Dermatology: Practical and Conceptual


Quiz  |  Dermatol Pract Concept 2015;5(1):13 75

DERMATOLOGY PRACTICAL & CONCEPTUAL
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A pigmented lesion with yellow-white 
globular-like structures

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. Dermatol Pract Concept 2015;5(1):13. doi: 10.5826/
dpc.0501a13

Received: May 8, 2014; Accepted: May 10, 2014; Published: January 30, 2015

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.

Funding: None.

Competing interests: The author has no conflicts of interest to disclose.

Corresponding author: Ayelet Rishpon, Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. Tel. 972 
36973585. Email: arishpon@gmail.com.

Figure 1. Skin of right upper back showing a hyperpigmented pap-

ule. (Copyright: ©2015 Rishpon.)

Figure 2. Close-up revealing subtle yellow areas at the central and 

upper part of the lesion. (Copyright: ©2015 Rishpon.)

The patient

A 28-year-old Caucasian woman with skin type II, multiple 

nevi, and a family history of melanoma presented with a 

pigmented lesion on the right upper back. Clinically a hyper-

pigmented papule was seen (Figure 1). Close-up revealed 

subtle yellow areas in the central and upper part of the lesion 

(Figure 2).



76 Quiz  |  Dermatol Pract Concept 2015;5(1):13

Dermoscopy with a contact polarized dermoscope 

re vealed a slightly asymmetric homogenous-reticular pattern. 

Within the lesion distinct yellow-white polygonal globular-

like structures were seen (Figure 3).

Histology revealed melanocytic nests at the dermo-epider-

mal junction and upper papillary dermis, showing vacuolated 

melanocytes (Figure 4).

Figure 4. Histopathology of the lesion with H&E staining show-

ing melanocytic nests at the dermo-epidermal junction and papillary 

dermis and, within them, showing vacuolated melanocytes. Original 

magnification x40. [Acknowledgement: Andrea Gat, MD] (Copy-

right: ©2015 Rishpon.)

Figure 3. Dermos-

copy with Dermlite 

DL3 (3Gen, Inc., San 

Juan Capistrano, 

CA) shows a mel-

anocytic lesion with 

a slightly asym-

metric homogenous 

reticular pattern. 

Within the lesion 

distinct yellow-white 

polygonal globular-

lik e structures are 

seen. (Copyright: 

©2015 Rishpon.)

What is your diagnosis?

Please send your answer to dpc@derm101.com. The first cor-

rect answer will receive a DL3N hand dermoscope [cordially 

sponsored by 3GEN]. The case and the answer to the question 

will be presented in the next issue of Dermatology Practical 

& Conceptual.