Revised pattern analysis

Question 1

Primary pattern of lines reticular or branched: Ddx

Answer 1

Melanocytic

B keratinocytic

Question 2

Primary pattern of lines reticular + asymmetry + clue or exception =

Answer 2

melanoma

Question 3

One pattern (reticular, curved, structure-less) + one colour brown + abrupt border

Answer 3

Solar lentigo

Question 4

Melanotic maculates of lip may have …… pattern

Answer 4

Reticular

Question 5

Melanotic macule of nail matrix and genitalia are expected to have ……. or ……. pattern

Answer 5

lines curved or structureless

Question 6

SK with asymmetry, grey colour, thick lines reticular, peripheral black dots/ clods, segmental radial lines require ……. for diagnosis of SK

Answer 6

Multiple criteria of SK including multiple orange and white clods, thick curved lines, abrupt border over total periphery.

Question 7

Peripheral reticular lines combined with paler central structureless +/- white lines is consistent with …

Answer 7

DF

Question 8

Pattern associated with accessory nipple

Answer 8

Peirpheral reticular lines with central structureless area

Question 9

Primary pattern of lines angulated: Ddx

Answer 9

Melanocytic
Benign keratinocytic
BCC

Question 10

One pattern of angulated lines + chaos colour or angulated lines combined asymmetrically with another pattern should be

Answer 10

excised on suspicion of melanoma

Question 11

Are angulated lines seen in BCC

Answer 11

Rarely

Question 12

Which benign lesions may have clue of angulated lines

Answer 12

Pigmented AK
SL
SK

Question 13

Primary pattern of lines radial Ddx

Answer 13

Melanocytic
BCC
SCC
DF

Question 14

If pseudopods occur together with lines radial then …

Answer 14

Radial lines take priority.

Pseudopods become a clue.

Question 15

In order for radial lines to constitute a pattern they need to be ..

Answer 15

circumferential

Question 16

Central structureless brown black or grey or dark clods with pattern of radial lines =

Answer 16

reed nevus or recurrent nevus

Question 17

Radial lines converging to a central point within lesions is ….

Answer 17

highly specific for BCC

Question 18

In pigmented SCC radial lines are usually composed of ….

Answer 18

dots in linear arrangement.

Question 19

Stable symmetrical lesions with pattern of radial lines surrounding structureless pale centre will be ..

Answer 19

dermatofibroma

Question 20

Primary pattern of lines curved Ddx

Answer 20

Melanocytic

Benign keratinocytic

Question 21

One pattern, lines curved + one colour, brown can be …

Answer 21

Nevus
SL
SK

Question 22

> 1 pattern, including lines curved + one colour, brown can be …

Answer 22

Melanoma
Nevus
SL
SK

Question 23

> 1 pattern, including lines curved, suspect melanoma when ….

Answer 23

other colours of melanin are present.

Question 24

Curved lines, melanoma expect ….

Answer 24

Dermatoscopic chaos inc chaos of border abruptness

Question 25

Curved lines, Nevus expect

Answer 25

Gradual border over total periphery. Biological symmetry.

Question 26

Curved lines, solar lentigo expect ..

Answer 26

flat, uniform abrupt scalloped border.

Question 27

Curved lines, SK expect

Answer 27

raised + uniformly abrupt border + additional clues to SK

Question 28

Melanotic macule on lip is likely to be ...

Answer 28

one pattern, lines curved, or structureless, small, well circumscribed, may contain some grey colour.

Question 29

Melanotic macules on the labia are likely to be ...

Answer 29

large and poorly circumscribed, mandating biopsy.

Question 30

Pattern of pseudopods

Answer 30

Melanoma or Reed (Rarely Spitz) nevus

Question 31

Primary pattern of circles Ddx

Answer 31

Melanocytic Benign keratinocytic SCC DF

Question 32

Ddx pigmented grey circles head and neck

Answer 32

Melanoma. Pigmented SCC in situ Pigmented AK LPLK

Question 33

Can nevus have pattern of circles

Answer 33

not expected

Question 34

Pattern of circles in SK can be caused by ...

