Extensive regression in pigmented skin lesions: a dangerous confounding feature

Citation: Lallas A, Apalla Z, Moscarella E, et al. Extensive regression in pigmented skin lesions: a dangerous confounding feature. Dermatol Pract Conc. 2012;2(2):8. http://dx.doi.org/10.5826/dpc.0202a08

History: Received: December 13, 2011. Accepted: February 20, 2012. Published: April 30, 2012.

Copyright: 2012 Lallas et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: None.

Competing interests: The authors have no conflicts of interest to disclose.

Corresponding Author: Aimilios Lallas, M.D., State Clinic of Dermatology, Hospital of Skin and Venereal Diseases of Thessaloniki, Delfon 124, 54643, Thessaloniki, Greece. Tel. 00306932368102; Fax. 00302310850762. Email: emlallas@gmail.com

Abstract

Spontaneous regression in melanomas is not an uncommon phenomenon, as it has been described in 10-35% of primary cutaneous lesions [1]. Regression does not appear to predict a more favorable course, since even fully regressed melanomas may progress into metastatic disease [2]. Several dermoscopic features have been correlated with the regression process, including white scar-like depigmented areas and gray-blue, pepper-like granules, which correspond to dermal scarring, pigment incontinence and presence of melanophages [3,4]. Regression may occur not only in melanomas, but also in melanocytic nevi, which similarly may exhibit white areas and gray-blue granules or areas under dermoscopy [5]. Overall, white areas have been proposed to be associated with the fibrosis type of regression and gray-blue areas to the melanosis type of regression of melanocytic tumors [3]. Lichen planus like keratosis (LPLK) is considered to represent a regressed solar lentigo or seborrheic keratosis. Dermoscopy of LPLK at the late stage of the regression process reveals a diffuse gray-blue granular pattern, similar to that observed in regressed melanocytic lesions [6].

In this context, when evaluating skin lesions that exhibit high degree of regression, interpretation of dermoscopic findings may be problematic, especially when no other dermoscopic clues can be recognized.

Keywords : pigmented lesion, regression, melanoma, lichen plants-like keratosis

References

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