Dots/globules on dermoscopy in nail-apparatus melanoma

Abstract

prescribed seven dermoscopicschemas of melanonychia. These schemas include bloodspots, brownish background discoloration, regular andirregular lines, grayish background and thin gray lines,(micro)-Huchinson sign, and microscopic grooves. Thepresence of some of these schemas leads to a high suspi-cion of melanoma.Case reportA 35-year-old man presented with left fourth digital longi-tudinal melanonychia, which had developed 5 yearsbefore. At the first admission, we recognized 9 mm-wideblack lines. On dermoscopy, we could see a brown back-ground discoloration, irregular lines, and dots/globules.However, we could not see the Huchinson’s sign. Further-more, there was no deformity of the nail plate. The lesionenlarged from 9 to 12 mm in two months (Fig. 1), there-fore total excision of the nail was performed. Histopatho-logically, the epithelium of the nail matrix showed markedacanthosis and elongation of rete ridges. Melanoma cellswith atypical nuclei were scattered in the epidermis anddermis with little inflammatory cell infiltration. Some