Dr. Sushil Kakkar
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a mark on my toe that has been there a few years and although my GP was not concerned, I am very scared it could be melanoma. It has not changed dramatically but it could have changed subtly as in some photos it looks a little darker and others a little bigger, although it is hard to tell due to changes in lighting.
Hello,
Welcome to icliniq.com.
I have viewed the images (attachment removed to protect patient identity). It seems a benign nevus, well-defined, regular, and uniformly colored. Moreover, it has not changed over the years. However, dermoscopy is the best way to be sure about that, as benign nevi have pigment along the furrows rather than the ridges of plantar dermatoglyphics (parallel furrow pattern) whereas melanoma also has pigment along the ridges (parallel ridge pattern) on dermoscopy.
Patient's Query
Thank you doctor,
I have looked at the photos of the parallel and ridge patterns online and from looking at that photo of my toe it seems like there is a lot of pigment on the ridges, not just the furrows. Also, there are some dots around the edges if you zoom in, and also some that are hard to see unless you look in person, on the ridges themselves that I have read could be infiltrated eccrine ducts which are even worse. Are you able to tell these things just by looking or am I jumping to conclusions? From the photos of furrow patterns I looked at it looked like pigment was in the furrows only.
Hi,
Welcome back to icliniq.com.
Naked eye is not good enough to correctly delineate the pattern. I suggest dermoscopy. Moreover, a lattice pattern, which is a subtype of parallel furrow pattern can look like your nevus with a naked eye. The white dots on ridges are openings of eccrine ducts or sweat gland and is perfectly normal.
Patient's Query
Hi doctor,
Thanks for your reply. The dots I was referring to are not white. There are some white dots but also some of them are brown. Does that mean it is automatically parallel ridge?
Hi,
Welcome back to icliniq.com.
I think those brown specks or dots are just part of the lattice pattern rather than infiltrated ducts. They do not seem to be of concern. Still, I would suggest dermoscopy.
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