Dermatoscopic patterns observed in acral nevi among 3 ethnic groups
J Am Acad Dermatol
Acral pigmented lesions have unique patterns of dermatoscopic features due to the skin anatomy in this region. We performed a pilot study documenting common dermatoscopic patterns of clinically benign acral nevi in white (W), Hispanic (H), and African-Americans (AA). This study was approved by the UIC institutional review board. We examined 141 consecutive patients who presented to the UIC dermatology clinic and volunteered to participate. Images were captured using a digital polarized dermatoscopy photography system. All images were reviewed by 2 investigators. Unclear images and those from transitional zones were not included in the review for a total of 106 lesions, 65 palmar melanocytic nevi, and 41 plantar melanocytic nevi. The largest group of hand (palm) nevi photographs were from AAs (39 total) had the following distribution of patterns: a) 26 parallel furrow pattern (PFP); b) 6 nontypical; c) 3 lattice-like; d) 1 fibrillar; e) 1 globulostreak; f) 1 globular; and g) 1 homogenous. A smaller number of images were available from H (12) andW (14) groups. Palmar patterns from Hs were a) 11 PFP and b) 1 globular pattern while among whites a) 11 PFP; b) 2 nontypical; and c) 1 homogenous pattern were observed. A total of 41 foot (plantar) melanocytic nevi were photographed. Among the AA group (16 images) there were a) 7 PFP; b) 3 nontypical; c) 2 lattice-like; d) 2 PFP with lattice-like; e) 1 fibrillar; and f) 1 bluish homogenous. Among H (10) with plantar nevi there were 9 PFP patterns and 1 bluish homogenous while among theW (15) volunteers 14 had PFP and 1 nontypical pattern. Benign melanocytic acral dermatoscopic patterns include PFP, lattice-like, fibrillar, homogenous, globulostreak- like, reticular, globular, and nontypical. Nontypical patterns do not have a pattern they can be classified into and are not suggestive of malignancy either clinically or dermatoscopically. The PFP was the most common pattern observed in all ethnicities (78/74%) in following proportions: hands 1) AA 26/66%; 2) H 11/92%; W 11/78%; for the lesions on the feet 4) AA 7/44%; 5) H 9/90%; and 6) W 14/93%. PFP with linear pigmentation was themost common variant while double-dotted the least. AAs had the largest variety of patterns while Hispanic and Caucasian lesions were more likely to show a parallel furrow pattern. AAs were also more likely to have the lattice-like and nontypical patterns on hands or feet. Larger studies can help further clarify ethnic variations in acral nevi.