Dermoscopy for Benign Melanocytic Skin Tumors

  • Giulia Tonini
  • Andrea Andreassi
  • Elisa Cinotti


In this chapter, we present the dermoscopic clues of the main categories of nevi, making a brief mention of their clinical and histopathological features. Not only junctional, dermal and compound nevi are described, but also congenital, blue, Spitz–Reed, Meyerson’s, desmoplastic, balloon, targetoid hemosiderotic, and sclerosing nevus are described.


Nevus Nevi Dermoscopy Globular pattern Pigmented network Homogeneous pattern Cobblestone pattern Starburst pattern Vessels Reticular depigmentation 


  1. 1.
    Zalaudek I, Manzo M, Savarese I, Docimo G, Ferrara G, Argenziano G. The morphologic universe of melanocytic nevi. Semin Cutan Med Surg. 2009;28(3):149–56.PubMedGoogle Scholar
  2. 2.
    Rogers T, Marino ML, Raciti P, Jain M, Busam KJ, Marchetti MA, et al. Biologically distinct subsets of nevi. G Ital Dermatol E Venereol Organo Uff Soc Ital Dermatol E Sifilogr. 2016 Aug;151(4):365–84.Google Scholar
  3. 3.
    Oliveria SA, Yagerman SE, Jaimes N, Goodwin AI, Dusza SW, Halpern AC, et al. Clinical and dermoscopic characteristics of new naevi in adults: results from a cohort study. Br J Dermatol. 2013 Oct;169(4):848–53.PubMedGoogle Scholar
  4. 4.
    Kim JK, Nelson KC. Dermoscopic features of common nevi: a review. G Ital Dermatol Venereol. 2012;147:141–8.PubMedGoogle Scholar
  5. 5.
    Brodell R, Sims DM, Zaim MT. Natural history of melanocytic nevi. Am Fam Physician. 1988 Nov;38(5):93–101.PubMedGoogle Scholar
  6. 6.
    Braun RP, Krischer J, Saurat JH. The “wobble sign” in epiluminescence microscopy as a novel clue to the differential diagnosis of pigmented skin lesions. Arch Dermatol. 2000 Jul;136(7):940–2.PubMedGoogle Scholar
  7. 7.
    Niederkorn A, Ahlgrimm-Siess V, Fink-Puches R, Wolf IH, Richtig E, Lackner HK, et al. Frequency, clinical and dermoscopic features of benign papillomatous melanocytic naevi (Unna type). Br J Dermatol. 2009 Sep;161(3):510–4.PubMedGoogle Scholar
  8. 8.
    Rao BK, Wang SQ, Murphy FP. Typical dermoscopic patterns of benign melanocytic nevi. Dermatol Clin. 2001 Apr;19(2):269–84.PubMedGoogle Scholar
  9. 9.
    Johr RH. Pink lesions. Clin Dermatol. 2002 Jun;20(3):289–96.PubMedGoogle Scholar
  10. 10.
    Schaffer JV, Glusac EJ, Bolognia JL. The eclipse naevus: tan centre with stellate brown rim. Br J Dermatol. 2001 Dec;145(6):1023–6.PubMedGoogle Scholar
  11. 11.
    Woltsche N, Schmid-Zalaudek K, Deinlein T, Rammel K, Hofmann-Wellenhof R, Zalaudek I. Abundance of the benign melanocytic universe: dermoscopic-histopathological correlation in nevi. J Dermatol. 2017 May;44(5):499–506.PubMedGoogle Scholar
  12. 12.
    Larre Borges A, Zalaudek I, Longo C, Dufrechou L, Argenziano G, Lallas A, et al. Melanocytic nevi with special features: clinical-dermoscopic and reflectance confocal microscopic-findings. J Eur Acad Dermatol Venereol. 2014 Jul;28(7):833–45.PubMedGoogle Scholar
  13. 13.
    Kolm I, Di Stefani A, Hofmann-Wellenhof R, Fink-Puches R, Wolf IH, Richtig E, et al. Dermoscopy patterns of halo nevi. Arch Dermatol. 2006 Dec;142(12):1627–32.Google Scholar
  14. 14.
    Krengel S, Scope A, Dusza SW, Vonthein R, Marghoob AA. New recommendations for the categorization of cutaneous features of congenital melanocytic nevi. J Am Acad Dermatol. 2013 Mar;68(3):441–51.PubMedGoogle Scholar
  15. 15.
    Cribier BJ, Santinelli F, Grosshans E. Lack of clinical-pathological correlation in the diagnosis of congenital naevi. Br J Dermatol. 1999 Dec;141(6):1004–9.PubMedGoogle Scholar
  16. 16.