Answer 34

pigment in follicular epithelium OR | basal hyperpigmentation in presence of acanthosis

Question 35

Circles in SK are .....

Answer 35

not associated with follicles and are usually distorted

Question 36

Circles in pigmented SCC may be present and are ....

Answer 36

in a linear arrangement

Question 37

reticular and curved lines take ...... over circles

Answer 37

priority

Question 38

Pattern of white circles in flat lesion on head or neck is clue to ...

Answer 38

AK or | SCC in situ

Question 39

Pattern of white circles in flat lesion on head or neck combined with grey dots is clue to ...

Answer 39

Pigmented AK or Pigmented SCC in situ

Question 40

Pattern of grey dots in p AK and SCC in situ

Answer 40

Distributed symmetrically, or surrounding hair follicles.

Question 41

Primary pattern of clods Ddx

Answer 41

``` Melanocytic Benign keratanocytic BCC Angioma Dermatofibroma. ```

Question 42

A lesion with one patter, clods, and one colour is assessed according to ....

Answer 42

colour of clods

Question 43

A lesion with one pattern, clods, and > one colour is assessed according to ...

Answer 43

symmetry and specific clues.

Question 44

Pattern of clods, melanoma ...

Answer 44

> 1 colour, dominant pigment melanin, asymmetry of colour, clue to melanoma OR combined asymmetrically with dot or structureless pattern + clue

Question 45

Pattern of brown clods confident predictor of ...

Answer 45

nevus likely congenital or Spitz

Question 46

Pattern of ski coloured clods

Answer 46

congenital nevus or SK

Question 47

One pattern clods, symmetrical, > 1 colour, dominant pigment is colour of melanin is predicted to be ...

Answer 47

nevus, congenital or Spitz

Question 48

Primary pattern of clods, other pattern limited to dots and structureless expected to be ...

Answer 48

congenital spitz or reed nevus

Question 49

Primary pattern of clods, combined asymmetrically with another pattern, melanin is dominant pigment, > 1 colour present : Ddx

Answer 49

Melanoma. BCC SK

Question 50

One pattern, clods and one colour + orange clods and sharply demarcated border

Answer 50

SK

Question 51

One pattern, clods which are yellow, white or skin coloured Ddx

Answer 51

SK | Congenital nevus

Question 52

One pattern, clods distributed asymmetrically, pigmented with colour of melanin, more than one colour, no clues

Answer 52

SK

Question 53

> 1 pattern, primary pattern clods, asymmetrical, clods yellow or white predicts

Answer 53

SK

Question 54

One pattern, clods and one colour blue =

Answer 54

BCC

Question 55

One pattern, clods and one colour orange without sharply demarcated border

Answer 55

BCC, orange clods dt ulceration

Question 56

> 1 pattern, primary pattern clods, asymmetrical, clods are orange. Ddx

Answer 56

BCC or SK, sorted by specific clues.

Question 57

Primary pattern of dots ddx

Answer 57

Any of major 5 categories

Question 58

Pattern of dots sorted on basis of ...

Answer 58

colour

Question 59

Grey dots ddx

Answer 59

LPLK Pigmented AK Pigmented Bowen's Melanoma

Question 60

Brown dots ddx

Answer 60

Pigmented bowen's | Clark nevus

Question 61

Grey dots + structureless Ddx

Answer 61

``` LPLK Pigmented Ak Pigmented Bowen's Melanoma BCC ```

Question 62

Brown dots + structureless Ddx

Answer 62

Pigmented Bowen's Clark nevus Solar lentigo Congenital nevus

Question 63

Blue dots likely

Answer 63

BCC

Question 64

Black dots ddx

Answer 64

Melanoma is some peripheral | Clark nevus

Question 65

Structureless pattern, Ddx

Answer 65

``` Melanocytic Benign keratinocytic BCC SCC DF Other ```