Labial Melanotic Macule: a Potential Pitfall on Reflectance Confocal Microscopy.

cytes. Immunostaining with melan-A antibody confirmed a moderate augmentation in the number of basal melanocytes with branching dendrites extending into the suprabasal layers of the epidermis, sometimes resembling the spreading branches of a tree ( fig. 1 e). Case 2. A 60-year-old man presented with a long-standing history of a pigmented macule of the lower lip. Clinical examination showed a brown homogeneous macule measuring 3 mm ( fig. 2 a). Dermoscopy showed a network pattern ( fig. 2 b). RCM showed a normal epidermis and numerous atypical dendritic cells at the DEJ ( fig. 2 c). Taking into consideration the benign clinical and dermoscopic presentations of the lesion, no biopsy was performed. Case 3. A 26-year-old woman presented with a pigmented macule of the lower lip that had appeared 2 years before. The lesion was homogeneous, brown/black, measuring 4 ! 3 mm ( fig. 3 a). Dermoscopy showed a benign so-called hyphal pattern ( fig. 3 b) [1] . RCM showed a normal epidermis and dendritic cells at the DEJ ( fig. 3 c). The lesion remained unchanged during consecutive digital monitoring. Case 4. A 37-year-old woman was referred for dermatological surveillance of her naevi. The patient was found to have 2 pigmented macules of the lower lip that had appeared 1 year prior to presentation ( fig. 4 a). Clinical examination and dermoscopy ( fig. 4 b) were not suspicious. RCM showed some dendritic cells at the DEJ ( fig. 4 c). The lesion remained unchanged during consecutive digital monitoring.