The importance of gray color as a dermoscopic clue in facial pigmented lesion evaluation: a case report

A 57-year-old man presented with a solitary flat pigmented lesion on his face, which had appeared two years previously and was slowly enlarging over time. Physical examination revealed a flat pigmented lesion, 8 mm in size, on the patient’s right cheek. The clinical diagnosis was suggestive of a solar lentigo (SL) because of the symmetric shape, the regular border, and the homogenous brown color (Figure 1). Pigmented actinic keratosis (PAK) and lentigo maligna (LM) were also included in the differential diagnosis. Dermoscopically, the lesion exhibited a brown pseudonetwork and a striking gray color, especially in the center (Figure 2). There were large gray circles that resembled rhomboidal structures, though unconvincingly, in the absence of the well-known clues for the diagnosis of LM. However, the presence of gray color, asymmetrically distribThe importance of gray color as a dermoscopic clue in facial pigmented lesion evaluation: a case report