Authors: L. Drlík 1; L. Pock 2; Z. Drlík 1,3,4; D. Kacerovská 2; M. Kotrlá 5; R. Macháčková 6 Authors‘ workplace: Dermatologická ambulance Mohelnice, vedoucí lékař MUDr. Lubomír Drlík 1; Bioptická laboratoř s. r. o., Plzeň, odborná vedoucí lékařka prof. MUDr. Alena Skálová, CSc. 2; Klinika chorob kožních a pohlavních, Lékařská fakulta, Univerzita Palackého Olomouc a Fakultní nemocnice Olomouc, přednosta odb. as. MUDr. Martin Tichý, Ph. D. 3; Lékařská fakulta, Masarykova univerzita, Brno 4; DERMAKLINIKA s. r. o. Červená Voda, Šumperk, vedoucí lékařka MUDr. Monika Kotrlá 5; DERMAMEDICA s. r. o. Náchod, vedoucí lékařka MUDr. Romana Macháčková 6 Published in: Čes-slov Derm, 101, 2026, No. 1, p. 13-24 Category: Dermatoscopy
The authors present a number of difficult dermoscopic cases, whose clinical and dermoscopic results did not lead to a clearly defined diagnosis and the histological findings were rather unexpected. They were solved in dermoscopic-histopathological correlations in an attempt to find the reason for these discrepancies. The case series study exhibits wide morphological diversity and highlights the need for a cautious approach to all cutaneous lesions.
melanoma – dermoscopy – histopathology – dermatofibroma – seborrhoeic keratosis
1. AlJASSER, M. I., MARTINKA, M., KALIA, S. Dermatofibroma mimicking melanoma dermoscopically. Clin Exp Dermatol, 2014, 39(1), p. 69–70.
2. AMIRCHAGHMAGHI, M., PAKFETRAT, A., KIAFAR, B. et al. Dermoscopy of pigmented oral lesions; A research study. Photodiagnosis Photodyn Ther, 2025, 52, p. 104524. doi: 10.1016/j.pdpdt.2025.104524. Epub 2025 Feb 16. PMID: 39965751.
3. CARRERA, C., SEGURA, S., AGUILERA, P. et al. Dermoscopic Clues for Diagnosing Melanomas That Resemble Seborrheic Keratosis. JAMA Dermatol, 2017,153(6), p. 544–551.
4. ĎURÍKOVÁ, P., BARTOŠ, V. Hemosiderotický dermatofibróm s atrofickými znakmi – kazuistika. Čes-slov Derm, 2025, 100 (3), p. 133–136.
5. EBBELAAR, CH. F., JANSEN, A. M. C., SPEET, L. C. M. et al. Clinical outcomes and genomic profiles of MAP2K1-mutated primary cutaneous melanocytic tumours. eBioMedicine, 2025, 114, 105643.
6. FERRARI, A., ARGENZIANO, G., BUCCINI, P. et al. Typical and atypical dermoscopic presentations of dermatofibroma. J Eur Acad Dermatol Venereol, 2013, 27(11), p. 1375–1380.
7. FERRARA, G., GIORGIO, C. M., ZALAUDEK, I. et al. Sclerosing nevus with pseudomelanomatous features (nevus with regression-like fibrosis): clinical and dermoscopic features of a recently characterized histopathologic entity. Dermatology, 2009, 219(3), p. 202–208.
8. GRANT-KELS, J. M., BASON, E. T., GRIN, C. M. The misdiagnosis of malignant melanoma. J Am Acad Dermatol, 1999, 40(4), p. 539–548.
9. GRCAR-KUZMANOV, B., BOSTJANCIC, E., BANDRES, J. A. C. et al. Sclerosing Melanocytic Lesions (sclerosing Melanomas with Nevoid Features and Sclerosing Nevi with Pseudomelanomatous Features) – An Analysis of 90 Lesions. Radiol Oncol, 2018, 52(2), p. 220–228.
10. HARUNA, K., SUGA, Y., MIZUNO, Y. et al. Malignant melanoma with a seborrheic keratosis-like clinical presentation. Indian J Dermatol, 2009, 54(4), p. 387 – 388.
