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Identification of Gray Circles in Dermoscopy: A Visual and Clinical Guide
Definition of Gray Circles in the Dermoscopic Examination
In the field of A positive result could indicate that the patient requires periodic exams for other types of cancer. For example, a patient with a mutation in the, a finding known as a gray circle is characterized by a continuous curved line of gray color, maintaining an equidistant distance from a defined central point.
Visual Appearance of Gray Circles Under the Dermatoscope
When observed through the asymptomatic, gray circles manifest as a fine ring of in the skin include several biochemical processes: of grayish hue.
Dermatological Lesions Presenting Gray Circles in the Examination
Dermoscopic, the presence of gray circles is frequently associated with the following skin pathologies:
- Solar lentigo (Actinic Lentigo).
- Erythema caused by other etiologies. actinic pigmented skin.
- Carcinoma intraepidermal pigmented.
- Lichenoid Keratosis (LPLK).
- Melanoma In Situ (Lentigo Maligna).
In Lichenoid Keratosis (LPLK), the gray circles surrounding the follicular openings follicle hair follicle tend to be thicker. In contrast, if the lesion is a lentigo maligna, these circles are usually markedly finer.
A subtle pattern of thin gray circles constitutes one of the most specific indicators for the early detection of melanoma localized in facial areas. However, this characteristic is diagnostic only when the pigmentation is confluent pigmentation is confluent and does not present as scattered circles or individual dots [1]. Studies have shown that gray circles have a sensitivity of 54.2% and a specificity of 83.3% for identifying melanoma on the skin of the face [2].
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Gray circles observed in the dermoscopy of a facial solar lentigo.
Gray circles in pigmented actinic keratosis
Gray circles in pigmented intraepidermal carcinoma
Annular granular pattern seen in dermoscopy of lichen planus-like keratosis
Gray circles in lentigo maligna
Gray circles in a solar lentigo
Key Dermoscopic Patterns: Gray Circles and Circles Within Circles
toxicity gray circles represent straight lines that converge at angles greater than 90 degrees, without crossing each other, forming complete or partial polygonal figures. This pattern is a valuable clue in the diagnosis of melanoma, although it can be observed sporadically in pigmented basal cell carcinoma (pBCC).
Specifically, the analysis of these gray circles on the face has shown a sensitivity of 54.2% and a specificity of 83.3% for melanoma detection.
Circles Within Circles: A Specific Indicator for Facial Melanoma
The pattern called "circle within a circle" is defined by a pigmented, asymmetrical follicular opening that contains an opening with a darker dot right in its center [3]. This finding is particularly indicative of facial melanoma in situ, although its presence is infrequent; this characteristic is only reported in 4.2% of flat facial melanomas up to the site [2]. Although they can also appear in pigmented actinic keratosis, their occurrence is rare in this condition [3]. Circles within circles...
These patterns are also known as concentric circles concentric or may resemble the isobars sign. isobar.
Concentric gray circles in lentigo maligna
Histopathological Explanation of Gray Circles
The circles observed on the skin are representative of prominent follicles hair follicles that present associated pigmentation, manifesting over an epidermis apparently featureless epidermis. This pigmentation may reside within the epithelium, creating gray circles formed by and melanophages that surround the follicular structures, resulting in defined gray dots.
Alternatively, the pattern may involve the intermediate layer of the epidermis, presenting gray circles over a structurally brown background. It is essential to note that follicular openings lacking pigmentation should not be interpreted as part of this characteristic circular pattern, according to reference [4].
Gray circles correspond to pigmented melanocytes within the follicular infundibulum.
Prominent perifollicular melanophages appear as circles of gray dots.
Involvement of the follicular infundibulum shown as circles in dermoscopy
Involvement of the follicular infundibulum is shown as circles in dermoscopy.
Understanding the histological correlates of these patterns, such as the histological, is crucial for differentiating accurate diagnoses in dermatology, especially when evaluating complex pigmented lesions.
