(1) Atypical pigment network |
Black, brown, or gray network with irregular meshes and thick lines |
Irregular and broadened rete ridges |
(2) Blue-whitish veil |
Irregular, confluent, gray-blue to whitish-blue diffuse pigmentation |
Acanthotic epidermis with focal hypergranulosis above sheets of heavily pigmented melanocytes in the dermis |
(3) Atypical vascular pattern |
Linear-irregular or dotted vessels not clearly combined with regression structures |
Neovascularization |
(4) Irregular streaks |
Irregular, more or less confluent, linear structures not clearly combined with pigment network lines |
Confluent junctional nests of melanocytes |
(5) Irregular pigmentation |
Black, brown, and/or gray pigmented areas with irregular shape and/or distribution |
Hyperpigmentation throughout the epidermis and/or upper dermis |
(6) Irregular dots/globules |
Black, brown, and/or gray round to oval, variously sized structures irregularly distributed within the lesion |
Pigment aggregates within stratum corneum, epidermis, dermoepidermal junction, or papillary dermis |
(7) Regression structures |
White areas (white scarlike areas) and blue areas (gray-blue areas, peppering, multiple blue-gray dots) may be associated, thus featuring so-called blue-whitish areas virtually indistinguishable from blue-whitish veil |
Thickened papillary dermis with fibrosis and/or variable amounts of melanophages |