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Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, October 2015.
Pigmented skin lesions refer to lesions that are brown, black or blue in colour, or may be confused with brown or black lesions (for example, vascular lesions, which sometimes look black with the naked eye but under dermatoscopy appear red, purple or blue).
The colour of pigmented skin lesions is due to:
Pigmented skin lesions are most often melanocytic. However, non-melanocytic lesions can also be pigmented, particularly in dark-skinned individuals. Non-melanocytic lesions are keratinocytic, vascular, or reactive.
Pigmented melanocytic lesions
Pigmented keratinocytic lesions
Dark-coloured vascular lesions
Reactive pigmented lesions
Many other lesions and skin conditions are occasionally mistaken for a melanocytic or keratinocytic pigmented skin lesion.
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