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August 19, 2012 / molehunter

Seborrhoiec keratosis with cerebriform appearance

The pigmented lesion in the middle of this older white woman’s back gave rise to mild concern as it appeared to have grown, she wasn’t sure how long it had been there, and it was larger than her other pigmented lesions with variable colour and lacking symmetry. It is also over 6mm, so fails the ABCD test.

The dermoscopy shows a cerebriform or ‘fat fingers’ appearance, so called as it resembles the sulci and gyri of the surface of the brain. This is one of the characteristic appearances of a thinner seborrhoiec keratosis. There are no worrying features and the patient can be confidently reassured despite the lesion failing the ABCD test. The minor variability in colour can be dismissed as irrelevant-its just two adjacent shades of brown probably representing different thickness. The paler central area can be similarly dismissed in view of the strong global feature of cerebriform pattern.

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