In vivo confocal microscopic substrate of grey colour in melanosis

Abstract

Our findings highlight that the presence of the grey colour on dermoscopy, considered as an alerting feature, is common in melanoses and it is related to the presence of melanin-laden inflammatory cells in the papillary dermis on RCM. When it is present as a 'pure' feature not associated to other colours than brown or to atypical dermoscopical structures, it could be related to the diagnosis of melanosis.

Melanosis of the lower lip subverted by filler injection: a simulator of early mucosal melanoma

“…Indeed, melanoses usually have fewer than two colours with few dermoscopic patterns (brown colour, circle or parallel pattern), while amalgam tattoos often show a homogeneous whitish/bluish pattern. 1,5 In conclusion, the grey in the dermoscopy of the mucosal lesions is related to melanophages in the superficial dermis and to an underlying inflammation, in our patient induced by HA. When the grey colour is not associated with a polychromatic pattern or to other atypical dermo- 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59…”

“…Melanosis is a common cause of the benign pigmentation of the mucosa and can be easily misdiagnosed as a melanoma. 1 In addition, various factors can affect the morphology and structure of melanoses, including chronic trauma, inflammation and exogenous materials. For this reason, a correct differential diagnosis is needed to avoid an unnecessary biopsy.…”

“…For this reason, a correct differential diagnosis is needed to avoid an unnecessary biopsy. 1 Soft tissue augmentation with HA fillers is one of the most popular contemporary aesthetic procedures. Melanoses is not a usual adverse effect of HA as N-acetyl glucosamine, a precursor of HA, is well known for its depigmenting proprieties.…”

Artificial Intelligence in Cutaneous Oncology

“…In recent years, development of high-resolution non-invasive diagnostic devices (e.g., confocal microscopy, multiphoton microscopy, etc.) that can detect cellular levels of the skin lesions without biopsy has also been enriched ( 4 – 6 ). In addition, diagnoses of such skin images using artificial intelligence (AI) have been shown to outperform the average diagnosis performances of doctors.…”

Dermoscopic features of pigmented vulvar intraepithelial neoplasia

“…The dermoscopic polychromia, a blue–white veil, irregular brown–black dots and atypical vessels may represent further dermoscopic features of pigmented VIN, and we believe it is important to highlight these, because they may be highly suspicious features for VM . In postmenopausal women, the main differential diagnosis of VM is melanosis, which can sometimes present alerting features such as an irregular shape and a grey colour, due to the presence of melanin‐laden inflammatory cells in the papillary dermis …”