Reflected light microscopy, milky glassy bluish opaque areas with comedo like keratin droplets

Reflected light microscopic phenomenon that shows comedon-like formations within greyish-blue opaque zones.

Reflected light microscopy: Multiple, comedo-like, light to dark brown or black keratin droplets surrounded by a light-coloured seam within greyish-blue opaque zones. The areas have a papillary aspect. In addition, intraepithelial, milia-like horn beads may occasionally appear, as they are typical for Verrucae seborrhoicae. Intensive visualization of the lesion usually reveals discrete melanoma-specific features, such as strong accumulations of pericapillary melanophages in the dermal papillae, peripheral brown/black dots, irregular vascular ectasia, pseudopodia, radial streaming and melanophagal trabeculae.

The appearance is characteristic of the verrucous type of malignant melanoma, which is clinically strongly reminiscent of Verrucae seborrhoicae or viral acanthomas.