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Practical Dermoscopy
Residual Findings
Vestigios
P. Zaballos Diego
Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla de Tarragona, Tarragona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Comment</span><p id="par0005" class="elsevierStylePara elsevierViewall">The common feature of these 3 pigmented lesions &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; apart from occurring in men&#44; their localization on the back&#44; and their uncertain history &#40;probably because of their site&#41;&#44; is that they are lesions that are regressing&#46; This is easy to identify on dermoscopy because of the presence of gray-blue granules or globules with a variable degree of confluence<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a>&#59; these can be seen on the left side of the image of the first lesion &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 2</a>&#41;&#44; in the upper part of the image of the second lesion &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 3</a>&#41;&#44; and on the right side of the image of the third lesion &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 4</a>&#41;&#46; The histopathological explanation of this gray-blue granule-globule pattern is the presence of melanophages&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">When investigating a lesion that is in regression&#44; the most important issue is to determine the nature of the lesion&#46; Dermoscopy can be a useful tool&#46; Looking at the dermoscopy images of the lesions&#44; we can identify the residual areas that are in regression&#58; the right side of lesion in the first case&#44; the inferior part in the second case&#44; and the left side in the third case&#46; In the first case &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 2</a>&#41;&#44; we can see fissures and ridges&#44; crypts&#44; and comedo-like openings&#44; which are characteristic dermoscopic structures of seborrheic keratoses&#46; In the second case &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 3</a>&#41;&#44; an atypical pigment network is present&#44; associated with pseudopods&#44; atypical dots and globules&#44; a pigmented structureless area in the superior part&#44; and areas of mixed regression&#59; together&#44; these dermoscopic structures are very suggestive of superficial spreading melanoma&#46; Finally&#44; in the third case &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 4</a>&#41; we can see a number of brown-colored bulbous projections situated at the periphery of the lesion&#46; These structures are reminiscent of the lobed leaves of certain plants and they are known as maple leaf-like areas&#59; they are highly characteristic of pigmented basal cell carcinoma&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Thus the dermoscopic diagnosis in the first patient would be regressing seborrheic keratosis or&#44; if preferred&#44; an intermediate stage in the transformation of a seborrheic keratosis into lichenoid keratosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> The diagnosis in the second patient would be regressing superficial spreading melanoma and&#44; in the third case&#44; regressing basal cell carcinoma&#46; The 3 diagnoses were confirmed by the pathologist after biopsy of the first lesion and excision of the other two&#46;</p></span></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Three pigmented lesions&#44; present for an unknown time&#44; situated on the backs of 3 patients&#46; A&#44; In a 55-year-old man &#40;clinical image in Fig&#46; 1A and dermoscopy in Fig&#46; 2&#41;&#46; B&#44; In a 90-year-old man &#40;clinical image in Fig&#46; 1B and dermoscopy in Fig&#46; 3&#41;&#46; And C&#44; In a 39-year-old man &#40;clinical image in Fig&#46; 1C and dermoscopy in Fig&#46; 4&#41;&#46;</p>"
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Article information
ISSN: 15782190
Original language: English
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Idiomas
Actas Dermo-Sifiliográficas
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