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June 26, 2012 / molehunter

2 more benign naevi

Beginners with the dermoscope often get scared by the new sub-macroscopic features they see that they never saw before, just like looking at the moon through a telescope for the first time. This is a normal part of the learning curve. The best way through this is to look at lots of moles and other pigmented lesions where there is no prior suspicion, in other words routine banal moles with no history of change that nobody is worried about. Learning with a tutor helps a lot. So does looking at loads of on line images. Here are 2 more.

This bland naevus shows a beautifully harmless light/medium brown reticular network, with several pale areas within the body of the mole. These are not, as some of my learners thought, regression, but normal multifocal hypopigmentation. This is of no significance at all but one of the many variants of normal.

Another unremarkable reticular network pattern naevus, which might cause the beginner a little concern due to the slightly eccentric central black blotch. A central black blotch is an absolutely OK variation of normal in a mole. Go back to the three basic questions (1) how many colours? (answer 2, black and brown), (2) how good is the symetry (answer, slightly eccentric but not seriously so) and (3) what is happening at the edge (answer, an even fade out all round). This is a harmless banal naevus, with the proviso that if it was new, growing and solitary (ugly duckling) in a high risk patient, you ought at least to measure/photo and review in 3 months. A useful tip, study the patient’s other naevi, if several all look like this, you can be even more reassured.

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