Figure 9.

Dermatoscopic image of a raised non-pigmented lesion. It does have the clue to malignancy of white lines (green arrows), which should lead to biopsy. If this was not noted and vessel pattern analysis was done it has a non-specific vessel arrangement. If this were interpreted as a structureless lesion (rather than clods-only), biopsy would therefore be indicated. If, however, it was interpreted as having a “clods-only” pattern, it can be seen on close inspection that there are vessels within some of the clods (black arrows). This by definition disqualifies this lesion from a benign “clods-only” categorization, which is important because this was a nodular melanoma (Breslow thickness 1.2 mm). [Copyright: ©2014 Rosendahl et al.]