Description: Pigmented lesion on chest wall.Pattern: >1, (clods blue, structureless) Colors:> 1, melanin dominates Clues: 1. Blue clods: melanoma, BCC 2. Blue structureless zone: melanoma, seb. keratosis 3.multiple orange clods: seborrheic keratosis, dermal nevus 4. white dots: seb. keratosis 5.vessels: some hairpin, but not typical, some spirals Add it up: it is a verrucous process with acanthosis, either melanoma (verrucous melanoma or melanoma arising in a dermal nevus) or seborrheic keratosis.

History:

This gentleman had noticed this lesion appear and enlarge over last 6-8 months .View this Blog Case and the discussion.

Harald Kittler's Descriptive terms

I use only 5 basic elements
1. lines
2. circles
3. dots
4. clods
5. pseudopods
Every pattern in dermatoscopy is composed of one ore more of these 5 basic elements. If no basic elements are present= structureless
A clod is any well-circumscribed, solid object that is larger than a dot. Clods usually vary in size and shape (dots are always round and do not vary in size and shape). Clods can be round, oval, or polygonal
red lacunes= red clods
blue ovoid nests= blue clods
brown globules= brown clods
cobblestone pattern= skin colored clods (which happen to be rectangular)
coarse gray granules= gray dots and clods

clear definitions, simple terminology, no metaphoric terms

Why are lacunes not globules (because they are red?). Why are blue ovoid nests not blue globules (because they are large? but according to the consensus paper, size is not a criterion for globules). Does the cobblestone pattern consist of cobblestones or of globules? What is a cobblestone if not a globule? What is the difference between granules and dots and globules? Why are there different words for the same objects with different colors? Why..