We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
skINsight |

The Zig-Zag Pattern of Lentigo Maligna

Jordan B. Slutsky, MD; Ashfaq A. Marghoob, MD
Arch Dermatol. 2010;146(12):1444. doi:10.1001/archdermatol.2010.307.
Text Size: A A A
Published online


Dermoscopic clues to lentigo maligna (LM) include asymmetrical pigmented follicular openings, perifollicular slate-gray dots and granules, circles within circles, atypical blood vessels, and linear pigmented lines forming rhomboidal structures.1 We have observed a previously unreported dermoscopic pattern in LM that consists of brown to bluish gray dots and lines arranged in an angulated linear pattern, creating a zig-zag appearance (Figures 1, 2, 3, and 4). The zig-zag pattern probably represents incompletely formed rhomboidal structures. Like other dermoscopic findings, the zig-zag pattern is not pathognomonic for LM, but in our experience, it is a suggestive dermoscopic pattern that may aid in the diagnosis of some otherwise difficult to diagnose LMs. All of the dermoscopic structures seen in LM can also be manifested in pigmented actinic keratoses, including the zig-zag pattern. However, one clinical clue to differentiate pigmented actinic keratoses from LMs is the presence of a rough texture in the former.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

4 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles