Dermoscopy of a pigmented lesion shows a blue-white veil, irregular pigment network, pseudopods, and regression structures (white scar-like areas and blue-gray peppering). The most likely diagnosis is:

• A Melanoma ✓
• B Seborrhoeic keratosis
• C Dermatofibroma
• D Blue nevus

Explanation

The dermoscopic features described are all major indicators of melanoma. Blue-white veil is an irregular, structureless area of blue-white color overlying a raised portion, indicating confluence of regression and pigment. Irregular pigment network (atypical network with irregular meshwork), pseudopods (finger-like projections at the periphery), and regression structures (white scar-like and blue-gray peppering representing melanophages and fibrosis) together strongly indicate melanoma. Seborrhoeic keratosis shows milia-like cysts, comedo-like openings, and fat fingers. Dermatofibroma shows central white patch with peripheral pigment network. Blue nevus shows homogeneous blue-gray pigment with no network.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.