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Naevus Dermoscopy — SCE Dermatology MCQ

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EasySkin CancerNaevus DermoscopySCE Dermatology

A 30-year-old woman has a melanocytic naevus that dermoscopy shows is homogeneous (structureless) and uniformly brown. There is no pigment network, no dots/globules, and no other structures. What is the likely histological correlate?

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Correct answer: B — Intradermal naevus (melanocytes are deep in the dermis — no junctional component producing a pigment network)

A uniformly brown structureless (homogeneous) dermoscopic pattern in a melanocytic naevus corresponds histologically to an intradermal naevus — melanocytes are located entirely within the dermis without a junctional component. Without junctional melanocytic nests, there is no pigment network visible on dermoscopy. The brown colour comes from dermal melanin visible through the epidermis. Intradermal naevi are benign and require no intervention. This pattern must be distinguished from the homogeneous blue pattern (steel-blue — deeper dermal melanin in blue naevus) and from homogeneous patterns with other concerning features. A structureless tan-brown pattern without other features is reassuring for a benign intradermal naevus.

Reference: BAD 2016 Dermoscopy Guidelines