Author: Naomi Ashman, Dermoscopist, Torbay Skin, Auckland, New Zealand; DermNet Editor in Chief Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Created December 2018. Updated August 2020.
An annulargranular pattern consists of grey or brown dots (granular) around follicular openings (annular) and is regarded as a characteristic of lentigo maligna. In descriptive terminology, it is known as 'grey dots arranged around follicular openings'.
What does an annular granular pattern look like through the dermatoscope?
Through the dermatoscope, an annular granular pattern is seen as:
Dots and structureless areas arranged around follicle openings (and involving adnexal openings)
Gray dots and circles on the face.
Annular granular pattern on dermoscopy
Cheek
Lentigo maligna
Annular granular pattern and rhomboids seen in dermoscopy of lentigo maligna melanoma
In which lesions is an annular granular pattern seen in through the dermatoscope?
Through the dermatoscope, an annular granular pattern may be seen in the following lesions:
In lichenoidkeratosis, grey dots around the follicular openings tend to be coarse, regular and widespread, whereas in lentigo maligna they are much finer and focal.
Annular granular pattern on dermoscopy
Lichenoid keratosis
Lichenoid keratosis
Lichenoid keratosis
Pigmented actinic keratosis
Lentigo maligna
Lentigo maligna
What is the histological explanation of an annular granular pattern?
Histologically, slate grey dots are due to melanin in melanophages.
References
Kittler H, Rosendahl C, Cameron A, Tschandi P. Dermatoscopy, Pattern Analysis of Pigmented and Non-Pigmented Lesions; 2nd edition. Facultas Verlags- und Buchandels AG facultas Universitatsverlag, Vienna, Austria. 2016.
