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Quiz  |  Dermatol Pract Concept 2015;5(2):16 85

DERMATOLOGY PRACTICAL & CONCEPTUAL
www.derm101.com

Below is the answer to the quiz by Dr. Rishpon presented in 

the previous issue of Dermatology Practical & Conceptual 

[2015;5(1):13].

Answer
Balloon cell nevus

Discussion
Balloon cell changes in a nevus correspond to nests of vacu-

olated melanocytes, caused by enlargement and disintegra-

tion of melanosomes [1]. Dermoscopic correlation has been 

reported as white or yellow globules [2-4]. These globules 

were confirmed to correlate with junctional and dermal mela-

nocytic nests seen on reflectance confocal microscopy, similar 

in size and location to the balloon cell nests in histology [2]. 

It is important to differentiate the white/yellow globules from 

other structures similar in color and shape, including milia-

like cysts and sebaceous glands [3].

This case highlights how clinical and dermoscopic pri-

mary morphology serves as a direct correlate of unique 

histologic features.

Congratulations to Dr. Akhilesh Shukla (drakhilesh89@

gmail.com), who was the first to send us the correct answer!

References
1. Martinez-Casimiro L, Sánchez Carazo JL, Alegre V. Balloon cell 

naevus. J Eur Acad Dermatol Venereol 2009;23(2):236–7.
2. Jaimes N, Scope A, Welzel J, et al. White globules in melano-

cytic neoplasms: in vivo and ex vivo characteristics. Dermatol 
Surg 2012;38(1):128–32.

3. Jaimes N, Braun RP, Stolz W, et al. White globules correlate with 
balloon cell nevi nests. J Am Acad Dermatol 2011;65:e119–20.

4. Cinotti E, Perrot JL, Labeille B, et al. Yellow globules in balloon 
cell naevus. Australas J Dermatol 2013;54(4):268-70.

A pigmented lesion with yellow-white globular-like 
structures—Answer

Ayelet Rishpon1

1 Department of Dermatology, Tell-Aviv Sourasky Medical Center, Tel-Aviv, Israel

Citation: Rishpon A. A pigmented lesion with yellow-white globular-like structures—Answer. Dermatol Pract Concept 2015;5(2):16. doi: 
10.5826/dpc.0502a16

Copyright: ©2015 Rishpon. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which 
permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Corresponding author: Ayelet Rishpon, Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. Tel. 972 542 195 
569 Email: arishpon@gmail.com.