Clinical findings

A 57-year-old man presented with a solitary flat pigmented lesion on his face, which had appeared two years previously and was slowly enlarging over time. Physical examination revealed a flat pigmented lesion, 8 mm in size, on the patient’s right cheek. The clinical diagnosis was suggestive of a solar lentigo (SL) because of the symmetric shape, the regular bor-der, and the homogenous brown color (Figure 1). Pigmented actinic keratosis (PAK) and lentigo maligna (LM) were also included in the differential diagnosis. Dermoscopically, the lesion exhibited a brown pseudo-network and a striking gray color, especially in the cen-ter (Figure 2). There were large gray circles that resem-bled rhomboidal structures, though unconvincingly, in the absence of the well-known clues for the diagnosis of LM. However, the presence of gray color, asymmetrically distrib-The importance of gray color as a dermoscopic clue in facial pigmented lesion evaluation: a case repor