 85f, 224f
S
Sarcoidosis 298f
Sarcoptes scabiei 289
Scabies 289
Scleroderma 315
pattern 312, 314
active 314f
Sclerotic blue nevus 156f
Sebaceous hyperplasia 27f, 104, 104f, 105f, 217, 219f
Seborrheic keratosis 3f, 16, 16t, 18f, 19f, 26f, 28f, 33f, 35f, 41f48f, 49, 207, 211f, 213, 217, 217f220f, 225, 225f, 271f, 277f, 278f, 282f
Senile purpura 220f
Sentinel lymph node 150
Shiny white structures 250
Signature nevus 10, 200
Solar
keratoses 83
lentigo 18f, 49, 49f53f, 83f, 267f, 217, 223, 224, 275f, 276f
Spider spine 291
Spitz nevus 5f, 35f, 124, 145, 147f149f, 275
Spitzoid melanoma 146f
Spitz-Reed nevus 207, 213
Splinter hemorrhages 242, 242f, 243f
Squamous cell carcinoma 9f, 25f27f, 83, 88, 91f, 92, 94f, 207, 208f, 213, 217, 333, 334f, 336f
in situ 89f, 90f, 91, 91f94f, 279f, 333
Stable melanocytic lesions 258f
Starburst 15
pattern 146, 162, 250
Stratum spinosum/granulosum 323
Strawberry pattern 84f86f, 223, 224f
Subpapillary plexus 309, 310f, 315
visualization 312f, 316, 317f
Subungual hematoma 7f, 210f
Subungual hemorrhage 242f, 243f
Superficial basal cell carcinoma 83f, 329f
Superficial spreading melanoma 162, 164168f, 169, 169f, 170f, 172f, 194f, 195f, 250f, 323, 324, 324f, 326f
Systemic lupus erythematosus 309, 315
disease activity index 316
Systemic sclerosis 309, 315, 315f
T
Targetoid hemosiderotic hemangioma 75
Telangiectasia, narrow short 65, 68
Telangiectasic vessels 297f
Thrombosed angioma 74f
Thrombosed hemangioma 207, 209f, 213
Tinea capitis 288, 302, 302f
Tinea nigra 288, 288f
Total dermoscopy score 251f, 252
Transition pattern 234, 234f, 235
Traumatized angioma 74f
Trichoepithelioma 101, 101f
Trichoscopy 299, 301
Trichotillomania 301, 302f
Tunga penetrans 290
Tungiasis 290
U
Ugly duckling sign 10, 200, 203f
Ulcerations 36f, 63, 68
Ulcers, digital 315, 315f
Ultraviolet-enhanced trichoscopy 302
Urticaria 296, 297f
V
Verrucae vulgaris 102, 102f
Videocapillaroscopy 309
Viral
infections 287
wart 287f
W
Warts 287
White shiny linear streaks 78, 81f
Whitish striae 296f
Z
Zigzag hairs 302f
×
Chapter Notes

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FM1Color Atlas of DermoscopyFM2
FM3Color Atlas of Dermoscopy
Horacio Antonio Cabo MD PhD Head Professor of Dermatology Universidad de Buenos Aires (UBA) Buenos Aires, Argentina Specialist in Dermatology Universidad de Buenos Aires (UBA) Head of Dermatology Institute of Medical Research Universidad de Buenos Aires (UBA) Ex-President The Argentine Society of Dermatology Member Executive Committee of Ibero-Latin Americano College of Dermatology (CILAD) and The Board of the International Dermoscopy Society (IDS) Graz, Austria Foreword Fernando Stengel
FM4
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© 2017, Jaypee Brothers Medical Publishers
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All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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Color Atlas of Dermoscopy
First Edition: 2017
9789386056306
FM5Dedicated to
My wife, sons and daughters, grandchildren and my patients
FM7Contributors FM9Foreword
If you believe that augmenting your diagnostic skills with available, office-based and cheap hand-held intruments is your duty as a dermatologist, this book will prove helpful to you.
Drawn from personal experience and in association with a group of world-recognized experts, Professor Cabo covers the growing field of Dermoscopy, including melanocytic and nonmelanocytic lesions, benign and malignant total body follow-up photography, entomodermatoscopy, inflammatoscopy, tricoscopy, capillaroscopy and in vivo reflectance confocal microscopy.
The information in this state-of-the-art volume is presented in a simple manner, with the aid of clear diagrams, that emphasize the things one should look out for. Data are highlighted with the use of tables that single out the characteristic signs of each individual entity.
The authors present a user-friendly book, a practically rapid consultation reference in the office.
As the use of the dermatoscope expands, so have its applications widened, well beyond the original differential diagnosis of melanocytic lesions. The recognition of vascular patterns associated with nonpigmented (amelanotic) melanomas, the importance of diagnostic algorithms, the chapters on Revised Pattern Analysis and Chaos and Clues, all emphasize the fact that dermoscopy is a rapidly evolving diagnostic technique. Thus, to achieve high specificity and sensitivity, the method requires knowledge and hands-on expertise.
It is no surprise that colleagues with this wonderful hand-held device—a dermatoscope—would begin to visualize the normal and disease-related fauna on/in the skin superficial layers; that they would look at hairs, nailfolds and nailbed and ‘dig into’ inflammatory skin conditions. The results of their efforts are well represented in the corresponding chapters!
The main author of this book hopes that his readers may improve their dermoscopic skills for the benefit of their patients. Color Atlas of Dermoscopy is a step in the right direction.
Fernando Stengel MD
Ex-Assistant Professor
Skin & Cancer Unit
New York University
New York City, New York, USA
Ex-Chief
Department of Dermatology
Clinical Hospital
University of Buenos Aires
Buenos Aires, Argentina
Ex-Chief
Centro de Educación Médica e Investigaciones Clínicas (CEMIC)
Buenos Aires, Argentina
FM11Preface
Many years have passed since I began to use the dermatoscope with nonpolarized light.
For over twenty years, I have attended courses, I have read many journals and books, I have published articles, my own books, CD-ROMs, I have taught numerous courses, and presented hundreds of cases.
Today, I finish a much-cherished project, my first book in English.
Here I share all the experiences amassed in these years. I hope, dear reader, that you will find it useful to improve your dermoscopic learning for the benefit of your patients.
Horacio Antonio Cabo
FM13Acknowledgments
To Estela Riviere for helping me in this project.
To all the contributors.
I thank Mr Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Chetna Malhotra Vohra (Associate Director–Content Strategy), Ms Angima Shree (Senior Development Editor) and the production team of Jaypee Brothers Medical Publishers, New Delhi, India for giving us a go-ahead at the very beginning and helping us in every way possible to bring out this book.