Dermoscopic “Landscape Painting Patterns” as a Clue for Labial Melanotic Macules: An Analysis of 80 Cases

BACKGROUND: Labial melanotic macules (LMMs) are benign pigmented lesions that usually take the shape of flat asymmetrical macules with tan-brown to black color and variable size. Whereas the dermoscopic features of other pigmented skin lesions have been relatively well described, little is known about LMMs. OBJECTIVE: To describe the dermoscopic features and find typical and schematic dermoscopic patterns in LMMs. METHODS: A retrospective dermoscopic study was conducted on 80 lesions with histopathologically proved LMMs. RESULTS: We described and defined, for the first time to our knowledge, landscape painting patterns found in 65 of 80 melanotic lesions (81.3%), characterized by parallel lines or circle lines, overlapping vessels with background brown pigmentation. The background brown pigmentations were observed in 74 of 80 lesions (92.5%), the parallel lines in 62 (77.5%), the circle lines in 20 (25.0%), and overlapping vessels in 69 (86.3%). The structureless black pigmentations were only presented in 26 of 80 (32.5%). CONCLUSION: Dermoscopy can be useful for the clinical detection of LMMs, and “Landscape painting patterns” may represent a dermoscopic clue for the diagnosis of these lesions.