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July 13, 2011 / molehunter

2 more benign moles-hypopigmented centres

This kind of mole sometimes causes concern as it has 2 colours. In fact, they are just brown with a loss of pigment centrally. If there are no other features, these are OK-especially if the patient has a number which all look like this. Always bear in mind, no 2 naevi are identical and the vast majority are benign. And, yes, they lack perfect symmetry-believe me, no skin lesion is perfectly symmetrical. Don’t worry. count the colours-just light/medium brown. no black, blue, red or white. The centres are NOT white, they are pale flesh tone. The white of regression is different and usually associated with red, blue and grey. I find that beginners with dermoscopy tend to overdiagnose regression.

we can see a reticular pigment network though one lesion, the other is mixed reticular and amorphous, but nothing dramatic. The edge is uneven for contour, but very regular in terms of the overal colour, architecture and fade out.

Do not get hung up on minor degrees of asymmetry of contour. Dermoscopy, especially when the images are stored and projected, magnifies minor degrees of geometric asymmetry hugely which can alarm beginners. Think about it, a 5mm mole magnified up to 15cm is x 30 diameter!!! Viewing several hundred naevi about which there is no suspicion will help you develop a mental picture of what harmless looks like. Always consider all the features (including of course the history and the patients’ other naevi) and make a holistic decision.

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