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Three-Dimensional Melanin Distribution of Acral Melanocytic Nevi Is Reflected in Dermoscopy Features: Analysis of the Parallel Pattern

Kimoto M.a · Sakamoto M.b · Iyatomi H.c · Tanaka M.d
Departments of aDermatology and bPathology, Keio University School of Medicine, cDepartment of Electronic Informatics, Hosei University Faculty of Engineering, and dDepartment of Dermatology, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan Dermatology 2008;216:205–212 (DOI:10.1159/000112927)


Background: Acral melanocytic nevi have parallel patterns on dermoscopy; however, it is not understood why pigment distributions exhibit such patterns. Aim: To clarify the reason why melanin distributions in acral melanocytic nevi exhibit a parallel pattern on dermoscopy. Methods: A serial sectioning perpendicular to the skin markings was performed, and each section was stained with modified Fontana-Masson staining to pick out melanin granules. These sections were then reconstructed to three-dimensional images by an image processing software, and these three-dimensional images were analyzed. Results: Melanin columns in the cornified layer were mainly seen in the dermoscopic images of acral melanocytic nevi. In the parallel-furrow pattern melanin columns were arranged vertically, and in the fibrillar pattern they were arranged in a slanting fashion. Conclusion: Melanin columns in the cornified layer, not melanin in the basal layer, mainly contribute to the dermoscopic pattern of acral melanocytic nevi.


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