Dermatoscopy of a primary dermal melanoma

This is a case report of a primary dermal melanoma and its dermatoscopic findings. A 50-year-old man in 2002 presented on the right anterior aspect of the thorax a 1.5-cm-diameter lesion with a rough surface and multiple papules of "vascular-like" appearance. It lacked the usual dermatoscopic findings, such as atypical pigmented network and radial streaks, related to the infiltration of malignant melanoma cells into the epidermis. Papillomatous projections with light brown and dark brown blotchy areas were seen under dermatoscopy, due to dermal melanin reflection from macrophages and neoplastic melanocytic cells near the junctional area. Other areas of papillomatous projections had a light brown-pink color surrounded by a thin whitish septum caused by the reflection of dermal vessels.