    Seidenari S, Pellacani G, Martella A, Giusti F, Argenziano G, Buccini P, et al. Instrument-, age- and site-dependent variations of dermoscopic patterns of congenital melanocytic naevi: a multicentre study. Br J Dermatol. 2006 Jul;155(1):56–61.PubMedGoogle Scholar
  17. 17.
    Ferrara G, Soyer HP, Malvehy J, Piccolo D, Puig S, Sopena J, et al. The many faces of blue nevus: a clinicopathologic study. J Cutan Pathol. 2007 Jul;34(7):543–51.PubMedGoogle Scholar
  18. 18.
    Pizzichetta MA. Clinical and dermoscopic features of agminated blue nevus. Arch Dermatol. 2007 Sep 1;143(9):1209.Google Scholar
  19. 19.
    Ishida M, Kagotani A, Yoshida K, Iwai M, Okabe H. Endometrioid adenocarcinoma concurrent with a blue nevus of the endometrium and uterine cervix: a case report. Oncol Lett. 2013 Nov;6(5):1219–21.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Zembowicz A, Carney JA, Mihm MC. Pigmented epithelioid melanocytoma: a low-grade melanocytic tumor with metastatic potential indistinguishable from animal-type melanoma and epithelioid blue nevus. Am J Surg Pathol. 2004 Jan;28(1):31–40.Google Scholar
  21. 21.
    Di Cesare A, Sera F, Gulia A, Coletti G, Micantonio T, Fargnoli MC, et al. The spectrum of dermatoscopic patterns in blue nevi. J Am Acad Dermatol. 2012 Aug;67(2):199–205.PubMedGoogle Scholar
  22. 22.
    Ma C, Chambers CJ, Kiuru M, Marsee DK, Silverstein M. Amelanotic blue nevus. JAAD Case Rep. 2017 Mar;3(2):93–4.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Guadagni M, Nazzari G. Clinical and dermoscopic features of an evolving deep-penetrating nevus. Arch Dermatol. 2005;141:1490.Google Scholar
  24. 24.
    Zembowicz A, Phadke PA. Blue nevi and variants: an update. Arch Pathol Lab Med. 2011 Mar;135(3):327–36.PubMedGoogle Scholar
  25. 25.
    Argenziano G, Soyer HP, Chimenti S, Talamini R, Corona R, Sera F, et al. Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. J Am Acad Dermatol. 2003 May;48(5):679–93.PubMedGoogle Scholar
  26. 26.
    Moscarella E, Al Jalbout S, Piana S, Argenziano G, Lallas A, Longo C, et al. The stars within the melanocytic garden: unusual variants of Spitz naevi. Br J Dermatol. 2015 Apr;172(4):1045–51.PubMedGoogle Scholar
  27. 27.
    Levy RM, Ming ME, Shapiro M, Tucker M, Guerry D, Cirillo-Hyland VA, et al. Eruptive disseminated Spitz nevi. J Am Acad Dermatol. 2007 Sep;57(3):519–23.PubMedGoogle Scholar
  28. 28.
    Saroufim M, Novy M, Taraif S, Habib RH, Loya A, Rauscher B, et al. BRAF mutational epidemiology in dysplastic nevi: does different solar UV radiation exposure matter? J Eur Acad Dermatol Venereol. 2014 May;28(5):615–25.PubMedGoogle Scholar
  29. 29.
    Lallas A, Apalla Z, Ioannides D, Lazaridou E, Kyrgidis A, Broganelli P, et al. Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society. Br J Dermatol. 2017 Sep;177(3):645–55.PubMedGoogle Scholar
  30. 30.
    Peris K, Ferrari A, Argenziano G, Soyer HP, Chimenti S. Dermoscopic classification of Spitz/Reed nevi. Clin Dermatol. 2002 Jun;20(3):259–62.PubMedGoogle Scholar
  31. 31.
    Kerner M, Jaimes N, Scope A, Marghoob AA. Spitz nevi. Dermatol Clin. 2013 Apr;31(2):327–35.PubMedGoogle Scholar
  32. 32.
    Argenziano G, Soyer HP, Ferrara G, Piccolo D, Hofmann-Wellenhof R, Peris K, et al. Superficial black network: an additional dermoscopic clue for the diagnosis of pigmented spindle and/or epithelioid cell nevus. Dermatology. 2001;203(4):333–5.PubMedGoogle Scholar
  33. 33.
    Requena C, Requena L, Kutzner H, Yus ES. Spitz nevus: a clinicopathological study of 349 cases. Am J Dermatopathol. 2009 Apr;31(2):107–16.PubMedGoogle Scholar
  34. 34.
