Lines White

Lines White

 Melanoma

 BCC

White lines are seen mainly in  BCCs, invasive melanomas and rarely in Dermatofibromas and scars and some Spitz nevi. They are best seen with a polarising dermatoscope. They may cross each other at right angles.  Some people believe these white lines are just polarising artefacts but I doubt it. Collagen in the dermis is birefringent to polarised light. Sometimes these white lines on a pink background are all you see in a desmoplastic melanoma!

Because white lines are collagen in the dermis you can also see them in dermatofibromas 

Shiny white lines or streaks is the latest terminology - white lines orientated parallel or at right angles to each other correlating with stromal fibrosis

Negative network (White lines reticular) A negative pigment network is described as the opposite of a normal network where you have white lines making up the net and dark areas representing the holes between the net lines. Histologically there are elongated hypomelanotic rete ridges. A negative network can be seen in melanoma, Spitz nevi and dysplastic nevi. It is a highly specific feature of melanoma but not very sensitive! 

 The composite image below is of two lesions from the blog illustrating a negative network. The one on the left was a malignant melanoma.