Dots Brown or Black

Dots  Brown/Black 

Pig IEC 

Clark nevus 

Melanoma 

Black dots represent melanin in either melanocytes or keratinocytes usually high up in the epidermis near the stratum corneum. Hence they can be a feature of pagetoid spread in superficial melanomas.

Brown dots are usually nests of melanocytes at the dermoepidermal junction. If proliferating in the dermal papillae they can be in the centre of  the reticular network holes, particularly in congenital nevi but often these nests are a considerable size and best described as clods. 

Brown dots proliferating at the periphery of a network suggest an actively growing lesion and can be seen in early  melanoma (often accompanied by pigment streaks or lines radial peripheral.

 Dots over the lines of the pigment network suggest nevus nests at the tips of the rete ridges where they should be in benign nevi! If all over the place it is a more chaotic lesion and suggests melanoma.

 

 Brown dots in lines in the middle of a pigmented lesion without a definite network are a strong predictor of pigmented IEC (Intraepidermal carcinoma SCC in situ)