    Meyerson LB. A peculiar papulosquamous eruption involving pigmented nevi. Arch Dermatol. 1971 May;103(5):510–2.PubMedGoogle Scholar
  35. 35.
    Schepis C, Siragusa M. The Meyerson phenomenon in a teenager. Dermatol Online J. 2008 Feb 28;14(2):28.PubMedGoogle Scholar
  36. 36.
    Elenitsas R, Halpern AC. Eczematous halo reaction in atypical nevi. J Am Acad Dermatol. 1996 Feb;34(2 Pt 2):357–61.PubMedGoogle Scholar
  37. 37.
    Longo C, Segura S, Cesinaro A, Bassoli S, Seidenari S, Pellacani G. An atypical Meyerson’s naevus: a dermoscopic, confocal microscopic and immunohistochemical description of one case. J Eur Acad Dermatol Venereol. 2007 Mar;21(3):414–6.PubMedGoogle Scholar
  38. 38.
    Ferrara G, Brasiello M, Annese P, Francione S, Giorgio CM, Moscarella E, et al. Desmoplastic nevus: clinicopathologic keynotes. Am J Dermatopathol. 2009 Oct;31(7):718–22.PubMedGoogle Scholar
  39. 39.
    Mackie RM, Doherty VR. The desmoplastic melanocytic naevus: a distinct histological entity. Histopathology. 1992 Mar;20(3):207–11.PubMedGoogle Scholar
  40. 40.
    Meffert JJ, Peake MF, Wilde JL. “Dimpling” is not unique to dermatofibromas. Dermatology. 1997;195(4):384–6.PubMedGoogle Scholar
  41. 41.
    Poulalhon N, Dalle S, Thomas L. Diagnostic dermoscopique des dermatofibromes. Ann Dermatol Vénéréologie. 2008 Dec;135(12):886–7.Google Scholar
  42. 42.
    Martinez-Casimiro L, Sánchez Carazo J-L, Alegre V. Balloon cell naevus. J Eur Acad Dermatol Venereol. 2009 Feb;23(2):236–7.PubMedGoogle Scholar
  43. 43.
    Oliveira A, Zalaudek I. Balloon cell naevus: new perspectives using high-definition optical coherence tomography with dermoscopic and reflectance confocal microscopic correlation. J Eur Acad Dermatol Venereol. 2016 Sep;30(9):1624–5.PubMedGoogle Scholar
  44. 44.
    Jaimes N, Braun RP, Stolz W, Busam KJ, Marghoob AA. White globules correlate with balloon cell nevi nests. J Am Acad Dermatol. 2011 Oct;65(4):e119–20.PubMedGoogle Scholar
  45. 45.
    Cinotti E, Perrot JL, Labeille B, Douchet C, Thuret G, Cambazard F. Yellow globules in balloon cell naevus: yellow globules in balloon cell naevus. Australas J Dermatol. 2013 Nov;54(4):268–70.PubMedGoogle Scholar
  46. 46.
    Fabrizi G, Pennacchia I, Pagliarello C, Massi G. Sclerosing nevus with pseudomelanomatous features. J Cutan Pathol. 2008 Nov;35(11):995–1002.PubMedGoogle Scholar
  47. 47.
    Ferrara G, Amantea A, Argenziano G, Broganelli P, Cesinaro AM, Donati P, Pellacani G, Zalaudek I, Tomasini C. Sclerosing nevus with pseudomelanomatous features and regressing melanoma with nevoid features. J Cutan Pathol. 2009 Aug;36(8):913–5.PubMedGoogle Scholar
  48. 48.
    Patrizi A, Giacomini F, Savoia F, Misciali C, Neri I. Targetoid hemosiderotic naevus. J Eur Acad Dermatol Venereol. 2009 Apr;23(4):493–4.PubMedGoogle Scholar
  49. 49.
    Tomasini C, Broganelli P, Pippione M. Targetoid hemosiderotic nevus. Dermatology. 2005;210(3):200–5.PubMedGoogle Scholar
  50. 50.
    Kovács S, Megahed M. Targetoider hämosiderotischer Nävus: Ein Melanomsimulator. Hautarzt. 2007 Nov;58(11):931–2.PubMedGoogle Scholar
  51. 51.
    Scalvenzi M, Balato A, De Natale F, Francia MG, Mignogna C, De Rosa G. Hemosiderotic dermatofibroma: report of one case. Dermatology. 2007;214(1):82–4.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Giulia Tonini
    • 1
  • Andrea Andreassi
    • 1
  • Elisa Cinotti
    • 1
  1. 1.Department of Medical, Surgical and Neurological Science, Dermatology SectionUniversity of Siena, S. Maria alle Scotte HospitalSienaItaly

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