Non-specific Structures (can be present in Melanocytic/Non-melanocytic Lesions)

Question 1

Non-specific dermoscopic structures

Answer 1

Dots
Blotch
Peppering/granularity + scar-like depigmentation
Shiny white structures  - 
- streaks
- rosettes
- blotches and strands 
Blue-white veil
Scale
Erosion/ulceration

Question 2

Dots

Answer 2

Black - Aggregates of melanocytes/melanin granules in the upper epidermis

Brown - Aggregates of melanocytes/melanin granules at the DEJ

Blue grey - free pigment in the papillary dermis/inside dermal melanophages vs BCC tumour nests

Naevus, melanoma, BCC, keratinocyte CA

Question 3

Blotch

Answer 3

Hyperpigmentation with abundant melanin throughout epidermis

Naevi (regular centrally located)
Melanoma (multiple, off-centred)
Seborrhoeic keratosis
BCC

Question 4

Peppering/granularity histopathologic correlate

Answer 4

Sign of regression

Free melanin in the papillary dermis/dermal melanophages

Melanoma, LPLK, naevi (if focal)

Question 5

Scar-like depigmentation

Answer 5

Sign of regression

Dermal fibroplasia

Melanoma

Question 6

Shiny white streak

Answer 6

Altered dermal collagen

Spitz naevi
Atypical naevi
Melanoma
LPLK
BCC

Question 7

Rosettes (bright white four leaf clover)

Answer 7

Sun damaged skin

Hyperkeratosis of follicular openings

AK
SCC
Melanoma

Question 8

Shiny white blotches and strands

Answer 8

? Fibrosis of underlying stroma (unclear)

BCC
LPLK
Melanoma

Question 9

Blue-white veil over raised areas

Answer 9

Heavily pigmented melanocytes/melanophages in the dermis
Acanthosis
Compact orthokeratosis

Melanoma
Reed/Spitz naevi
Pyogenic granuloma
BCC
Seborrhoeic keratosis

Question 10

Scale

Answer 10

Hyperkeratosis
Parakeratosis

AK
Porokeratosis
SCC
Inflammatory skin diseases

Question 11

Erosions/ulceration

Answer 11

Erosion = epidermal loss
Multiple —> superficial BCC, SCC, trauma

Ulceration = loss of entire epidermis to depth of papillary dermis
Single —> nodular BCC, melanoma, SCC, trauma