Dermatology: Practical and Conceptual


DERMATOLOGY PRACTICAL & CONCEPTUAL
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Quiz  |  Dermatol Pract Concept 2014;4(2):13 63

The patient

A 61-year-old white man presented with an asymptomatic 

brown-red nodular lesion located on his back. The patient 

reported the lesion had been present for years (Figure 1). He 

had no previous skin cancers and there was no family history 

of melanoma.

On dermoscopy, the lesion showed a multicomponent pat-

tern, characterized by blue-gray dots, globules and a network 

disposed centrifugally at the periphery with a polymorphous 

vascular pattern and chrysalis structures centrally (Figure 2).

An excisional biopsy was performed with 2 mm margins.

The diagnoses proposed to the pathologist included basal 

cell carcinoma and melanoma.

An atypical pigmented lesion
Claudia Costa1, Franco Palmisano1, Massimiliano Scalvenzi1

1 Department of Dermatology, University of Naples Federico II, Naples, Italy

Citation: Costa C, Palmisano F, Scalvenzi M. An atypical pigmented lesion. Dermatol Pract Concept. 2014;4(2):13. http://dx.doi.
org/10.5826/dpc.0402a13.

Copyright: ©2014 Costa et al. 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: Massimiliano Scalvenzi, via Pansini 5, 80129 Naples. Italy. Email: scalvenz@unina.it

FIGURE 1.

FIGURE 2.

mailto:scalvenz@unina.it


64 Quiz  |  Dermatol Pract Concept 2014;4(2):13

What is your diagnosis?

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

correct answer will receive a DL3N hand dermoscope [cor-

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

question will be presented in the next issue of Dermatology 

Practical and Conceptual.

The morphological field (Figure 3) shows a neoplasia with 

dermal dislocation, composed of a well-defined nodule in the 

middle surrounded by small nests in which multiple keratinic 

cysts can be identified (red arrows). Some of them are locus 

of dystrophic calcification (green arrows). The neoplasia 

is composed of basaloid cells with mild cytology without 

acceptable mitotic activity.

 FIGURE 3.