Dermatoscopic evaluation of papulonodular nevi in the head and neck region

Dermatoscopy, is an intravital and noninvasive method that analyses the upper and the upper section of the middle part of the alive skin with application a glass plate on immersion oil drop and an epi-illumination by a tool using 10-40 fold magnification.MIESCHER and UNNA nevi are two major subtypes of dermal naevocellular nevi. Their dermatoscopic features and differences have been widely ignored even though they are very common in general population. In this study, it is aimed to evaluate the findings in MIESCHER and UNNA nevi and other papulonodular lesions that are on the head and neck region in patients over 40 years, by using dermatoscopy and to describe the determining features in diagnosis and differential diagnosis. For this purpose, clinically diagnosed lesions (170 MIESCHER nevi, 38 UNNA nevi, 17 compound nevi, 70 seborrheic keratoses, 11 nodular basaliomas, 6 blue nevi and 2 skin tags) were evaluated by using dermatoscopy.In this study, globular pattern was detected in 64.5%, homogeneous pattern was seen in 32.4% and cobblestone pattern was observed in 2.9% of MIESCHER nevi. Elongated comma vessels (47.1%) were most common, but comma vessels (33.5%), branched vessels (11.2%) and linear vessels (4.7%) were also seen. UNNA nevi showed the following dermatoscopic patterns: cobblestone (47.4%), globular (31.6%) and homogeneous (21.1%). Comma vessels were detected in 65.8% and elongated comma vessels were seen in 15.8% of UNNA nevi. Neither atypical/polymorphous vessels nor dotted vessels were seen in any of UNNA nevi. In the dermatoscopic analysis of the seborrheic keratosis, milia like cysts and comedo like openings that are regarded to be characteristic features, were detected at a rate of 38.6% and 62.9%, respectively. The dermatoscopic features that were observed in compound nevi, nodular basaliomas and blue nevi were consistent with those reported in the dermatologic literature. Skin color and light brown homogeneous pigmentation were the only dermatoscopic finding in two skin tags that were evaluated in this study.`Branched vessels? that were seen in 11.2% of MIESCHER nevi, were different from those that were seen in nodular basaliomas because they showed `star-like? branching.As a conclusion we think that this study is the first study in the dermatologic literature evaluating the dermatoscopic features and determining the frequency of the elongated comma vessels and identifying the `star? vessels in MIESCHER nevi. The data emphasizes that dermatoscopy is a useful technique in the differentiation of papulonodular nevi in the head and neck region.