11. CHAIMA, K., MARIEM, A., KHADIA, S. et al. Unilateral hyperpigmented lesion of the breast. Clin Case Rep. 2023, 11, e7132. doi:10.1002/ccr3.7132
12. ISBARY, G., CORAS-STEPANEK, B., DYALL-SMITH, D. et al. Five patients with melanosis of the nipple and areola clinically mimicking melanoma. J Eur Acad Dermatol Venereol, 2014, 28(9), p. 1251–1254.
13. IZIKSON, L., SOBER, A. J., MIHM, M. C. Jr. et al. Prevalence of melanoma clinically resembling seborrheic keratosis: analysis of 9204 cases. Arch Dermatol, 2002,138(12), p. 1562–1566.
14. JANOWSKA, A., ORANGES, T., IANNONE, M. Seborrheic keratosis-like melanoma: a diagnostic challenge. Melanoma Research, 2021, 31(5), p. 407 – 412.
15. KEROUACH, A. Jr., HALI, F. Sr., BELANOUANE, S. et al. Verrucous Melanoma of the Scalp Initially Misdiagnosed as Seborrheic Keratosis. Cureus, 2022,14(9), p. e 29098. doi: 10.7759/cureus.29098. eCollection 2022 Sep.PMID: 36249606.
16. LALLAS, A., APALLA, Z., IOANNIDES, D. et al. Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society. Br J Dermatol, 2017, 177(3), p. 645–655.
17. LI, C., ALLEN, H., LOXAS, M. et al. Hemosiderotic dermatofibroma mimicking melanoma: A case report and review of the literature. Clin Case Rep, 2021, 9(3), p. 1387 – 1392.
18. ORZAN, O. A., DOROBANTU, A. M., GURAU, C. D. et al. Challenging Patterns of Atypical Dermatofibromas and Promising Diagnostic Tools for Differential Diagnosis of Malignant Lesions. Diagnostics, 2023, 13(4):671. Dostupné na www: https://doi. org/10.3390/diagnostics13040671.
19. PAREDES, B., HARDMEIER, T. Naevus Spitz und Naevus Reed: bei Erwachsenen ein Melanomsimulator [Spitz nevus and Reed nevus: simulating melanoma in adults]. Pathologe, 1998,19(6), p. 403–411.
20. PITTIS, J. D., BARBER, F. A. Melanosis of the areola. Arch Dermatol, 1990,126(4), p. 542–543.
21. POCK, L. Atypické melanocytární léze, Čes-slov Derm., 2013, 88(3), p. 107–122.
22. POCK., L., DRLÍK, L., DŮRA, M. Atypické melanocytární léze: aktualizace, Čes-slov Derm, 2023, 98 (5), p. 235–253.
23. POCK, L., DRLÍK, L., HERCOGOVÁ, J. Dermatoscopy of pigmented actinic keratosis – a striking similarity to lentigo maligna. Int J Dermatol, 2007, 46(4), p. 414–416.
24. ROH, D., HA, D. L., KIM, Y., et al. Comparison of Dermoscopic Features Between Melanoacanthomas and Melanoacanthoma-Like Malignant Melanomas in Korean Patients. J Cutan Med Surg, 2021, 25(3), p. 243–248.
25. SUNSHINE, J. C., KIM, D., ZHANG, B. et al. Melanocytic Neoplasms With MAP2K1 in Frame Deletions and Spitz Morphology. Am J Dermatopathol., 2020, 42(12), p. 923–931.
26. THOMAS, I., KIHICZAK, N. I., ROTHENBERG, J. et al. Melanoma within the seborrheic keratosis. Dermatol Surg, 2004, 30(4 Pt 1), p. 559–561.
27. TRAN, P. T., TRUONG, A. K., MUNDAY, W. et al. Verrucous melanoma masquerading as a seborrheic keratosis. Dermatol Online J, 2019, 25(2), p. 13030/ qt1m07k7fm. PMID: 30865414.
28. ZABALLOS, P., ÁLVAREZ-SALAFRANCA, M., LLAMBRICH, À. et al. Dermoscopy of haemosiderotic/ aneurysmal dermatofibroma: A morphological study of 110 cases. J Eur Acad Dermatol Venereol, 2023, 37(2), p. 317–327.
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