A 55 year old lady was referred with a long-term lesion on the palm with a definite history of change in size and shape. What do you see dermoscopically?
Traditionally this is described as a lattice pattern with parallel furrow lines that interlink with each other by perpendicular short lines. Instead I prefer to call what I can see, which essentially can be described as an angulated pigment network. Either way the features are in keeping with a benign melanocytic naevus, despite of the history of change.
Now look closer at the clinical image below, and with the naked eye you can see the same pattern.
Metaphorically we think about a pigment network as something we only find in melanocytic lesions on standard body sites ie the trunk and limbs. However, my personal preference remains that of descriptive terminology, which can aid in diagnosis, especially when starting to learn dermoscopy, for example:
- An angulated pigment network on the palms and soles (lattice pattern) is reassuring
- Whereas, an angulated pigment network on the face is suspicious of lentigo maligna
Images copied with kind permission from South Tees Hospitals NHS Foundation Trust.
