Dark but harmless mole
The patient was worried about this mole as it was dark and somewhat irregular in shape.
However, the dermoscope reveals a perfectly benign pattern of reticular network, allowing a safe and confident assurance that this is a harmless naevus.
Although the mole (naevus, nevus) is quite dark, the darkness fades out gently from the centre to the edge in every direction. Symmetry is quite good in the vertical plane (i.e. divide the lesion in half with an imaginary line from north to south, the 2 halves are then almost mirror images.) Its not bad in the horizontal plane either. Minor degrees of asymmetry in shape (geometry) are irrelevant in lesions like this. Asymmetry of colour and dermoscopic architecture (for example, irregular globules or an abrupt black blotch at one edge) count for much more.
This is a dark but perfectly harmless mole showing an even reticular network that fades gently into the surrounding skin. The patient can be reasured, but , as always, the consultation should be used as a ‘teachable moment’ and the importance of keeping an eye on one’s moles and reporting any significant change should be mentioned.
The learner at dermoscopy needs to view hundreds of normal naevi to programme their brains with the range of normality. I will be posting images of lots of harmless skin lesions here to help learners develop this sense of the range of normal, if you are a doctor or nurse learning or wanting to learn dermoscopy, why not subscribe and get news of each new post?