Saturday, November 21, 2015

Dermatoscopic Pointillism

The patient is a 45 yo woman who presented with a new lesion on the right malar eminence.  It looked innocuous, perhaps, a lentigo.  The dermatoscopic image revealed a pointillist pattern.  One of our VGRD members, Dr. Phung Huynh described “pointillist nevus” some years ago.  While this is not a nevus, it shows a similar pattern.

A 3 mm punch biopsy was taken to establish what this lesion is and it is being presented for interest since I could find no reference to this phenomenon in PubMed.
For Art's Sake
Pathology: The biopsy shows a focal lichenoid lymphocytic infiltrate, scattered colloid bodies and melanophages consistent with lichen planus-like keratosis (LPLK).

1. Pointillist nevi.
Huynh PM, Glusac EJ, Bolognia JL. J Am Acad Dermatol. 2001 Sep;45(3):397-400. PubMed.

2.  Dermoscopy of lichen planus-like keratosis: a model of inflammatory regression.  Bugatti L, Filosa G. J Eur Acad Dermatol Venereol. 2007 Nov;21(10):1392-7.  PubMed.

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