This document discusses patterns seen in benign and malignant skin lesions. For uncertain or multicomponent patterns, it recommends either short-term mole monitoring or a biopsy depending on the clinician's experience. It then describes malignant patterns as generally having more than three colors, asymmetry in color and structure distribution, and non-uniformity of structures departing from expected locations in benign lesions. Specific malignant patterns discussed are reticular, globular, and homogeneous patterns that appear disorganized.

2. Benign Patterns

3. Reticular - Globular - Homogeneous
Uncertain or Multicomponent Patterns

4. We recommend either short - term mole monitoring
or a biopsy for these lesions, depending on the
clinician’s level of experience.
Nevi Malignant
Melanoma

5. Malignant Patterns
Nevi Malignant
Melanoma

6. Malignant Patterns
* Global Evaluation of Lesion
Color: Generally more than
3 colors
Reticular
Brown Blue
White Gray
Black Red
Asymmetry:
Refers to the non-
uniform distribution of colors and
Homogeneous Globular structures on either side of the
axis and not by lesion shape.
Disorganization:
Non-uniformity of
structures and their departure
from the expected locations
traditionally seen in benign
* Adapted from Hofmann-Wellenhof R, Blum A, Wolff IH,
Soyer HP et al (2001) Arch Dermatol 137: 1575-1580 lesions.

7. Malignant Patterns
A pattern is created by the placement of structures in a
lesion. When these structures are asymmetrically distributed
and there are more than 3 colors noted, they create patterns
seen in many malignant lesions.
Reticular Globular Homogenous
disorganized disorganized disorganized

8. Malignant Patterns
Reticular
Homogeneous Globular

9. Reticular
Disorganized

10. Reticular Disorganized