Tristar Vessels: A Newly Described Dermoscopic Vessel Pattern of Miescher’s Nevus

Purpose: Although it is very common in people over 30 years old, little is known about the validity of dermoscopic criteria to differentiate Miescher’s nevus (MN) from other papulonodular lesions located on the head and neck. The aim of this study is to evaluate the dermoscopic findings in MN on the head and neck in patients over 40 years by using dermoscopy. Methods: In this descriptive cross-sectional study 170 MN were evaluated by using polarized light dermoscopy. frequencies of dermoscopic findings in MN were determined using Statistical Package for Social Sciences for Windows 15.0. Results: The most frequently detected dermoscopic pattern in MN was globular pattern (64.5%), less often homogeneous (32.4%) or cobblestone pattern (2.9%). Globules were observed in 75.3% of MN and dots were seen in 12.4%. They frequently had skin-colored (87.1%) or light-brown (49.4%) homogeneous structureless areas. Elongated comma vessels (47.1%) were the most common vascular findings. Although comma vessels (33.5%) and linear vessels (4.7%) were also observed, 11.2% of MN presented “tristar vessels” (a newly described vascular pattern) that showed regular ‘tristar like ramifications’ in the distal part of the vessels. Conclusions: Firstly identified “tristar vessel pattern” is a dermoscopic description of MN that can be a useful clue to differential diagnosis.