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Editorial |

Dermoscopic Patterns of Acral Melanocytic Nevi Their Variations, Changes, and Significance

Toshiaki Saida, MD, PhD; Hiroshi Koga, MD
Arch Dermatol. 2007;143(11):1423-1426. doi:10.1001/archderm.143.11.1423.
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Dermoscopy has opened a new morphologic dimension in clinical dermatology. Using this noninvasive method, we can recognize various kinds of novel morphologic characteristics unrecognizable with the naked eye. Dermoscopy is particularly useful in evaluating pigmented lesions on acral volar skin because dermoscopic patterns detected in pigmented lesions affecting this unique anatomic site are rather simple and easy to interpret. Acral volar skin is the most prevalent site of malignant melanoma in nonwhite populations; about half of all cutaneous melanomas in Japanese patients are seen in acral skin.1 Melanocytic nevi are also prevalent in acral skin, found in about 7% to 9% of the Japanese general population.2 Dermatologists often experience difficulty in clinically differentiating early acral melanona from acral nevi because both lesions are seen as brownish-black macules. Our recent studies have revealed that dermoscopy is immensely helpful in this differentiation. The 2 biologically distinct melanocytic entities show completely different dermoscopic patterns in acral volar skin.3

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Figure 1.

Dermoscopic features of melanocytic nevi on the sole. A, The parallel furrow pattern is not infrequently associated with the fibrillar pattern. B, In some cases, the 3 major patterns, the parallel furrow, latticelike, and fibrillar patterns, are detected within a single lesion.

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Figure 2.

Three-step algorithm for the management of acquired acral melanocytic lesions. PFP indicates parallel furrow pattern; LLP, latticelike pattern.

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