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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.

Melanocytic naevus

Congenital naevus

Blue naevus

Melanoma

Seborrhoeic keratosis

Solar lentigo

Basal cell carcinoma

Intraepidermal carcinoma

Splinter haemorrhage

Cherry angioma

Kaposi sarcoma

Angiokeratoma

Dermatofibroma

Dermatofibroma

Lichen aureus

Lichen planus
Many other lesions and skin conditions are occasionally mistaken for a melanocytic or keratinocytic pigmented skin lesion.