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Pigment Network Histology — SCE Dermatology MCQ

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HardSkin CancerPigment Network HistologySCE Dermatology

Dermoscopy of a stable melanocytic naevus shows a uniform light-brown network with evenly spaced holes and lines that fade at the edge. Which histological arrangement produces this structure?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Pigmented rete ridges surrounding relatively pale dermal papillae

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · B = shown as D

D is correct. In a pigment network, the brown lines correspond predominantly to melanin within elongated and anastomosing epidermal rete ridges, while the lighter holes overlie intervening dermal papillae. Regularity of line colour, thickness and spacing supports an orderly junctional melanocytic process; irregular thick lines, variable holes or abrupt peripheral ending increase concern. Keratin and acrosyringia generate different surface structures, vascular loops appear red rather than as a brown network, and dermal melanophages produce grey or blue dots and peppering rather than reticulation. The answer links the two-dimensional dermoscopic image to the orientation of the epidermal architecture.

Reference: DermNet dermoscopic-features course: https://dermnetnz.org/cme/dermoscopy-course/dermoscopic-features