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November 22, 2014 / molehunter

5 harmless moles showing minor asymmetry and globules

Pretty much what it says in the title bar. Five harmless moles (naevi, nevi).

patient aged under 30 with 40 or 50 moles, a dozen of them over 6mm, several over 1cm, a couple of them were somewhat irregular in shape.

Most of the largest ones had a peripheral globule pattern. This is of no concern, especially in a younger person and ESPECIALLY when several naevi all look similar on dermoscopy.

As ever, click on the image for a bigger version if necessary. Images ‘auto corrected’ to make globules a bit clearer.

??????????????????????????????? ?????????????????????????????????????????????????????????????? ???????????????????????????????  5 harmless (5)

The beginner at dermoscopy will often note minor degrees of asymmetry in colour, shape and pattern and become anxious. Don’t. The answer is to study many, many pigmented lesions about which there is no clinical concern or history of change. you will NEVER see a perfectly symmetrical skin lesion. Experience teaches you how much asymmetry is acceptable. If in doubt, seek advice

The above naevi are a good example of minor degrees of asymmetry and peripherally arranged globules. Move along, nothing happening here.

learning point 1-Globules or dots indicate growth. Symmetrical, gradual growth in under 30s is normal. Asymmetrical growth especially in older people may be cause for concern, especially if it’s just one mole.

learning point 2-when we see globules or dots, ask 3 questions.

-are they all a similar SIZE?

-are they all a similar COLOUR?

-are they arranged SYMMETRICALLY or NOT?

learning point 3-it is usually a good idea to inspect the whole of the skin, not just one mole. Context is important when interpreting the dermoscopy of a slightly odd mole-if there are many others that are slightly odd in the same way, most likely it iis the person’s genetic mole pattern and of no concern. Also, inspection of the whole skin sometimes reveals a dangerous lesion the person was unaware of or didn’t realise was potentialy dangerous.

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