Gallery
Is there CHAOS?
Image B: there is no asymmetry of structure and/or colour; therefore, there is no chaos. Dx: Seborrhoeic keratosis
Image F: There is an asymmetry in colour (multiple colors, brown vs. dark brown abrupt non symmetrical in the axial plane) and structure (branched lines with black clods, peripheral). Dx: Melanoma, invasive
The Nine Clues to Malignancy in Chaotic Pigmented Lesions:
(1) Grey or Blue Structures: Melanin in the superficial and deep dermis, respectively.
(2) Eccentric (Non-Central) Structureless Areas: Pattern correlated with fibrosis after regression.
(3) Thick Lines Reticular or Branched: The lines are thicker than the holes they surround.
(4) Black Dots or Clods (Peripheral/Circumferential): Melanocytes moves closer tot he stratum corneum by pagetoid spread.
(5) Lines Radial or Pseudopods (Segmental): Signifies radial growth of melanocytes extending.
(6) White Lines: Whiter than surrounding skin, with polarized light or not.
(7) Polymorphous Vessels: Multiple types of structures (i.e. geometrical shape) and arrangements (i.e., distribution) of blood vessels.
(8) Polygons: Geometrical shapes formed by straight lines meeting at angles
(9) Lines parallel on the ridges of palm/soles (acral) OR lines parallel (chaotic) nails: Signs of acral melanoma.
* More rules apply.
(9) Lines parallel on the ridges of palm/soles (acral) OR lines parallel (chaotic) nails: Signs of ungual melanoma.
* More rules apply.