Purely dermal moles may have a globular dermoscopic pattern, which may be obscured by a milky veil.
A 50-year-old man presented with a 3 mm diameter irregular dark mole on his upper back (Figure 1). According to the patient’s history, it had been present for at least three years. Dermoscopy revealed a mole with an irregular border and a globular pattern that was obscured by a hazy milky veil (Figure 2). The globules varied in size and shape and were tan to grey–blue. The mole lacked a pigment network. The surrounding skin had a patchy network with pale areas associated with telangiectasia. Excision biopsy showed aggregates of uniform pigmented naevus cells within the dermis (Figure 3). There was no evident cellular atypia or mitoses on multiple sections. The overlying epidermis showed a relative absence of pigment, and there was no junctional or intraepidermal melanocytic proliferation.